Background: Almost one billion people live in slum environments across low- and middle-income countries. Little is known about the mental health status of slum residents or its associations with living conditions. Methods: A cross-sectional, population-representative survey was conducted among 892 adults in four slum communities in Port-au-Prince. Psychological distress was assessed with the Kessler Psychological Distress Scale (K-6). Log-binomial regression modeled the association of sociodemographic variables, living conditions, and material hardship and severe psychological distress [SPD]. Results: Eighty-six percent of adults reported psychological distress (24% severe and 62% moderate). Reliance on an outdoor drinking water source (versus bottled water) and a pit toilet (versus a flush toilet) were marginally positively associated with SPD (adjusted prevalence ratio [aPR]=1.42, 95% confidence interval [CI]: 1.00–2.02 and aPR=1.74, 95% CI: 0.96–3.15, respectively). The prevalence of SPD was higher among women (versus men, aPR=1.66, 95% CI: 1.26–2.19), residents who had foregone healthcare to afford food (versus those who had never done so, aPR=1.60, 95% CI: 1.16–2.45), and persons who drank alcohol at least twice a week (versus monthly or less, aPR=1.73, 95% CI: 1.22–2.45). Limitations: Data were cross-sectional and lacked information on potential risk factors such as exposure to trauma. Conclusions: Psychological distress was highly prevalent and associated with poor living conditions. Prospective studies on the mechanisms through which slum living conditions are associated with psychological distress are needed. Research should also assess the feasibility and acceptability of implementation strategies to increase access to mental health screening and treatment for slum residents.
Bibliographical noteFunding Information:
The study was funded by the Fogarty International Center (through the VECD Fogarty Global Health Fellows Program), the National Heart, Lung, and Blood Institute, the National Institute of Allergy and Infectious Diseases, the National Institute of Mental Health, and the Eunice Kennedy Shriver National Institute of Child Health and Human Development of the National Institutes of Health ( NIH ) ( D43 TW009337 , D43 TW009606-03S1 , K01 MH114721 , R24 HD041023 , and R01 HL143788 ).The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.
- Material hardship
- Psychological distress