Haitian-Americans\u27 Conceptualization of Mental Illness: The Role of Acculturation, Ethnic Identification, and Ethnic Group Appraisal

The underutilization of mental health services by members of the Haitian American community is a well-documented phenomenon. The reasons for this occurrence are less clear. One explanation for this underutilization may be that Haitians\u27 conceptualization of mental illness differs from traditional Western models of psychopathology, and they therefore utilize alternative resources to address symptoms. Over 25 years of observational data has revealed that biological, environmental, interpersonal, and supernatural etiologies of mental illness exist in the Haitian worldview. However, little exploration has been conducted into the various cultural dimensions upon which Haitians can differ and their influence on conceptualizations of symptoms. This study employed an etic approach to examine the extent to which attributions of mental illnesses varied as a function of cultural variables in a sample of Haitians living in the United States. The extent to which perceptions of symptoms influenced recommendations for help-seeking was also examined. A sample of 75 participants of Haitian descent completed either online or paper versions of the study questionnaires. Participants were presented with three vignettes manifesting a prescribed set of symptoms (associated with depression, schizophrenia, or post traumatic stress disorder), after which they responded to questions about symptom etiology and recommended interventions. Information relevant to cultural variables (acculturation, ethnic identification, and ethnic group appraisal) was also obtained. Results indicated that those individuals whose behavior was associated with high acculturation to U.S. society were less likely to endorse environmental, psychological, and supernatural conceptualizations of mental illness. Additionally, respondents\u27 conceptualizations of symptoms were significantly correlated with their recommendations for help-seeking. Results also revealed significant differences in demographic and cultural variables based on participants\u27 response method (i.e., online or paper-based), pointing towards two distinct sub-samples. Results provide valuable, current, and empirical data on Haitian-Americans\u27 views of mental illnesses and the types of interventions they consider most appropriate. Results also highlight the importance of cultural variables in understanding the mental illness conceptualizations and preferred modes of help-seeking of Haitians living in the U.S. Implications for evidenced based, culturally sensitive mental health practices with Haitian-Americans are discussed