The Suriname Indigenous Mental Health (SIMH) study

Globally, mental and substance use disorders account for 14% of the total burden of disease, and particularly people living in low- and middle-income countries, where inaccessibility to care, scarcity of resources and a lack of understanding of how to best care for people with mental problems impacts on the care and treatment are affected. Suriname is a multicultural middle-income country with a highly centralized mental health care system. When looking at mental health problems among the national population it was found that depression rated from 16% to 18% and alcohol abuse rated at 15% and 17% for men. However, little is known for the Indigenous people, descendants of the original inhabitants of Suriname mainly living in the interior of Suriname and comprising 3.7% of the total population. Indigenous people face a lot of social and economic adversity, and the rates and severity of mental health problems are suspected to be higher than in other population groups. Therefore, the Psychiatric Center Suriname and the Medische Zending expressed the urgent need for evidence on prevention and treatment of mental health problems among indigenous people in Suriname. As little is known, as a first step, the idioms of distress, local concepts and expression of mental health problems, risk and resilience factors, pathways to formal and informal healthcare, and best treatment for (severe) mental health problems among indigenous people, including collaborative efforts between the formal and traditional health care system are explored. To foster collaboration a participatory approach was applied and a qualitative study by focus group discussions and semi-structured interviews with stakeholders, community members and healthcare professionals was conducted in three selected study areas. Apoera is a village in Western Suriname (700 inhabitants) which can be reached by car, Kwamalasamutu is a village in the South of Suriname in the inlands (1100 inhabitants) only to be reached by plane, and Pikin Saron (population 500) is an area close to Paramaribo, the capital of Suriname.