: Jamaican soccer, poiesis and post-colonial transformation.

This article presents a case study of an innovative culturally based therapeutic approach using collective poiesis to improve the functioning of a youth sports team in Jamaica. In recent decades, Jamaica has endured high levels of violence and corruption, and has been ranked among the top four countries in the world in terms of murder rate per capita. We conjecture that a high prevalence of personality disorder linked to the legacy of slavery and colonialism often impedes Jamaicans from achieving success in diverse fields, including sports.

Community Engagement Mental Health Model for Home Treatment of Psychosis in Jamaica.

Economic constraints in low- and middle-income countries like Jamaica challenge health care services to identify efficient methods of mental health care. This column describes the community engagement mental health (CEMH) model in Kingston, Jamaica, for patients with mental disorders, including psychosis. The CEMH uses a task sharing methodology to deliver acute psychiatric treatment within a community setting.

Owning our madness: Contributions of Jamaican psychiatry to decolonizing Global Mental Health.

The contentious debate on evidence-based Global Mental Health care is challenged by the primary mental health program of Jamaica. Political independence in 1962 ushered in the postcolonial Jamaican Government and the deinstitutionalization of the country's only mental hospital along with a plethora of mental health public policy innovations. The training locally of mental health professionals catalyzed institutional change.

Current research on transcultural psychiatry in the Anglophone Caribbean: epistemological, public policy, and epidemiological challenges.

In this article, we review recent research on mental health in the Caribbean. Three major themes emerge: (a) the effects of colonialism on the Caribbean psyche; (b) decolonization of psychiatric public policy, including innovative treatment approaches, deinstitutionalization, and community and policy responses to mental health issues; and (c) the nature and epidemiology of psychiatric pathology among contemporary Caribbean people, with particular focus on migration, genetic versus social causation of psychosis and personality disorders, and mechanisms of resilience and social capital. Caribbean transcultural psychiatry illustrates the principles of equipoise unique to developing countries that protect the wellness and continued survival of postcolonial Caribbean people.

Promoting Resilience in High-risk Children in Jamaica: A Pilot Study of a Multimodal Intervention.

Objective: To assess the effectiveness of a multimodal afterschool and summer intervention called the Dream-A-World (DAW) Project for a cohort of school-aged Jamaican children from an impoverished, disadvantaged inner-city community in Kingston, Jamaica. Children were selected by their teachers based on severe disruptive disorders and academic underachievement and compared with a matched control group. The pilot was a child focused therapeutic modality without parental intervention for disruptive conduct and academic failure.

Issues of clinical and cultural competence in Caribbean migrants.

The level of out-migration from the Caribbean is very high, with migration of tertiary-level educated populations from Caribbean countries being the highest in the world. Many clinicians in receiving countries have had limited diagnostic and therapeutic experience with Caribbean migrants, resulting in diagnostic and therapeutic controversies. There is an urgent need for better understanding of these cultural differences.

Understanding patients in multicultural settings: a personal reflection on ethnicity and culture in clinical practice.

Objective: To identify and discourse on the complexities of ethnicity and culture, their role in the social and psychological functioning of patients and their potential impact on clinical assessment and treatment of these patients in diverse cultural contexts.

Design: Description of aspects of the cultural competence required by clinicians in mental health service provisions in therapeutic interactions involving the therapist and patient and also in the encounter between practitioners.

Results: The four-decade clinical experience of the author, an African Jamaican psychiatrist, encompasses clinical experience in the Caribbean, North America, Europe and New Zealand.

Redefining personality disorder: a Jamaican perspective.

Objective: To characterize and assess the factor structure of phenomenological features of DSM-IV personality disorder diagnosis in Jamaican patients and determine any similarities with those of traditional criteria, associations with disorder severity, and/or significant relationships between variables to inform the current debate on the relevance of established personality disorder diagnostics.

Methods: This was a case-control study. All the patients included were seen by one private psychiatric practice from 1974 to 2007.

Deinstitutionalization and attitudes toward mental illness in Jamaica: a qualitative study.

Objective: To consider whether or not deinstitutionalization and the integration of community mental health care with primary health care services have reduced stigma toward mental illness in Jamaica.

Methods: A qualitative study of 20 focus groups, with a total of 159 participants grouped by shared sociodemographic traits. Results were analyzed using ATLAS.

"Mad, sick, head nuh good": mental illness stigma in Jamaican communities.

Stigma may be an important factor in mental health service seeking and utilization. However, little work on stigma has been conducted in developing nations in the Caribbean, including Jamaica. We explored mental illness stigma in Jamaica by conducting focus groups with 16 community samples.

Psychic centrality: reflections on two psychohistoriographic cultural therapy workshops in Montreal.

The use of psychohistoriographic cultural therapy (PCT) developed in Jamaica is described in the context of two workshops in Montreal. PCT is a form of group intervention that seeks to elicit and clarify the "psychic centrality" of a group. Psychic centrality refers to a sense of psychological containment or organization of diverse individual points of view through creating a historical map of collective experience.

Fostering resilience in children at risk through a cultural therapy intervention in Kingston, Jamaica.

This report explores an initiative in Kingston, Jamaica to foster resilience in children in an inner-city community plagued by violence and other social problems. This initiative was undertaken by CARIMENSA, the Caribbean Institute for Mental Health and Substance Abuse.

Psychiatry in Jamaica.

The intense historical relationship linking Jamaica and Britain to 300 years of the transatlantic slave trade and 200 years of colonialism has left 2.7 million souls living in Jamaica, 80% of African origin, 15% of mixed Creole background and 5% of Asian Indian, Chinese and European ancestry. With a per capita gross domestic product of US$4104 in 2007, one-third of the population is impoverished, the majority struggling for economic survival.

Internalizing stigma associated with mental illness: findings from a general population survey in Jamaica.

Objectives: The culture of stigma associated with mental illness is particularly intense when persons who are normally victims of that stigmatization (mentally ill persons and their family members) themselves act negatively toward others whom they associate with mental illness. We attempt to determine the extent of this internalization and assimilation of stigmatizing attitudes, cognitions, and behaviors in persons who are at risk for such stigmatization in Jamaica.

Methods: Data from a 2006 national survey on mental health were analyzed.

Open papers, open minds? Media representations of psychiatric de-institutionalization in Jamaica.

Little research has been conducted on media representations of psychiatric de-institutionalization in low-income countries. We set out to examine whether the Jamaican media takes a positive or negative orientation to psychiatric de-institutionalization, and which arguments and rhetorical devices are employed to support the media's position. This was done by the collection, review, and analysis of all stories related to psychiatric de-institutionalization published over a 26-month period from 2003 to 2005 by Jamaica's principal broadsheet newspaper.