Haiti - Mental Health Issues

[Thornton]

http://www.cnn.com/2010/HEALTH/01/15/haiti.mental.psychological.effects/?hpt=Sbin

In Haiti, mental aftershocks could be far-reachingBy Elizabeth Landau, CNN
January 15, 2010 8:42 a.m. EST


(CNN) -- As Haitians struggle to recover from the devastation of Tuesday's 7.0-magnitude earthquake, mental health experts caution that the most severe psychological effects won't take form until individuals' situations stabilize.
Feelings of confusion, fear, agitation, grief and anger that surround a large-scale traumatic event such as the Haiti earthquake give way to more pronounced psychological disorders once people's basic human needs are taken care of, experts say.
"Once the initial resources are in, when actually most people are going to start feel out of danger, is when the psychological aftereffects are going to hit people," said Dr. Daniella David, professor of clinical psychiatry at the University of Miami's Miller School of Medicine. "People need to ask for help when that happens."
In the immediate short-term period after a large-scale traumatic event, people are concerned primarily with self-preservation and taking care of family and friends, said Dr. Sandro Galea, chair of the Department of Epidemiology at Columbia University's Mailman School of Public Health. These people experience acute stress and anxiety, which is taken up by trying to fulfill the immediate physical needs.

?.
Haiti has the potential for higher rates of mental illness and a slower recovery after this episode because the population is already strained from weak social and economic supports, Galea said. In those conditions, they may already be predisposed to developing mental illness irrespective of the earthquake itself, he said.
?

"Rebuilding lives, rebuilding social supports, rebuilding financial and practical supports will go a long way to minimizing the health consequences of the event that has passed," he said.
?

Retired Army Lt. Gen. Russell Honor?, who led relief efforts for Hurricane Katrina, said Thursday that a lack of information "created a lot of anxiety for people because they didn't know what was going on."
"We need to correct that, and as soon as we can, start pushing information to people, because rumors can cause the victims to make bad decisions," he said.

 

[Thornton]

Re: Haiti - Mental Health Issues

How will Haitians Cope

http://news.health.com/2010/01/14/how-will-haitians-cope/

Haitian-born psychologist Guerda Nicolas, PhD, has written extensively about how Haitians cope with tragedies, especially natural disasters.

By Michael Slenske
THURSDAY, Jan. 14, 2010 (Health.com) ? The earthquake that hit Haiti on Tuesday has caused untold physical devastation, flattening much of the capital of Port-au-Prince and leaving tens of thousands dead. The psychological effects of the disaster may be similarly devastating, and they are likely to persist long after the aftershocks have subsided, for the people in Haiti as well as for Haitians abroad who are watching the events unfold on TV.
Haitian-born clinical psychologist Guerda Nicolas, PhD, the chair of the department of educational and psychological studies at the University of Miami, has written extensively about how Haitians cope with tragedies, especially hurricanes and other natural disasters. (A study of hers appears in a new book, Mass Trauma and Emotional Healing Around the World.) Nicolas is currently coordinating counseling efforts in Miami?s large Haitian community and plans to travel to the island next week to assist with mental-health outreach.

Q: What are the immediate psychological concerns following a disaster like this?
A: There isn?t an immediate response. When an individual is in the midst of that?and I?m saying this not just as a professional, but from experience and the work I?ve done in Haiti?you?re in action mode, and you?re just thinking about what?s going to happen. The actual trauma, the psychological impact, doesn?t occur until several months after. It?s when things get quiet and there?s not much going on that you start to feel the impact and the sadness of the images that you witnessed. Having come so close to death starts to set in.
Q: Is that when post-traumatic stress begins?
A: Exactly.
??.

 

[Thornton]

Re: Haiti - Mental Health Issues

Resource for Haitians in Boston Area

http://www.cha.harvard.edu/psychiatry/mh_haitian.shtml

Cambridge Health Alliance - Department of Psychiatry
617-591-6033

The Haitian Mental Health Program is a special program for people from Haiti. Our staff speaks Haitian Kreyol, French, and English. They also understand the Haitian culture.
We help people every day. You can come to us and talk about your life and your problems. This can help you improve your life. Our work covers the fields of psychiatry, psychology, social work, and family therapy. We provide care in a safe and sensitive setting.

