”Att nästan inte få existera” : före detta sektmedlemmars erfarenheter – med fokus på psykisk hälsa och mötet med sjukvården

Sammanfattning: Background: The controlling culture of a cult can be harmful to its members. Living in and leaving a cult can be challenging, lead to mental illness and experience the need for support.Aims: I - To explore former cult members' perceptions of consultations with healthcare professionals for mental illness that they relate to their cult involvement. The study also aims to identify the needs, obstacles, and facilitating factors related to these consultations. II - To explore the experiences of acculturation into secular Swedish society of former members of cults, with particular focus on mental health, needs and resources. III - To explore exposure to violence and coercive control in cults, and its consequences for mental health.Design: A qualitative approach was used in all studies. Semi structured interviews (I, III) and the cultural formulation interview from DSM -5 (II) were used to collect data. Studies I and II were analyzed using qualitative content analysis with systematic text condensation. Study III was analyzed using reflexive thematic analysis.Participants: Adult former members of ideological or religion-based cults. Studies I and III include nineteen participants who had been in contact with Swedish healthcare professionals due to mental illness related to their cult involvement. Study II include eleven participants.Results: Being a cult member involved constant exposure to threats and violence. The acculturation process after leaving the cult put them in an in-between state and it took time and effort to resettle in mainstream society. They struggled with a persisting coercive bond to the cult's ideals, shame, trauma, and mental health sequalae. In their consultations with healthcare professionals the former cult members remained affected by the cults rules and belief system. This made it harder for them to communicate their needs and accept care.Conclusion: Former cult members face a complex acculturation process while they struggle in several aspects of life with mental health, shame, problems with trust and personal boundaries. To effectively understand and support former cult members, healthcare professionals must consider both the cultural and existential aspects of former cult members' lives, in addition to their mental health and persisting bond to the cult.