Mental Health Initiative in Haiti

1. Mental Health Initiative in Haiti Jen Horner BA1, Zupenda Davis MPH, MCHES1, Shonta D. Collins RN, BSN, MPA, MSN-FNPc2, and Crystal Taylor Psy.D2 1Drexel University School of Public Health, 2Explorers Sans Frontières Purpose With Explorers Sans Frontières further expanding their services in Haiti to include mental health, it was important to develop specific goals and objectives for this program. Additionally, best practices to use with this population needed to be established and then disseminated to all appropriate ESF and Haitian staff. When dealing with mental health issues after a natural disaster, the signs and symptoms translate across all continents. However, the ways in which victims of disaster deal with their symptoms varies based on cultural norms. The purpose of this project was to further expand upon ESF’s mental health mission and sort out interventions that would be the most effective in reaching this population. • Deliverables • Mental health goals and objectives for both local Philadelphia outreach efforts, as well as goals for Haitian outreach • Comprehensive list of mental health Mindfulness exercises that are best to be used in both Philadelphia and/or Haiti, to be translated into Creole and French for the Haitian component. • Implications • Further research is needed to determine other effective mental health interventions for the Haitian population to expand efforts further. Additionally, these Mindfulness techniques need to be piloted in the Haitian community so revisions can take place. Background Information Explorers Sans Frontières (ESF) is a non-profit organization based in Philadelphia. Founded in 2007 by Shonta D. Collins, ESF originally focused its efforts on reducing health disparities within Philadelphia by partnering with a variety of other organizations in support of their mission. Since its inception, ESF has expanded to tackle global health concerns in Senegal. Most recently, ESF has broadened its scope even further as a result of the Haitian earthquake of January 2010. Problem Statement Following the devastating earthquake in Haiti which killed an estimated 300,000 people, many members of the Haitian community were left with minimal resources and support to deal with the aftermath of this natural disaster. One of the key components missing from their recovery is mental health services that address their emotional needs in dealing with the trauma of being displaced, losing a loved one, or being traumatized from the experience itself. Many Haitian mental health professionals have not returned, leaving much of the population without these vital services many needed before the earthquake, and many more need in its aftermath. Sustainability ESF staff will be in Haiti in June 2011. Pending the approval of the chosen Mindfulness exercises and their translation into Creole and French, these exercises will then be taught to staff to be implemented during trips to Haiti. Revisions will be done as needed to ensure these mental health techniques are effective in reaching this population. Findings In addressing the mental health needs of Haitian adolescents and adults, traditional “American” forms of therapy were not effective. These individuals, culturally, are not used to opening up and “sharing” their feelings in the same way as Americans. As a result, the best practice for this population was determined to be using Mindfulness techniques. What is Mindfulness? Mindfulness involves intentionally bringing one’s attention to the internal and external experiences occurring in the present moment. It is often taught using meditation exercises. Why Mindfulness? Mindfulness exercises give the Haitian population an outlet in which they can release stress felt mentally and somatically. Once learned, these exercises can be done without the assistance of mental health staff. Have everyone stand up and spread out. Pass out blindfolds to each person. A group facilitator will go around and whisper to each person a name of an animal (bear, horse, snake, frog, duck, pig, etc.). Make sure there are pairs of the same animal sound, because the object of this game is to find the same animal in the group as you are. Tell the group, “When I ring the bell three times, you are to start making the sound of the animal I whispered to you. Your goal is to find the same animal in the room with the blindfold on. When you process this exercise at the end, discuss how clients had to “throw themselves in” and let go of self-consciousness, fear of failure, judgment, etc. Animal Sounds Have clients focus on something in the room. While they are doing this, have them become mindful of their breath. Tell them to count their breath. Breathe in, that’s one. Breathe out, that’s two, and so on. Have them go all the way to ten and then start back at one. Tell your clients that if a thought, urge, distraction, etc. comes into their mind, just notice it and turn their mind back to counting their breath. If they lose count, start back at one. Get clients to learn how to “describe” using “JUST THE FACTS”. Remind them to describe “just what they know”, “only what they observe”, “add nothing, subtract nothing”. Put objects on the table (a flower, a shoe, etc.) Instruct clients to describe each object one at a time using their describe skill. If clients feel you are “nit picking”, tell them to just “observe” this, use a “non-judgmental stance” and to get back to using “just the facts”. Tie in the fact about how we tend to assume things as they are and usually our assumptions are wrong. Get them to look at “what is” (reality) and respond from there. Observing Your Breath Nit Pickin’ Acknowledgements Shonta D. Collins, RN, BSN, MPA, MSN-FNPc Crystal Taylor, Psy.D