The lived experience of psychosis in Nicaragua: a qualitative examination of the views of service users

Abstract

Background

The experience of psychosis is individual and influenced by a complex intersection of identity, thought processes, perceptions and culture. Little is known about the lived experience of psychosis in Nicaragua.

Aim

To explore the subjective experience of psychosis in Nicaragua from the perspectives of service users.

Methods

Focus groups with 28 service users with experience of psychosis. A qualitative analysis using both inductive and deductive approaches was used to analyse these data.

Results

Participants mostly attributed the onset of psychosis to external factors such as physical or psychological trauma and highlighted the impact of long-term conflict in the area. Whilst medication was generally viewed positively where this was available participants foregrounded lay and community support networks and engagement in valued activities in their narratives about the management of psychosis. Religious and magical forces were salient in participants’ accounts of causal pathways, wider Nicaraguan culture and management practices. Stigma, social exclusion and limited access to formal health services and psychological interventions in particular were the major barriers reported to recovery from psychosis.

Conclusion

Our findings point to the potential utility of culturally adapted psychological interventions in Nicaragua as well as the value of lay and community workforces in delivering such interventions.

Keywords:

• Psychosis
• mental health
• lived experience
• Nicaragua
• LMIC
• qualitative study

Acknowledgements

The authors would like to thank Cuenta Conmigo and Matagalpa tours for their support with the project and all participants who took the time to take part in focus groups. Also, we would like to thank Dr’s Karl Nielsen and Danilo Avendaño for their support during the initial stages of the project.

Ethical approval

Ethical approval was obtained from the Health and Life Sciences Research Ethics Committee (Psychology, Health and Society) at the University of Liverpool (Ref: 4699). Participants gave written consent for their data to be used in the research.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by the University of Liverpool GCRF pump priming fund under grant JXG11723.