[#WHD2017 Blog Series] Inspiring Innovations: Blended Care in Haiti

This blog is part of our series celebrating World Health Day, this year themed “Depression: Let's Talk.” Hear what our community of innovators has to say about the ideas behind their Inspiring Innovations, and how they address depression across the globe.

Here, Akwatu Khenti from CAMH presents his innovation: Blended Care in Haiti, which combines spiritual resources with culturally adapted cognitive behaviour therapy.


Tell us about your country’s context and the circumstances that inspired your innovation.

The reality in Haiti is that there have been very few facilities dedicated to mental health services other than those needed to securely house those that are a risk to themselves or others. There are only approximately two psychiatrists, a psychologist, 10-18 psychiatric nurses and no social workers in mental health serving a population of almost 8 million; moreover, few general physicians have been trained in mental health diagnostics and treatment practices. Because there are so few professionals and support staff designated to deliver mental health services in Haiti, the informal mental health care sector is currently providing the bulk of mental health support: that being spiritual leaders.

What aspect of your project are you most excited about? How is the project innovative or unique?

Our project is unique in drawing upon an abundant human resource across the country; one that already serves as a first point of contact for mental illness. This project engages existing networks of spiritual leaders, both urban and rural, and from Catholic, Protestant and Voodoo denominations, in an effort to combine spiritual resources and practices with culturally adapted cognitive behaviour therapy (ca-CBT) methods of mental health treatment and programming. This approach creates linkages between traditional beliefs and modern treatment programs that build on the strengths of each and create synergy in the eyes of persons with mental health problems and their families, by involving Christian and Voodoo priests and practitioners in community-based mental health care efforts.

Have you noticed an impact ‘on the ground’? What is the best feedback you have received (from service users, team members, or otherwise)?

I felt like having gotten rid of a heavy weight, something that weighted heavily on my heart. I feel free. The therapist really counselled me well. She listens to me and understands me. I feel good.

 

I was suffering, I could not eat, my lungs were hurting. Then, I worked with the Mambo and I feel much better.

 

Big changes happened in my life. I no longer am the same person that I was before taking the therapy. Now, I communicate well with everybody, I understand better. This therapy helped me adapt to the system because I was totally disconnected.

 

He helped me think differently. He really changed my life. Now, and it has been a while, I am less stressed. I no longer think the same way. I no longer think pessimistically.

 

Well, what has changed for good is my reasoning capability. I now think before acting and when faced with difficulties, I analyze them and find an answer.

 

I sometimes spend my time thinking about things. It helps me better understand things and now, I react differently. There were days I spent lying down doing nothing. I was thinking about things. You know that I am very stressed. Now, I no longer do this. I do other things, like reading, studying or doing other leisure activities.

Clients are discussing with family/friends/community their experiences of being in therapy and referring others.

What’s next?

We would like to do some form of randomized controlled trial to prove the efficacy of the intervention. Scaling it up across the country is also a consensual dream all the organizers share and want to see happen.

What is the one message about depression you want people to take away from your innovation?

Depression is one mental health problem that can be effectively addressed in a cost effective way by low income countries right away.  There is no need to find or inject huge new resources in order to make good use of existing knowledge and evidence from the worlds of religious and mental health science and wisdom.


To read more about the Innovation, visit the case study page.

To see the other blogs in this series, visit our [#WHD2017 Blog Series].

Region: 
Central America and the Caribbean
Setting: 
Community
Approach: 
Task sharing
Treatment, care and rehabilitation
Disorder: 
Depression/anxiety/stress-related disorders
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