 

[Thornton]

Re: Haiti - Mental Health Issues

Treating Haitian patients: Key cultural aspects

http://cat.inist.fr/?aModele=afficheN&cpsidt=14454003

Auteur(s) / Author(s)
DESROSIERS Astrid (1 2) ; FLEUROSE Sheila St. (2) ;
Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)
(1) Haitian Mental Health Clinic, ETATS-UNIS
(2) Harvard Medical School, Cambridge, MA, ETATS-UNIS


R?sum? / Abstract
The Haitian community in the United States is growing steadily. They make up a significant portion of many cities. As a group, Haitian immigrants are a challenge to mental health professionals. Their view and concepts of the world are unique. Non-Haitian clinicians need to be knowledgeable of the culture in order to provide competent care. The goal of this article is to help clinicians understand aspects of Haitian culture that will facilitate mental health treatment. A historical perspective is offered since the history of Haiti has shaped society, families and therefore individuals. The role of the supernatural is addressed to provide a better understanding of the Haitian psyche. The political and economic climate in Haiti has led to a significant increase in the number of Haitians migrating to the United States. Haitians are faced with the challenge of adapting to a new culture; they experience stress and become vulnerable to mental illness. As a result, there is increasing demand for mental health services. This article highlights aspects of Haitian culture relevant to mental health clinicians. It provides an overview of Haitians' attitudes toward mental health and the utilization of psychotherapy. Concepts relevant to Voodoo beliefs and practices are discussed since these beliefs can shape attitudes, and compliance with treatment. Recommendations for engaging and maintaining Haitian clients in psychotherapy are made. Case vignettes are provided for illustration.
Revue / Journal Title
American journal of psychotherapy ISSN 0002-9564 CODEN AJPTAR
Source / Source
2002, vol. 56, no4, pp. 508-521 [14 page(s) (article)] (4 ref.)

 

[Thornton]

Re: Haiti - Mental Health Issues

New Jersey Resource
http://www.njamha.org/

NJAMHA and NJMHI Offer Mental Health Assistance to Family Members of Haitian Earthquake Victims Recognizing the immense psychological aid and support that will be needed in the coming days, weeks, and months ahead to help family members cope with the loses they have suffered as a result of yesterday?s devastating earthquake in Haiti, the New Jersey Association of Mental Health Agencies, Inc. (NJAMHA) and the New Jersey Mental Health Institute, Inc. (NJMHI) today offered to coordinate assistance to family members affected by this tragedy.

?I have watched, along with the rest of the world, with great sadness and sympathy as the people affected by this earthquake struggle to simply survive,? said Dr. Wentz. ?Because of our experience in assisting with the deadly tsunami in late 2004, including my own firsthand experience being on-site in Sri Lanka while the tsunami occurred, NJAMHA and NJMHI are well prepared to assist with a natural disaster of this magnitude.?

Dr. Wentz added that the most serious mental health problems still lie ahead for victims, their families and relief workers. While it is normal in the days following a natural disaster to feel a range of emotions: irritability, night terrors, depression, hopelessness and anxiety, the challenge is to keep these feelings from taking root.

 

[Thornton]

Re: Haiti - Mental Health Issues

Dr. Astride Desrosiers speaking on Haitian mental health

http://newroutes.org/node/30239

Dr. Astride Desrosiers speaking on Haitian mental health
Posted by Susan Foley October 29, 2009
http://infohaiti.net/Nouvelles/Nouvelles_astride_desrosiers_blessee.html
Dr. Astride Desrosiers speaks at a conference in Cambridge Massachusetts in November of 2008 about mental health issues in the Haitian community. In October 2009, Dr. Desrosiers was injured in an incident with a patient with mental illness. She survived and is recovering, however, her patient was killed by an off-duty police officer who happened to be nearby at the time of the incident. These incidents are tragic for so many people, for the patient and his family, the doctor and her family, the police officer and his family, and for the community at large. In her own words, Dr. Desrosiers speaks about the importance of taking care of your mental health.

Videotape in ? French
http://infohaiti.net/Nouvelles/Nouvelles_astride_desrosiers_blessee.html

 

[Thornton]

Re: Haiti - Mental Health Issues

Comment on Vicarious Traumatization

Viewing the events in Haiti hurts. It should hurt. But adding more victims of despair or anger will not help the people of Haiti. Those of us who are watching, reaching out, must balance information gathering against the impossbile effort to make sense of it all. Review the guidelines for self care: limit TV and computer scanning, attend to daily life, reach out to help those afar and hug those who are near.
Joe Thornton, MD

Vicarious Traumatization
http://www.ncbi.nlm.nih.gov/pubmed/15091303?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_SingleItemSupl.Pubmed_Discovery_RA&linkpos=2&log$=relatedarticles&logdbfrom=pubmed

J Nerv Ment Dis. 2004 Mar;192(3):217-26.

