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No sovereign remedy: distress, madness, and mental health care in Guyana

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dc.contributor.advisorKempadoo, Kamala
dc.contributor.authorPersaud, Savitri
dc.date.accessioned2022-12-14T16:44:29Z
dc.date.available2022-12-14T16:44:29Z
dc.date.copyright2022-09-19
dc.date.issued2022-12-14
dc.date.updated2022-12-14T16:44:28Z
dc.degree.disciplineSocial & Political Thought
dc.degree.levelDoctoral
dc.degree.namePhD - Doctor of Philosophy
dc.description.abstractThis dissertation is an ethnographic examination of how mental distress is read and understood in Guyana. Through semi-structured qualitative interviews, site observations, media analysis, and document analysis (primary, secondary, tertiary, and grey literature), this research investigates (i) competing and complementary discourses and etiologies of distress; (ii) diverse care pathways and practices utilized by Guyanese to address and ease distress; (iii) and the histories, legacy of empire, and socio-politico-economic factors that inform and spring from this exploration. This research commenced in response to deaths and incidents of violence against women and girls who were labelled “mad”, “mentally ill”, and “demon possessed” in Guyanese news reports. These cases signalled the polyvalent, intersectional, and fluid ways in which Guyanese make sense of and respond to mental distress; thereby prompting research questions on belief systems, modalities of care, and the social relations that are produced, organized, and practiced as Guyanese attend to mental distress on their own terms. Interviews were conducted in Guyana with 37 helping practitioners, inclusive of medical doctors, nurses, social service agents, civil society/NGO actors, government officials at Guyana’s Ministry of Health, and religious/spiritual practitioners belonging to various faiths. Observations were carried out at the country’s National Psychiatric Hospital – informally known as the “Madhouse”. Participants emphasized how mental distress is colloquially and primarily perceived through the stigmatized and meaning-centred language of “madness”. They reported that the general public seldom uses the clinical terms “mental illness”/“mental disorder”, which reference the dominant, Western biomedical model of psychiatry. Instead, participants revealed how mental distress is expressed through an array of perceived explanatory models: biomedical; socio-economic/structural; (inter)personal; and supernatural. A major point of consensus among all 37 participants is how perceived supernatural causality is viewed as an intelligible landscape for understanding distress among the public; therefore, there is a propensity for religious/spiritual practitioners to act as first responders. Per participant accounts, Guyanese appear to embrace plurality and refuse either/or models of care. Consequently, these findings present crucial implications for theory, research, policy, and practice aimed at addressing and reducing mental distress experienced by Guyanese and fostering safe, comprehensive, responsive, and accountable public health systems.
dc.identifier.urihttp://hdl.handle.net/10315/40795
dc.languageen
dc.rightsAuthor owns copyright, except where explicitly noted. Please contact the author directly with licensing requests.
dc.subjectSociology
dc.subjectMental health
dc.subjectCaribbean studies
dc.subject.keywordsMental health
dc.subject.keywordsMadness
dc.subject.keywordsMad
dc.subject.keywordsMental distress
dc.subject.keywordsDistress
dc.subject.keywordsMental illness
dc.subject.keywordsMental disorder
dc.subject.keywordsExplanatory model
dc.subject.keywordsIllness model
dc.subject.keywordsCare pathways
dc.subject.keywordsEthnography
dc.subject.keywordsEthnographic fieldwork
dc.subject.keywordsDisability
dc.subject.keywordsCritical disability studies
