Language, Measurement, and Structural Violence: Global Mental Health Case Studies from Haiti and the Dominican Republic

This chapter explores three essential concepts in Global Mental Health research and practice: language and communication, cross-cultural measurement of mental illness, and the role of structural violence in creating and perpetuating mental health disparities. Examples are drawn from multiple field projects conducted in Haiti and the Dominican Republic from 2010 to 2013. The focus on language and communication chiefly concerns idioms of distress and their potential to improve cross-cultural understandings of mental illness. We discuss both universalist and particularist approaches to cross-cultural measurement of mental illness, including adaptation of standard mental health screening instruments, as well as ‘on-the-ground’ development of new screening instruments in a given context. We close our discussion by framing our studies within the broader rubric of structural violence theory, which can be helpful in not only ascertaining root causes of mental health disparities but also guiding policy and advocacy efforts in their elimination.