Television images and probable posttraumatic stress disorder after September 11: the role of background characteristics, event exposures, and perievent panic.
Ahern J, Galea S, Resnick H, Vlahov D.
New York Academy of Medicine, Center for Urban Epidemiologic Studies, New York, NY, USA.
Television viewing has been associated with posttraumatic stress disorder (PTSD) symptoms after disasters and traumas; we examined characteristics that may explain this association among New Yorkers after September 11, 2001. Among 2001 respondents to a random-digit dial telephone survey conducted 4 months after September 11, people who viewed more television images in the 7 days after September 11 had more probable PTSD. People in the highest third of viewing had a 2.32 times greater odds of probable PTSD after September 11 compared with people in the lowest third of viewing; after adjustment for explanatory variables, the relative odds of probable PTSD were 1.66. Adjustment for perievent panic accounted for 44% of the reduction in association between television and probable PTSD, suggesting that perievent emotional reactions may play an important role in the television and psychopathology association. Television may merit consideration as a potential exposure to a traumatic event.

 

[Thornton]

Re: Haiti - Mental Health Issues

THE TASK AT HAND ..

I am posting a few more abstracts on Haitian mental health. The issue at hand covers several distinct tasks: (1) immediate care of survivors with respect to mental health; (2) long term psychological impact of the disaster on the survivors, (3) immediate impact on rescue workers, long term impact on rescue workers, and (4) the impact on observers.

Part of our limitations in mental health prevention is related to terminology. Traumatization refers to the event eg the earthquakes? immediate impact. Secondary traumatization refers to the impact on rescue workers of listening to the stories of the survivors. Vicarious traumatization overlaps with secondary traumatization and also includes the trauma experiences by people who view the events through media.

The highest yield in preventing long term disability due to the mental health impact of the earthquake is to minimize what I call iatrogenic or systems traumatization. This is the trauma that is experience due to the social events in reaction to the earthquake, eg handling of dead, work with causalities, organization of aid, communications and social media.
The most immediate task now is two fold: rebuild the natural social networks and align the emergency response to the culture. Locally we can all reach out to members of the Haitian community or those who have contacts in the community to help expand the connections locally and to help re-establish the network of the Haitian Diaspora. Within Flutrackers.com the forum is already serving well as a source of information in Multilanguage and multicultural formats.

We can expand the effort by helping to make the connections by listing local Haitian resources like the forum did with H1N1 vaccine availability. Invite your Haitian contacts to work through the resources here. Support empowerment of those affected here and in Haiti. I will try to make this a sub forum to help navigate and I am seek assistance on the best way to organize the resources (faith based, geographical etc).

I conclude with a quote from Desrosiers and St Fleurose 2002

the strengths from their cultural heritage, such as fortitude; perseverance in the most arduous circumstances; deep religious faith; high self-respect; reliance on the extended family; and the tradition of sharing. Building on these assets may assist Western mental health-care providers in offering culturally sensitive mental health care to Haitians.

Selected references:

http://www.ncbi.nlm.nih.gov/pubmed/12520887?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_SingleItemSupl.Pubmed_Discovery_RA&linkpos=1&log$=relatedarticles&logdbfrom=pubmed


Am J Psychother. 2002;56(4):508-21.
Treating Haitian patients: key cultural aspects.
Desrosiers A, St Fleurose S.
Harvard Medical School, Cambridge, MA, USA.
The Haitian community in the United States is growing steadily. They make up a significant portion of many cities. As a group, Haitian immigrants are a challenge to mental health professionals. Their view and concepts of the world are unique. Non-Haitian clinicians need to be knowledgeable of the culture in order to provide competent care. The goal of this article is to help clinicians understand aspects of Haitian culture that will facilitate mental health treatment. A historical perspective is offered since the history of Haiti has shaped society, families and therefore individuals. The role of the supernatural is addressed to provide a better understanding of the Haitian psyche. The political and economic climate in Haiti has led to a significant increase in the number of Haitians migrating to the United States. Haitians are faced with the challenge of adapting to a new culture; they experience stress and become vulnerable to mental illness. As a result, there is increasing demand for mental health services. This article highlights aspects of Haitian culture relevant to mental health clinicians. It provides an overview of Haitians' attitudes toward mental health and the utilization of psychotherapy. Concepts relevant to Voodoo beliefs and practices are discussed since these beliefs can shape attitudes, and compliance with treatment. Recommendations for engaging and maintaining Haitian clients in psychotherapy are made. Case vignettes are provided for illustration.



