Haiti & mental health challenges

by Tom Gallagher

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"Clearly, mental health has never been a priority in this country [Haiti]."

In early February 2010, I wrote a column on the post-earthquake mental health challenges for Haitians."

The next day The Wall Street Journal reported on the pending revamp of the U.S. manual on mental health, which could dramatically impact the delivery of mental health services in the U.S.

Saturday's New York Times carries a jarring story about the state of psychiatric care in Haiti.

As disasters often do in poor countries, Haiti’s earthquake has exposed the extreme inadequacies of its mental health services just at the moment when they are most needed. Appalled by the Mars and Kline Psychiatric Center, the country’s only hospital for acute mental illness, foreign psychiatrists here have vowed to help the Haitian government create a mental health care system that is more than just an underfinanced institution in the capital city.

“Conditions at Mars and Kline are particularly bad, although this kind of place is not unique to Haiti,” said Dr. Giuseppe Raviola, director of mental health and psychosocial services for the Boston-based Partners in Health, which runs 10 hospitals in Haiti. “Still, now that we’ve seen the hospital in the capital city, it is clear that that we have to treat people in their communities.”

Ultimately, international experts are encouraging the Haitian Health Ministry, which they say is receptive and eager for help, to incorporate mental health care into the primary health care system and to make it available throughout the country.

Right now, though, the need for psychological first aid and emergency psychiatric treatment is so acute that foreign psychiatrists are seeing patients, setting up programs and rapidly training Haitian doctors, nurses and community workers in everything from psychopharmacology to group relaxation techniques. (Before the quake, there were only about 15 psychiatrists in all of Haiti.)"

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