Unveiling Mental Health Challenges in Belize: Exploring Social Determinants and Pathways to Sustainable Solutions

Background and Purpose: The access and care of mental health in low-resourced countries is an ongoing epidemic. The trauma of colonialism and generational struggles with conflicting cultures continue to impact the health and well-being of the people of those lands. Specifically, the country of Belize has endured many political and economic shifts in the past half-century which have influenced the vitality of social programs and influenced the rising rate of mental health concerns. The Social Determinants of Health provides a lens to identify the macro influxes that contribute to the current mental health hardships. This research uses the Social Determinants of Health to identify societal structures that contribute to the existing conditions of mental health in Belize.

Methods: This research used qualitative exploratory methods to guide nine interviews with individuals at a healthcare clinic in Southern Belize. A variety of professionals were interviewed to explore their observations and perceptions of working with diverse individuals in a low-resourced community. The interviews were transcribed, translated, and input into NVivo for qualitative analysis. The Social Determinants of Health model was then used as a lens during initial and axial coding to identify codes and categories. Thematic analysis was then used to identify themes that aligned with the model.

Results: The results of this study demonstrate the influences of the community, the government, the economy, and identifies protective factors to individual mental health in Belize. Community norms, stigma, and a lack of education about mental health impact individual behaviors to address mental health, such as avoiding discussion and holding prejudices. Governmental programs limit mental health care with little cultural competency, especially for indigenous individuals or individuals who speak languages other than English. The economy influenced feelings of stress and depression with little financial assistance, a decrease in employment rates, and an increase in the cost of living. Nonetheless, informal structures, such as faith-based institutions and familial relationships were identified as protective factors to mental health concerns.

Conclusions and Implications: While the Belizean government has stated the importance of mental health care and has dedicated itself to increasing access to services, low-resourced communities have yet to see change from a macro perspective. Community outreach and awareness are necessary to decrease stigma and create a norm for discussing mental health. Additionally, cultural humility paired with an increase of social service and mental health clinicians is necessary to address the rise of mental health concerns and the suicide rate in the community. While social work education exists in Belize, it is limited, yet the program has the potential to impact the lives of Belizeans by educating more individuals to competently provide and advocate for social services.