Limits...
Community perceptions of mental health needs: a qualitative study in the Solomon Islands.

Blignault I, Bunde-Birouste A, Ritchie J, Silove D, Zwi AB - Int J Ment Health Syst (2009)

Bottom Line: Contrary to our expectations, conflict-related trauma was not identified as a major problem by the community who were more concerned about the economic and social sequelae of the conflict.Communities identify and are responding to a wide range of mental health challenges; the health system generally can do more to learn about how this is being done, and build more comprehensive services and policy on this foundation.The findings underscore the need to promote awareness of those services which are available, to extend mental health care beyond urban centres to rural villages where the majority of the population live, and to promote community input to policy so as to ensure that it 'fits' the context.

View Article: PubMed Central - HTML - PubMed

Affiliation: The University of New South Wales, Sydney, Australia. i.blignault@unsw.edu.au

ABSTRACT

Background: Psychosocial and mental health needs in the aftermath of conflict and disaster have attracted substantial attention. In the Solomon Islands, the conceptualisation of mental health, for several decades regarded by policy makers as primarily a health issue, has broadened and been incorporated into the national development and social policy agendas, reflecting recognition of the impact of conflict and rapid social change on the psychosocial wellbeing of the community as a whole. We sought to understand how mental health and psychosocial wellbeing were seen at the community level, the extent to which these issues were identified as being associated with periods of 'tension', violence and instability, and the availability of traditional approaches and Ministry of Health services to address these problems.

Methods: This article reports the findings of qualitative research conducted in a rural district on the island of Guadalcanal in the Solomon Islands. Key informant interviews were conducted with community leaders, and focus groups were held with women, men and young people. Wellbeing was defined broadly.

Results: Problems of common concern included excessive alcohol and marijuana use, interpersonal violence and abuse, teenage pregnancy, and lack of respect and cooperation. Troubled individuals and their families sought help for mental problems from various sources including chiefs, church leaders and traditional healers and, less often, trauma support workers, health clinic staff and police. Substance-related problems presented special challenges, as there were no traditional solutions at the individual or community level. Severe mental illness was also a challenge, with few aware that a community mental health service existed. Contrary to our expectations, conflict-related trauma was not identified as a major problem by the community who were more concerned about the economic and social sequelae of the conflict.

Conclusion: Communities identify and are responding to a wide range of mental health challenges; the health system generally can do more to learn about how this is being done, and build more comprehensive services and policy on this foundation. The findings underscore the need to promote awareness of those services which are available, to extend mental health care beyond urban centres to rural villages where the majority of the population live, and to promote community input to policy so as to ensure that it 'fits' the context.

No MeSH data available.


Related in: MedlinePlus

Mental disorder due to conflict with church teachings. Case related by older woman, edited and paraphrased for clarity.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC2667440&req=5

Figure 3: Mental disorder due to conflict with church teachings. Case related by older woman, edited and paraphrased for clarity.

Mentions: One man was particularly concerned about conflict between accepted cultural practices and church teachings, citing the example of a married person who had left their spouse to live with someone else and therefore "cannot fully enter into the sacrament of the church". An example of how this was perceived to have led to mental illness is given in Figure 3.


Community perceptions of mental health needs: a qualitative study in the Solomon Islands.

Blignault I, Bunde-Birouste A, Ritchie J, Silove D, Zwi AB - Int J Ment Health Syst (2009)

Mental disorder due to conflict with church teachings. Case related by older woman, edited and paraphrased for clarity.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2667440&req=5

Figure 3: Mental disorder due to conflict with church teachings. Case related by older woman, edited and paraphrased for clarity.
Mentions: One man was particularly concerned about conflict between accepted cultural practices and church teachings, citing the example of a married person who had left their spouse to live with someone else and therefore "cannot fully enter into the sacrament of the church". An example of how this was perceived to have led to mental illness is given in Figure 3.

Bottom Line: Contrary to our expectations, conflict-related trauma was not identified as a major problem by the community who were more concerned about the economic and social sequelae of the conflict.Communities identify and are responding to a wide range of mental health challenges; the health system generally can do more to learn about how this is being done, and build more comprehensive services and policy on this foundation.The findings underscore the need to promote awareness of those services which are available, to extend mental health care beyond urban centres to rural villages where the majority of the population live, and to promote community input to policy so as to ensure that it 'fits' the context.

View Article: PubMed Central - HTML - PubMed

Affiliation: The University of New South Wales, Sydney, Australia. i.blignault@unsw.edu.au

ABSTRACT

Background: Psychosocial and mental health needs in the aftermath of conflict and disaster have attracted substantial attention. In the Solomon Islands, the conceptualisation of mental health, for several decades regarded by policy makers as primarily a health issue, has broadened and been incorporated into the national development and social policy agendas, reflecting recognition of the impact of conflict and rapid social change on the psychosocial wellbeing of the community as a whole. We sought to understand how mental health and psychosocial wellbeing were seen at the community level, the extent to which these issues were identified as being associated with periods of 'tension', violence and instability, and the availability of traditional approaches and Ministry of Health services to address these problems.

Methods: This article reports the findings of qualitative research conducted in a rural district on the island of Guadalcanal in the Solomon Islands. Key informant interviews were conducted with community leaders, and focus groups were held with women, men and young people. Wellbeing was defined broadly.

Results: Problems of common concern included excessive alcohol and marijuana use, interpersonal violence and abuse, teenage pregnancy, and lack of respect and cooperation. Troubled individuals and their families sought help for mental problems from various sources including chiefs, church leaders and traditional healers and, less often, trauma support workers, health clinic staff and police. Substance-related problems presented special challenges, as there were no traditional solutions at the individual or community level. Severe mental illness was also a challenge, with few aware that a community mental health service existed. Contrary to our expectations, conflict-related trauma was not identified as a major problem by the community who were more concerned about the economic and social sequelae of the conflict.

Conclusion: Communities identify and are responding to a wide range of mental health challenges; the health system generally can do more to learn about how this is being done, and build more comprehensive services and policy on this foundation. The findings underscore the need to promote awareness of those services which are available, to extend mental health care beyond urban centres to rural villages where the majority of the population live, and to promote community input to policy so as to ensure that it 'fits' the context.

No MeSH data available.


Related in: MedlinePlus