Recovery From Psychotic Disorders in Rural Haiti: The Perspectives of Persons With Lived Experience of Psychosis, Family Caregivers, Health Care Providers, and Community Leaders

Abstract

The lived experience of psychosis in Haiti and in the Zanmi Lasante (ZL) mental health program is poorly understood, but crucial to document and explore in order to better facilitate the recovery of those suffering from psychosis. This thesis is based on a qualitative study, conducted in Mirebalais and Petite-Rivière de l’Artibonite, which used purposeful maximal variation sampling. It investigates the local knowledge, the lived experience, and the best paths to recovery from psychosis. Drawing on these research findings, it offers lessons for the design and improvement of services. This thesis presents novel research on the lived experience of recovery from psychosis in rural Haiti. Persons with lived experience of psychosis and their families narrated their journeys before entering the ZL program and revealed experiences that were personally, socially and economically devastating. Family members involved in the care seeking and caregiving processes reported many structural constraints such as inaccessibility of care, poverty and stigma. They often faced moral quandaries and were forced to make impossible choices while desperately trying to take care of their loved ones. Structural violence appeared as a root cause of the inhumane conditions of the lived experience of people with mental illness in rural Haiti. Their experiences suggest a model of recovery that encompasses clinical recovery, social and spiritual connections, and the ability to fulfill one’s social role. With this model of recovery in mind, implementers must seek to go beyond clinical improvement to facilitate the learning of needed skills. They must also engage the community and accelerate structural changes that will allow persons with lived experience of psychosis to fulfill the social roles they value most. The findings of this study can inform the further development of appropriate rehabilitation programs and tools, and inform a national mental health system in Haiti that effectively facilitates recovery.