West Georgia Voices
Professor Jeannette Diaz-Laplante flew to Haiti to work on a community mental health program just a week and a half before the earthquake hit. She describes the program and the work that continues in Haiti through a UWG grant.
Pwogwam Sante Mental – Jeremie, Haiti
In the aftermath of the indescribable tragedy that struck Haiti on January 12, 2010, my colleagues and I began to take stock of the significant changes in the landscape of Haiti, not only physically, but psychologically.
Even prior to the earthquake, the people of Haiti had endured deep intergenerational psychological and economic stress. As such, we began a project last July with the goal of developing community-based mental health services for Haiti.
Our goal remains unchanged; the catastrophe which hit Haiti last week only underscores the need for trained counselors on the ground, particularly in the months and years to come as people resettle, tally their losses and readjust themselves to a new, and most likely much more difficult, reality.
How the program was inspired
The backdrop for this project is a highly successful community mental health program, Sangath, developed and established in Doa, India.
The heart of the Sangath model is an understanding of the crucial link between economic underdevelopment and mental health. Sangath began as a pilot program in one room of someone’s house and is now the largest NGO in India. It recently won the McArthur Foundation International award.
The underpinning of Sangath is the understanding that psychological conditions such as depression, stress and trauma do not, for the most part, require the services of a psychologist or a psychiatrist, rather they require the development of a therapeutic relationship with someone who is able to listen carefully, diagnose properly and develop sensitive and culturally appropriate intervention strategies.
When Sangath came to my attention and to the attention of my colleague, Renate Schneider, we immediately recognized the potential and implications for Haiti. I received a faculty research grant from the University of West Georgia to develop the first steps in this project.
How the program was started
We traveled to Jeremie, Haiti, in July of last year where we conducted interviews and focus groups and came to several conclusions: without fail all we spoke to agreed of the need for a community based mental health program; people were suffering deeply from depression, substantive abuse and anxiety with very few resources to turn to.
We learned that for this department (Haiti is divided into 10 departments) of Grande Anse where Jeremie is the seat, there was one psychologist for nearly one million people, and this psychologist had only just arrived to Jeremie for a special HIV/AIDS program.
Understanding and Erasing the Stigma is key
Many of the people in the area live in remote mountain regions, very isolated with minimal services available. The stigma attached to mental illness is such that often someone suffering from depression or trauma may leave his or her home and travel further up into the mountain where he or she will die from dehydration and neglect.
Working in partnership with a small group of local people, we developed a small survey to begin to gain an understanding of how it is people experience depression and chronic stress, how people respond to these issues.
In November 2009, 200 surveys were completed in the mountain regions. We received these data in January of this year and plan to have it analyzed and written up in the next two months.
The trip to Haiti weeks ago
We returned in January of this year, a week and a half prior to the catastrophic earthquake that hit Haiti. During this visit, we established a connection with three medical clinics that will serve as our initial pilot sites – one in the city of Jeremie, one in the rural area of Dekade and one in the mountain town of Gatineau. Each of these areas serves a very different group of people. We will use these sites to pilot and develop appropriate assessment tools indigenous to Haiti.
In addition to formalizing relationships with each of the sites we also conducted a brief introductory seminar to psychology where we discussed the underlying values which we bring to the work (humanistic psychology, community psychology, liberation psychology, feminist psychology,) the mental health model developed in India that clearly links economic conditions to mental health conditions, and a brief exercise in stress reduction.
We have begun to pull together our Board of Directors, have established a name, and a cadre of folks who will be part of a clinical training seminar; we are moving forward as quickly as possible to raise the funds for this training seminar.
Our vision is to develop successful assessment tools, intervention strategies, and business models at these three sites, develop a team of “mobile” community mental health workers and eventually have sites throughout the Grand Anse regions and the other nine departments which comprise greater Haiti.
The World Health Organization has stated that the next global epidemic will be an epidemic of depression; this epidemic may have already started in Haiti.
Time is of the essence to move forward with on the ground training, assessment and intervention. The immigration from Port-au-Prince back to the rural areas is already underway.
It is imperative that a resource base be established in these rural areas to be able to effectively deal with the psychological and economic and aftershocks of January 12, 2010.
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