http://www.ncbi.nlm.nih.gov/pubmed/19378650?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_SingleItemSupl.Pubmed_Discovery_RA&linkpos=4&log$=relatedarticles&logdbfrom=pubmed

Fam Process. 2009 Mar;48(1):135-50.
Empathic family stress as a sign of family connectedness in Haitian immigrants.
Nicolas G, DeSilva A, Prater K, Bronkoski E.
University of Miami, School of Education, 5205 University Dr., Coral Galdes, FL 33146, USA. nguerda@miami.edu
Research on familial experiences has documented the important role of receiving family support, but has not examined the effects of providing such support. Empathic family stress refers to the stress that individuals experience in response to difficult life circumstances of family members. The current study took a first step in examining the empathic family stress of 134 Haitian immigrants. Results from hierarchical regressions indicate that empathic family stress is a significant predictor of depressive symptoms, but not acculturative stress, for Haitian immigrants. Findings from the study are examined from a strengths-based perspective, where empathic family stress is viewed as a sign of strong family connections among Haitian immigrants. Recommendations are provided for clinicians working with Haitian immigrants to help them experience empathic family stress in a healthy manner.




J Psychosoc Nurs Ment Health Serv. 1989 Dec;27(12):22-5.
Western voodoo: providing mental health care to Haitian refugees.
Gustafson MB.
University of Minnesota, School of Nursing, Minneapolis 55455.
This article described certain aspects of Haitian life, voodoo and its role in Haitian society, the quality and quantity of psychiatric and mental health care for Haitians in Haiti, and suggestions for providing appropriate mental health care to Haitian refugees in the United States. Conway and Buchanan (1985) described what has helped Haitian refugees adapt in the transition to life in the United States: the strengths from their cultural heritage, such as fortitude; perseverance in the most arduous circumstances; deep religious faith; high self-respect; reliance on the extended family; and the tradition of sharing. Building on these assets may assist Western mental health-care providers in offering culturally sensitive mental health care to Haitians.



http://www.ncbi.nlm.nih.gov/pubmed/17503679?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_SingleItemSupl.Pubmed_Discovery_RA&linkpos=2&log$=relatedarticles&logdbfrom=pubmed

Am J Psychother. 2007;61(1):83-98.
Expression and treatment of depression among Haitian immigrant women in the United States: clinical observations.
Nicolas G, Desilva AM, Subrebost KL, Breland-Noble A, Gonzalez-Eastep D, Manning N, Prosper V, Prater K.
Boston College, Lynch School of Education, Campion Hall 305B, 140 Commonwealth Avenue, Chestnut Hill, MA, USA. nicolagu@bc.edu
Existing research demonstrates that culture has a profound impact on the expression and manifestation of mental illness, especially on depressive disorders among ethnically diverse populations. Currently, little research has focused on the Haitian population, despite the growing number of Haitians living in the United States. This paper discusses clinical observations of the expression of depression among Haitian immigrant women living in the United States. Specifically, this paper examines three distinctive types of depression (pain in the body, relief through God, and fighting a winless battle), explains their symptoms, and provides case examples to illustrate the expression of each type of depression. Additionally, the paper describes treatment processes for each type of depression and makes recommendations to mental health providers with respect to each type of depression. The information provided in this paper highlights the importance of a more systematic and scientific investigation of depression among Haitian women, men, and youths in the United States.





Confl Health. 2009 Mar 24;3:4.

Mortality, violence and access to care in two districts of Port-au-Prince, Haiti.

Ponsar F, Ford N, Van Herp M, Mancini S, Bachy C.

M?decins Sans Fronti?res, 94 rue Dupr?, Brussels, Belgium.
Frederique.ponsar@brussels.msf.org.

