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Haiti’s Need for Mental Health Services Heightened During COVID-19

mental health in haitiLocated on the island of Hispaniola is the Caribbean nation of Haiti. The country gained independence in 1804, becoming the first country led by formerly enslaved peoples. A long history of political instability and corruption accompanied by catastrophic natural disasters has devastated Haiti’s population and economy. Additionally, a lack of infrastructure and access to basic resources ranks Haiti as one of the world’s least developed countries. This has created a crisis for mental health in Haiti, which has only worsened during the COVID-19 pandemic.

The Humanitarian Crisis in Haiti

Haiti is now home to over 11.4 million people, and nearly 60% of the population lives below the poverty line. Income inequality and unemployment rates are high, while the country does not meet its citizens’ basic needs. In fact, nearly 90% of people in rural areas lack access to electricity and plumbing.

Several natural disasters have also damaged Haiti in the past decade. The 7.0-magnitude earthquake of January 2010 devastated the nation’s capital city of Port-au-Prince. Indeed, the earthquake was one of the worst natural disasters to strike an urban area. An estimated 250,000 people died, while 300,000 people got injured and over 5 million became displaced. Six years later, Hurricane Matthew wiped out trade roads and coastal infrastructure. Conversely, lengthy periods of drought have paralyzed local agricultural markets. This has resulted in the inflation of even the most basic foods and necessities.

Though Haiti has focused on efforts to recover from natural disasters, longstanding economic and sociopolitical crises remain. One often overlooked problem lies in how these humanitarian crises affect mental health in Haiti.

Mental Health in Haiti: Existing Services

The ongoing humanitarian crises in Haiti create an extraordinary psychological toll on people. In particular, poverty and socioeconomic disadvantage increase the crisis of mental health in Haiti. Following the earthquake, 25% of the population reported experiencing PTSD. Additionally, 50% experienced a major depressive disorder. Disasters have also caused many Haitians to experience trauma and the loss of loved ones and livelihoods.

Despite these negative psychological outcomes, mental health in Haiti remains neglected. This is largely due to the majority of Haitians attributing mental health problems to supernatural forces. Specifically, many Haitians rely on inner religious and spiritual strength to overcome mental health issues. This culturally important Haitian belief, in tandem with the country’s inadequate mental healthcare services, leaves vast numbers of the population neglected.

Many people in Haiti simply go without mental healthcare. For a nation of around 11 million people, Haiti has a mere 23 psychiatrists and 124 psychologists. Haiti’s investment in healthcare services has even declined from 16.6% to 4.4% since 2017. Additionally, even if Haitians could find mental health services, they may not be able to afford or access them. Available services are often costly and inaccessible for those who do seek care.

The Implications of COVID-19

During the pandemic, Haiti has seen a rise in the cost of mental health services and medication. The country’s two running psychiatric hospitals have stopped accepting patients. Other hospitals, many now at full capacity due to the pandemic, have become testing facilities for COVID-19.

The pandemic has further exacerbated mental health in Haiti. General anxiety and concerns relating to the coronavirus and its effects have skyrocketed. Additionally, quarantine mandates have increased rates of domestic violence and abuse. Fatigued health professionals and medical staff also suffer from increased rates of depression. In short, medical professionals as well as the general population are experiencing the devastating mental impacts of COVID-19.

Moving Forward

Humanitarian crises and the coronavirus pandemic persist in the small island nation of Haiti. The aftermath of natural disasters, trauma and continuing political and economic instability lead to a crisis of mental health in Haiti. The country needs attention to the mental health needs of its citizens, in the midst of current and past crises.

Thankfully, nonprofit organizations like Partners in Health are striving to improve mental health in Haiti. Based out of Boston, Partners in Health is dedicated to establishing long-term relationships with organizations in the world’s poorest developing countries. Through its partnerships with local governments and other organizations in Haiti, Partners in Health has helped to innovate mental healthcare delivery models that integrate cultural beliefs about health and current biopsychosocial knowledge. Mobile health clinics also help ensure ensure that patients living in even the most remote regions of Haiti have access to necessary mental health services.

In the years to come, continued funding and support of programs like Partners in Health and its partnership organizations will be vital to improving the mental health and overall well-being of Haitians. Only then can the country truly overcome its current crises and past history.

– Alana Castle
Photo: Flickr 

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Mental Health in Haiti

Mental Health in Haiti
On January 12, 2010, large scale earthquake occurred, affecting the island of Hispaniola and most severely affecting the small country of Haiti. Five years after this catastrophe, many people in this country still suffer from post-traumatic stress disorder (PTSD) and other mental health issues.

Earthquake Consequences on Mental Health in Haiti

As a result of the earthquake, over 90.5 percent of Haitians had relatives that either died or were seriously injured and 93 percent saw dead bodies. Moreover, 24.6 percent of the earthquake survivors developed PTSD symptoms and 28.3 percent developed major depressive disorder (MDD) symptoms. That accounts for more than half the population suffering from mental illness post-quake.

It is not surprising that so many people were traumatized by the event, as the quake left more than two million affected, 222,750 killed, 80,000 bodies missing, 188,383 houses destroyed or damaged and 1.5 million displaced. Before the earthquake, the mental health system in Haiti was almost non-existent mostly due to stigma.

Problems in Resolving the Issue

The good news is that the earthquake united Haitians to put some focus on mental health, still not nearly enough, but just enough to get the ball rolling. However, due to the overwhelming need for mental health services and very limited resources, most Haitians are not getting the psychiatric help they need. Now that mental health issues are more widespread, there is a stronger push for the government to invest more in training professionals and increase resources for mental health in Haiti.

One of the issues around Haitians not receiving mental health is religion. Mental health issues tend to be attributed to supernatural forces, where three out of four Haitians will see an herbalist or Vodou priests for treatment instead of seeking clinical services. This is due to both cultural beliefs and inadequate resources for mental health. Clinical practice in Haiti must include mental health treatment intersected with Vodou beliefs to effectively care for patients of the country.

Center for Addiction and Mental Health

Out of more than 90 agencies that offered outreach to Haiti, only three offered psychiatric care. Center for Addiction and Mental Health (CAMH) Office of Transformative Global Health in Canada is one of those agencies. The organization collaborates with 40 religious healers of Haiti to provide cognitive behavioral therapy in an effective way that is in conjunction with cultural beliefs.

The adoption of task-shifting, or dedicating low-cost mental health workers such as community health workers (CHWs) who operate at the community and clinic levels to supplement integrated care, will help with efforts to decentralize mental health care. These improvements are being made in Haiti, however, there is still a long way to go. More investment in the health care system is needed to implement adequate mental health treatment for those still suffering from the trauma of the quake, and more generally, mental health treatment is needed for all.

In improving services for mental health in Haiti, poverty can also be reduced. Implementing adequate treatment can have far-reaching effects, as poor mental health is often the root cause of other health conditions, and it can inhibit people from participating in social and economic development.

Although not enough outreach to Haiti involved mental health services, mental health in Haiti is improving. Through the integration of community services between psychotherapy and religious or cultural practices, agencies like CAMH are facilitating change in the country. Reducing those inhibited by mental disorders also creates more contributors to the community and less burden placed on society due to mental disability. However, more funding is needing in the mental health practice to reduce illness and poverty.

– Anna Power

Photo: Google