dc.subject.keywordsMedical anthropology
dc.subject.keywordsMedical sociology
dc.subject.keywordsDisablement
dc.subject.keywordsGuyana
dc.subject.keywordsGuyanese
dc.subject.keywordsIndo-Guyanese
dc.subject.keywordsAfro-Guyanese
dc.subject.keywordsCaribbean
dc.subject.keywordsCaribbean diaspora
dc.subject.keywordsAnglophone Caribbean
dc.subject.keywordsRace
dc.subject.keywordsRacialization
dc.subject.keywordsRacism
dc.subject.keywordsSexism
dc.subject.keywordsClass
dc.subject.keywordsGlobal South
dc.subject.keywordsPostcolonial theory
dc.subject.keywordsDevelopment studies
dc.subject.keywordsGender
dc.subject.keywordsGender studies
dc.subject.keywordsFeminist studies
dc.subject.keywordsFeminist theory
dc.subject.keywordsReligion
dc.subject.keywordsSpirituality
dc.subject.keywordsHealing traditions
dc.subject.keywordsCaribbean religions
dc.subject.keywordsCaribbean healing traditions
dc.subject.keywordsTraditional medicine
dc.subject.keywordsBush medicine
dc.subject.keywordsSpirit possession
dc.subject.keywordsObeah
dc.subject.keywordsKali Mai
dc.subject.keywordsComfa
dc.subject.keywordsKomfa
dc.subject.keywordsHinduism
dc.subject.keywordsIslam
dc.subject.keywordsChristianity
dc.subject.keywordsSpiritualism
dc.subject.keywordsEmpire and medicine
dc.subject.keywordsViolence
dc.subject.keywordsViolence against women
dc.subject.keywordsGender-based violence
dc.subject.keywordsWomen's studies
dc.subject.keywordsTransnational feminism
dc.subject.keywordsFeminism
dc.subject.keywordsCaribbean feminism
dc.subject.keywordsMad studies
dc.subject.keywordsColonialism
dc.subject.keywordsBritish colonialism
dc.subject.keywordsImperialism
dc.subject.keywordsBritish imperialism
dc.subject.keywordsBerbice Madhouse
dc.subject.keywordsMad house
dc.subject.keywordsMadhouse
dc.subject.keywordsNational Psychiatric Hospital Guyana
dc.subject.keywordsGeorgetown Public Hospital Corporation
dc.subject.keywordsInstitutionalization
dc.subject.keywordsTotal institution
dc.subject.keywordsMental asylum
dc.subject.keywordsBritish lunatic asylum
dc.subject.keywordsColonial psychiatry
dc.subject.keywordsBiomedicine
dc.subject.keywordsBiomedical model
dc.subject.keywordsBiological psychiatry
dc.subject.keywordsBiomedical psychiatry
dc.subject.keywordsCross-cultural psychiatry
dc.subject.keywordsTranscultural psychiatry
dc.subject.keywordsSomebody do dem something
dc.subject.keywordsSomebody duh dem something
dc.subject.keywordsJumbie
dc.subject.keywordsJumbee
dc.subject.keywordsFolklore
dc.subject.keywordsMyth
dc.subject.keywordsOld higue
dc.subject.keywordsOle higue
dc.subject.keywordsEvil eye
dc.subject.keywordsBad eye
dc.subject.keywordsPsy-discipline
dc.subject.keywordsPsy-washing
dc.subject.keywordsPsych-washing
dc.subject.keywordsStigma
dc.subject.keywordsMental health stigma
dc.subject.keywordsWHO-AIMS
dc.subject.keywordsWHO
dc.subject.keywordsWorld Health Organization
dc.subject.keywordsPAHO
dc.subject.keywordsPan American Health Organization
dc.subject.keywordsmhGAP
dc.subject.keywordsmhGAP-IG
dc.subject.keywordsSuicide
dc.subject.keywordsSuicidality
dc.subject.keywordsSuicide rate
dc.subject.keywordsGlobal mental health
dc.subject.keywordsWorld mental health
dc.subject.keywordsSocial determinants of health
dc.subject.keywordsBiopsychosocial
dc.subject.keywordsBiopsychosocial-spiritual
dc.subject.keywordsGuyanese psychospiritual
dc.subject.keywordsOutside doctor
dc.subject.keywordsHealth beliefs
dc.subject.keywordsHolistic health
dc.subject.keywordsPerson-centred care
dc.subject.keywordsPatient care
dc.subject.keywordsPatient harm
dc.subject.keywordsPatient abuse
dc.subject.keywordsPublic health
dc.subject.keywordsHealth care
dc.subject.keywordsHealthcare
dc.subject.keywordsEthnomedical health care
dc.titleNo sovereign remedy: distress, madness, and mental health care in Guyana
dc.typeElectronic Thesis or Dissertation

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