ABSTRACT: BACKGROUND: Towards the end of 2006 open conflict broke out between
United Nations forces and armed militia in Port-au-Prince, Haiti. Fighting was
most intense in the district of Cit? Soleil. METHODS: A cross-sectional,
random-sample survey among the conflict-affected populations living in Cit?
Soleil and Martissant was carried out over a 4-week period in 2006 using a
semi-structured questionnaire to assess exposure to violence and access to health
care. Household heads from 945 households (corresponding to 4,763 people) in Cit?
Soleil and 1,800 household (9,539 people) in Martissant provided information on
household members. The average recall period was 579 days for Cit? Soleil and 601
days for Martissant. RESULTS: In Cit? Soleil 120 deaths (21 children) were
reported (CMR 0.4 deaths/10,000 people/day; <5 MR 0.5 deaths/10,000/day) while in
Martissant 165 deaths (8 children) were reported (CMR 0.3/10,000 people/day; <5
MR 0.2/10,000 people/day). Violence was reported as the main cause of adult
mortality in both locations (mainly gunshot wounds) accounting for 29.2% of
deaths in Cit? Soleil and 23% of deaths in Martissant. 22.9% of families in Cit?
Soleil and 18.6% in Martissant reported at least one victim of violence.
Destruction of property and belongings was common in both Cit? Soleil (52.4% of
families) and Martissant (14.9%). Access to health services was limited, with 11%
(22/196) of victims of violence in Cit? Soleil and 23% (49/212) in Martissant
unable to access care due to insecurity or lack of money. DISCUSSION:
Extrapolating to the total population of these two districts some 2,000 violent
deaths occurred over the recall period. Among the survivors, violence had lasting
effects in terms of physical and mental health and loss of property and
possessions.

Joe Thornton, M.D.

 

[Pathfinder]

Re: Haiti - Mental Health Issues

January 15, 2010 |

Are Infectious Diseases Now Really Haiti's Biggest Health Threat?

Despite much concern about diseases spreading through Haiti's earthquake-shattered areas, one epidemiologist explains that mental health issues will be more widespread

By Katherine Harmon

As the aftershocks of the January 12 magnitude 7.0 earthquake outside of Port-au-Prince, Haiti, taper off and the dust settles, new needs are coming to light. The health of many of the three million residents said to have been shaken by the quake will be determined in the coming weeks as aid workers and others rush to treat the wounded, provide food and water, and try to prevent disease outbreaks.

snip

So what is the rate of mental illness likely to be after an event like this?

In the first month after the event I would not be surprised to see 16 percent of the population with post-traumatic stress and a similar number—about 20 percent—with depression. That's a huge part of the population: about one in five.

You will find about half of the cases resolve about six months after the event.

Do you think there will be adequate ways to deal with this in Haiti?

This is part of the challenge with events that happen in poorer countries that don't have the infrastructure to deal with people trying to go back to normal life. I worry that there is not going to be the resources to deal with the overwhelming need that there's going to be.

http://www.scientificamerican.com/article.cfm?id=haiti-disease-mental-health&page=2

 

[AlaskaDenise]

Re: Haiti - Mental Health Issues

THE TASK AT HAND ..

I am posting a few more abstracts on Haitian mental health. The issue at hand covers several distinct tasks: (1) immediate care of survivors with respect to mental health; (2) long term psychological impact of the disaster on the survivors, ..........

The most immediate task now is two fold: rebuild the natural social networks and align the emergency response to the culture. Locally we can all reach out to members of the Haitian community or those who have contacts in the community to help expand the connections locally and to help re-establish the network of the Haitian Diaspora. .........Joe Thornton, M.D.

Some normalcy:

Haiti earthquake: Hymns and hope on a Sunday

From impromptu services held in streets outside damaged houses of worship to the hymns that can be heard resonating throughout the city, Haitians have come out on Sunday seeking strength as they look to recover and reconstruct everything that they have lost....

(snipped)

?Being in church, praying is transforming people in this time,? says Inesse Joseph, an evangelical pastor dressed in a denim beret and bright-blue dress who has been giving services all day.

Even for those who lost everything, church has brought back a sense of normalcy when everything else remains so unfamiliar around them....

Families walked in streets Sunday morning, Bibles in their hands, looking for services.

Claudy Laurore's church was closed, so he joined a service in the street three blocks away, where churchgoers raised their palms to the air, some sitting on chairs in the streets, others standing for hours at a time. Outside the cathedral, a blind man strummed his guitar, singing about the deaths of his father and sister.

?What happened to Haiti, you cannot put into words,? he sings. ?There are not enough tears for the sorrow.?

People stand around listening, the only solace many will receive today....


?We need so much hope right now,? says Duliepre Arnous, who plays the electric guitar in the church band and says music has soothed him in recent days.

In other parts of town, where the damage was much more widespread and those without homes set up camps, church services gave them a moment of respite from the realities they are experiencing right now: many of them have no access to bathrooms and little food, water, or medical care.

Ms. Joseph, the pastor, has been giving services in the settlements, already doing three.

?We are praying so that all of Haiti, our whole family, gets back their hope and their joy,? she says.

