October 10th was World Mental Health Day, and for the second year PIH/Zanmi Lasante mental health and psychosocial staff spent the day, and the entire month, raising awareness of mental health services available at PIH/ZL clinics and educating communities about signs and symptoms of common mental disorders.
From radio shows to trainings with school teachers, key community leaders, youth and community health workers, to large mass-mobilization events complete with music, sports events and question-and-answer contests, to community meetings and debates in schools and churches, events took place throughout October at each of PIH/ZL’s clinics and hospitals.
This year's theme, selected by the Haitian Ministry of Health and the national mental health working group, focused on "having a clear mind for ensuring a strong body" – "Ak tet klè kò a pi djanm" in Haitian Creole. In countries with small health budgets, like Haiti, roughly 2 percent of financial and human resources are allocated to mental health, according to the WHO, despite a global disability burden of approximately 13 percent.
Mental health in Haiti since the 2010 earthquake
Since the 2010 earthquake, PIH’s Mental Health program has been dedicated to finding, supporting and treating both psychosocial and acute mental health needs in the communities we serve. Following the earthquake the Haitian Ministry of Health asked PIH/ZL to support the Ministry's leadership in developing a national mental health response to the disaster. PIH/ZL proposed a two-pronged approach. First, mental health services must be decentralized. A key component of this includes training community health workers and nurses to find and refer people suffering from mental disorders.
Second, mental health services much be integrated into larger, comprehensive health systems. Since 1987, PIH/ZL has successfully introduced programs to prevent and treat infectious diseases such as HIV/AIDS and tuberculosis. These programs integrate the treatment for specific diseases into comprehensive health programs. Today, PIH/ZL is working to doing the same with mental health services.
The PIH Mental Health program has worked to link training and education, research and advocacy missions to the delivery of critical mental health services in collaboration with the Program in Global Mental Health and Social Change at Harvard Medical School. This has included the awarding of a US NIMH grant focused on the development of a school-based mental health intervention for youth in Haiti's Central Plateau, led by ZL Mental Health and Psychosocial Services Director Father Eddy Eustache, and Dr. Anne Becker of Harvard Medical School. Also this year, PIH and Harvard Medical School launched the Dr. Mario Pagenel Fellowship in Global Mental Health Delivery.
Treating those in need
The program is also working to integrate mental health services at PIH/ZL sites. Sixteen months after the earthquake, PIH/ZL staff had documented 20,000 individual and group appointments for mental health and psychosocial needs across Port-au-Prince and PIH/ZL’s 12 clinics and hospitals.
Whether injured in the earthquake, suffering from cholera or affected by longstanding mental illness, people have been able to reintegrate into their communities – returning to jobs, church, choir and school – after receiving mental health care from PIH/ZL. These efforts have had the added effect of reducing stigma and changing perceptions around mental health. As a result, there is growing awareness and enthusiasm about the need for these services in the community and the medical system.
To keep this momentum going, PIH/ZL is expanding its education services while continuing to find and treat men, women and children requiring mental health services – all free of charge.
Proving that mental health care can be delivered in developing countries
In October, PIH advocated for mental health in developing countries in the medical journal Lancet. In the commentary PIH Mental Health Director Giuseppe Raviola and PIH co-founder Paul Farmer, with Dr. Becker, underline the need for greater inclusion of mental health into the global health agenda, reflecting a truly “global scope for global health.”