BackgroundFor women in most low- and middle-income countries, the diagnosis with serious mental illness (SMI) leads to stigma and challenges related to starting or maintaining marriages. The purpose of this qualitative study was to explore perspectives on marriage, divorce and family roles of women with SMI in rural Ethiopia.MethodsA qualitative study was conducted in a rural setting of Butajira, South Central Ethiopia. A total of 39 in-depth interviews were carried out with service users (n = 11), caregivers (n = 12), religious leaders (n = 6), health extension workers (n = 4), police officers (n = 2), teachers (n = 2) and government officials (n = 2). Data were analyzed using a thematic approach.ResultsThree themes emerged. (1) Marriage and SMI: Chances of getting married for individuals with SMI in general was perceived to be lower: Individuals with SMI experienced various challenges including difficulty finding romantic partner, starting family and getting into a long-term relationship due to perceived dangerousness and the widespread stigma of mental illness. (2) Gendered experiences of marriageability: Compared to men, women with SMI experienced disproportionate levels of stigma which often continued after recovery. SMI affects marriageability for men with SMI, but mens' chances of finding a marital partner increases following treatment. For women in particular, impaired functioning negatively affects marriageability as ability to cook, care and clean was taken as the measure of suitability. (3) Acceptability of divorce and separation from a partner with SMI: Divorce or separation from a partner with SMI was considered mostly acceptable for men while women were mostly expected to stay married and care for a partner with SMI. For men, the transition from provider to dependent was often acceptable. However, women who fail to execute their domestic roles successfully were considered inept and would be sent back to their family of origin.ConclusionWomen with SMI or those married to partners with SMI are at greater disadvantage. Reducing vulnerabilities through stigma reduction efforts such as community outreach and mental health awareness raising programs might contribute for better social outcomes for women with SMI.
Considerable variation in the gender-specific prevalence of serious mental illness (SMI) has been reported in low-and middle-income countries (LMICs). In the rural setting of Butajira, Ethiopia, the male-to-female prevalence ratio of schizophrenia was reported to be 5:1. This qualitative study explores gender-specific experiences of SMI and the extent to which sociocultural factors may explain the observed difference in prevalence estimates. Using purposive sampling, 39 in-depth interviews were conducted with community members from Butajira, a rural district in South Central Ethiopia. Transcripts were analysed using thematic analysis to elicit community perspectives on cultural explanatory models of SMI and experiences in this region. Genderspecific experiences were reported to differ due to visibility of symptoms, community responses, and varying levels of family support towards individuals with SMI. Overall, respondents described
Background: The Republic of Liberia recently experienced several events that resulted in wide-ranging societal impacts, including long-term civil war and an outbreak of Ebola. These types of events are linked to higher prevalence of mental disorders and psychosocial distress. As a result, it is likely that there is an increased prevalence of mental health disorders in the population.Aim: To assess and review the recent mental health literature in order to provide insight into existing mental health needs and effective or recommended interventions in post-conflict Liberia.Setting: Articles included in this study enrolled Liberians living in Liberia.Methods: A search of four databases was conducted for studies of any type that assessed mental health in Liberia between 01 January 2003 and 27 March 2019. After reviewing 363 articles, 21 articles were included in the final analysis. Articles were coded to identify common themes and needs.Results: The majority of studies used qualitative designs and were conducted in Monrovia, the capital city of Liberia. Common topics included adolescent mental health, intervention and assessment and post-conflict impacts. One article focused on mental health impacts after recovery from Ebola.Conclusion: Overall, there is a dearth of mental health literature that focuses on Liberia. This suggests ample opportunity for researchers to investigate mental health needs amongst the Liberian population and effective psychiatric interventions. Existing recommendations often focus on addressing adolescent health needs, including substance use practices. Opportunities for future research particularly related to needs of adult populations and to mental health impacts of Ebola, abound.
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