The mental health and psychosocial effects of organized violence: a qualitative study in northern Haiti.

Historically, organized violence has been a chronic pervasive problem in Haiti. We set out to elicit Haitians' views on its effects to guide the development of interventions. In March 2006 we studied a population in the slum area of Cap-Haitien, Haiti's second largest city, and the nearby towns of Milot and Limbe. A convenience sample of adults was asked to free list all current problems affecting victims of organized violence. Two major categories emerged: psychological problems and financial problems. The psychological problems of "feeling startled and loss of self control," "sadness/grief," "continuing to suffer from reliving/reexperiencing past events," "problems in the head/mental problems," "deep suffering in the heart," and "thinking too much" emerged as themes from key-informant interviews. These may correspond to constructs of depression, dysthymia, and anxiety disorders including posttraumatic stress disorder in psychiatric nosology. The development of effective interventions can therefore consider those known to be effective for these problems in other settings. However in selecting interventions, considerations must also include local acceptability, perceived causes of problems, and their social effects.