S31.03 - When the healer is ill

Abstract

Since countries have relaxed immigration policies, mental health professionals have been confronted with clinical pictures necessitating a different reflection on their practice of psychiatry based on a western system of reference. Misdiagnosis can be the source of unnecessary hospitalization, harmful drug treatment and inadequate management of cases. From the perspective of migrating populations, they undergo a process of change with the necessity to cope with the host culture while preserving their previous cultural values. Sometimes migration awakens new hopes like the belief seen lately among Israeli Ethiopians that spirits won't migrate with them and won't anymore require their attention. It soon becomes apparent that the reality is different and Zar spirits pathology appear, provoking questions about its meaning. Beer-Yaacov Mental Health Center is located south of Tel-Aviv in an area where 20% of the Ethiopian community lives. Patients of Ethiopian origin, unresponsive to “traditional” Western treatment are referred to the hospital outpatient clinic for examination at the ethnopsychiatric consultation service. With the help of three clinical vignettes we will describe the psychopathology due to the issues of healers that can't heal or of people meant to be healers that couldn't fulfill their apprenticeship because of migration. We will show how an ethnopsychiatric-oriented interview combined with an ethnopsychiatric analysis of the clinical picture, allow a better diagnosis even in the context of a conventional institutional frame.