Gender Differences in Community Responses to Serious Mental Illness in Butajira, Ethiopia

Poster A22, Monday, October 8, 11:30 am - 1:00 pm, Essex Ballroom

Senait Ghebrehiwet1, Tithi Baul1, Juliana Restivo2, Teshome Shibre Kelkile3, Anne Stevenson4,5, Bizu Gelaye5, Abebaw Fekadu6,7, Maji Hailemariam8, Eshetu Girma9, Solomon Teferra6, David C. Henderson1,10, Christina P.C. Borba1,10; 1Boston Medical Center, Department of Psychiatry, Boston, MA, 2Boston University School of Public Health, Department of Global Health, Boston, MA, 3Horizon Health Network, Fredericton, NB, Canada, 4Broad Institute, Stanley Center for Psychiatric Research, Cambridge, MA, 5Harvard T. H. Chan School of Public Health, Department of Epidemiology, Boston, MA, 6Addis Ababa University, College of Health Sciences, School of Medicine, Department of Psychiatry, Addis Ababa, Ethiopia, 7King’s College London, Institute of Psychiatry, Department of Psychological Medicine, Centre for Affective Disorders, London, UK, 8Michigan State University, College of Human Medicine, Division of Public Health, Flint, MI, 9Addis Ababa University, School of Public Health, Department of Preventive Medicine, Addis Ababa, Ethiopia, 10Boston University School of Medicine, Department of Psychiatry, Boston, MA

Considerable variation in the gender-specific prevalence of serious mental illness (SMI) has been reported among 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 aimed to explore gender differences in community responses to individuals with SMI, and the extent to which sociocultural factors may explain the observed prevalence estimates in Ethiopia. Using purposive sampling, 39 in-depth semi-structured interviews were conducted with community members from Butajira, a rural district in South Central Ethiopia, between June and July 2015. Data analysis involved applications of grounded theory and axial coding to elicit cultural explanatory models of SMI from the community. Gender-specific experiences of individuals with SMI in rural Butajira were reported to vary due to the visibility of symptoms and varying levels of family support. Overall, respondents described how a community-wide awareness of female patients’ vulnerability differentially isolates women with SMI, greatly affecting community-based health care providers’ ability to identify and provide care to mentally ill women in the community. Our study findings suggest that in Butajira, various sociocultural factors subject women with SMI to a greater degree of social isolation relative to their male counterparts. Improvements for case detection methods in rural Ethiopia include the involvement of family members as they interact with women with SMI early on in the development of their symptoms and play an essential role in their path to mental health care.

Topic Area: Diagnosis and Phenomenology

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