.

 

[Emily]

Re: Haiti - Mental Health Issues

http://www.newscientist.com/article/mg20527441.200-how-the-us-exports-its-mental-illnesses.html?full=true
How the US exports its mental illnesses
20 January 2010 by Ethan Watters
"IN THIS age of globalisation, you would expect people to value and be sensitive about their local differences and diversity. And few areas could be more critical than different peoples' understanding of the human mind when it comes to mental health and illness.

For example, a Nigerian man might experience a culturally distinct form of depression by describing a "peppery" feeling in his head, while a Chinese farmer might speak only of shoulder or stomach aches. Salvadorean women refugees suffering psychological trauma after a long civil war, on the other hand, often experience something called calorias, a feeling of intense body heat.

For a long time, psychiatrists and medical anthropologists studying mental illness in different cultures found that mental illnesses are not evenly distributed globally, and do not take the same form from place to place. Unfortunately, mental health professionals in the US, who dominate the global discussion about how mental illnesses are categorised and treated, have often ignored or dismissed these differences.

Worse, local versions of mental illnesses are now being homogenised into American versions at an extraordinary rate. This is why I wrote Crazy Like Us, in which I explore the spread of four illnesses: post-traumatic stress disorder, anorexia, schizophrenia and depression. In this essay, I concentrate on two western forms of mental illness - depression and PTSD - which are spreading around the world with the speed of a contagious disease, bulldozing indigenous forms of mental illness as they go.

Two powerful but different forces are driving this. The diagnosis of PTSD is being spread by roving bands of western trauma counsellors who set up psychological first aid centres after wars and natural disasters...."

 

[Pathfinder]

Re: Haiti - Mental Health Issues

Med Center Doctors Return From Haiti
Wish they could've done more

Posted:8:46 PM Jan 31, 2010​

Reporter:WOWT

Excerpts:​

Two physicians from the University of Nebraska Medical Center and the Nebraska Medical Center Response Team arrived back in Omaha Sunday after spending a week in earthquake-ravaged Haiti.​

?Some of them have lost their whole families and no longer talk. It's just completely silent, so how do you heal the hearts of so many people who have been through such a traumatic event??​

http://www.wowt.com/news/headlines/83217987.html​

 

[Pathfinder]

Re: Haiti - Mental Health Issues

Haiti health emergency in new phase: Helping fragile, vulnerable minds after quake catastrophe

By Frank Bajak (CP) ? 20 hours ago

PORT-AU-PRINCE, Haiti ? The battered bodies may be mending, but the minds still struggle.

As many as one in five Haiti earthquake victims have suffered trauma so great with the multiple shock of lost homes, jobs and loved ones that they won't be able to cope without professional help, doctors say.

In a country where mental health services barely existed before the quake, building the required support is a huge challenge. The symptoms can't be diagnosed by stethoscopes, blood tests and X-rays, and can take time to surface after the initial shock of the disaster.

"It's not about immediate psychological counselling," said Dr. Lynne Jones, a senior medical adviser for the International Medical Corps. "It's about assisting mourning. People cannot recover if their social needs are not met."

Jones, a veteran of natural disasters and wars from Bosnia to Indonesia, is teaching front-line doctors how to identify "disabling fear" and, quite literally, hold people's hands and listen.

Much more at:
http://www.google.com/hostednews/canadianpress/article/ALeqM5hV0qlP4UTyNcf_-uVMGViv4CBQxA

 

[Thornton]

Re: Haiti - Mental Health Issues

The New York Times has an audio slide show and article today entitled "In Haiti, Mental Health System is in Collapse." They probably used the word collapse to tie in with the earthquake, but they actually are describing a new construction for the mental health system in Haiti.

The content of the articles do quote the psychiatry consultants describing a desire to help teach primary care providers to treat serious mental illness in the community. However, there is little in the article to show what effort is to develop a Haitian mental health system versus imposing a Western Mental Health system on a poor country. An example is a class on psychotropic medications that list the names of patent protected drugs, and a discussion on how hard it is to get prescriptions filled. This type of intervention by consultants is almost the same as you would find in any large urban American city just under more extreme circumstances.

I hope the Times will follow up with a Haitian perspective from the city and rural areas on how they would envison a new health system.

The audio slide show link is
http://www.nytimes.com/interactive/2010/03/20/world/americas/20100320-haitimental-audioss/index.html

The article may require free registration
http://www.nytimes.com/2010/03/20/world/americas/20haiti.html?pagewanted=2&th&emc=th