A Pilot Initiative to Deliver Community-based Psychiatric Services in Rural Haiti After the 2010 Earthquake

Background: Worldwide, there is a gap between the burden of mental distress and disorder and access to mental health care. This gap is particularly large in low- and middle-income countries (LMICs). After the 2010 earthquake in Haiti, the international health care organizations Partners in Health an...

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Autores principales:	David J. Grelotti, Amy C. Lee, Joseph Reginald Fils-Aimé, Jacques Solon Jean, Tatiana Therosmé, Handy Petit-Homme, Catherine M. Oswald, Giuseppe Raviola, Eddy Eustache
Formato:	article
Lenguaje:	EN
Publicado:	Ubiquity Press 2016
Materias:	Caribbean region community-based psychiatric and neurologic care delivery global mental health implementation World Health Organization Mental Health Gap Action Programme (WHO mhGAP) Infectious and parasitic diseases RC109-216 Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/340fa6339aa843eca533d2682e3b4ecf
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spelling	oai:doaj.org-article:340fa6339aa843eca533d2682e3b4ecf2021-12-02T03:52:56ZA Pilot Initiative to Deliver Community-based Psychiatric Services in Rural Haiti After the 2010 Earthquake2214-999610.1016/j.aogh.2015.08.028https://doaj.org/article/340fa6339aa843eca533d2682e3b4ecf2016-03-01T00:00:00Zhttps://annalsofglobalhealth.org/articles/1476https://doaj.org/toc/2214-9996Background: Worldwide, there is a gap between the burden of mental distress and disorder and access to mental health care. This gap is particularly large in low- and middle-income countries (LMICs). After the 2010 earthquake in Haiti, the international health care organizations Partners in Health and Zanmi Lasante worked to expand local mental health services in rural Haiti. Objective: The aims of this study are to describe clinical characteristics of the patients served during a pilot project to deliver community-based <a title="Learn more about Psychiatric Service" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/psychiatric-service">psychiatric services</a> in rural Haiti and to show how this experience complements the Mental Health Gap Action Programme (“mhGAP”), a tool developed by the World Health Organization to support mental <a title="Learn more about Delivery of Health Care" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/delivery-of-health-care">health care delivery</a> by nonspecialists in LMICs. Methods: The pilot was conducted in March 2011. A visiting psychiatrist traveled to rural Haiti and paired with local clinicians to evaluate patients and to support quality improvement practices in psychiatric care. Patients received a standard neuropsychiatric evaluation. mhGAP was an important clinical reference. To assess the experience, we conducted a retrospective chart review of outpatient encounters. Findings: Sixty-five patients presented with a wide range of common psychiatric, neurologic, and general medical conditions. Forty-nine of these patients (75%) reported primary problems subsumed by an mhGAP module. Fifteen patients (23%) reported headache as their chief complain, a condition that is not currently covered by mhGAP. Surprisingly, only 3 patients (5%), reported earthquake-related distress. Conclusions: Our clinical data reinforce the need for provision of standard psychiatric and neurologic services in LMICs. Such services ought to accompany interventions targeted specifically at disaster-related problems. Clinical situations falling outside existing mhGAP modules inspired the development of supplemental treatment protocols. These observations informed coordinated efforts at Zanmi Lasante to build a sustainable, integrated mental health system in Haiti that may be relevant to other resource-limited settings.David J. GrelottiAmy C. LeeJoseph Reginald Fils-AiméJacques Solon JeanTatiana TherosméHandy Petit-HommeCatherine M. OswaldGiuseppe RaviolaEddy EustacheUbiquity PressarticleCaribbean regioncommunity-based psychiatric and neurologic care deliveryglobal mental healthimplementationWorld Health Organization Mental Health Gap Action Programme (WHO mhGAP)Infectious and parasitic diseasesRC109-216Public aspects of medicineRA1-1270ENAnnals of Global Health, Vol 81, Iss 5, Pp 718-724 (2016)
institution	DOAJ
collection	DOAJ
language	EN
topic	Caribbean region community-based psychiatric and neurologic care delivery global mental health implementation World Health Organization Mental Health Gap Action Programme (WHO mhGAP) Infectious and parasitic diseases RC109-216 Public aspects of medicine RA1-1270
spellingShingle	Caribbean region community-based psychiatric and neurologic care delivery global mental health implementation World Health Organization Mental Health Gap Action Programme (WHO mhGAP) Infectious and parasitic diseases RC109-216 Public aspects of medicine RA1-1270 David J. Grelotti Amy C. Lee Joseph Reginald Fils-Aimé Jacques Solon Jean Tatiana Therosmé Handy Petit-Homme Catherine M. Oswald Giuseppe Raviola Eddy Eustache A Pilot Initiative to Deliver Community-based Psychiatric Services in Rural Haiti After the 2010 Earthquake
description	Background: Worldwide, there is a gap between the burden of mental distress and disorder and access to mental health care. This gap is particularly large in low- and middle-income countries (LMICs). After the 2010 earthquake in Haiti, the international health care organizations Partners in Health and Zanmi Lasante worked to expand local mental health services in rural Haiti. Objective: The aims of this study are to describe clinical characteristics of the patients served during a pilot project to deliver community-based <a title="Learn more about Psychiatric Service" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/psychiatric-service">psychiatric services</a> in rural Haiti and to show how this experience complements the Mental Health Gap Action Programme (“mhGAP”), a tool developed by the World Health Organization to support mental <a title="Learn more about Delivery of Health Care" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/delivery-of-health-care">health care delivery</a> by nonspecialists in LMICs. Methods: The pilot was conducted in March 2011. A visiting psychiatrist traveled to rural Haiti and paired with local clinicians to evaluate patients and to support quality improvement practices in psychiatric care. Patients received a standard neuropsychiatric evaluation. mhGAP was an important clinical reference. To assess the experience, we conducted a retrospective chart review of outpatient encounters. Findings: Sixty-five patients presented with a wide range of common psychiatric, neurologic, and general medical conditions. Forty-nine of these patients (75%) reported primary problems subsumed by an mhGAP module. Fifteen patients (23%) reported headache as their chief complain, a condition that is not currently covered by mhGAP. Surprisingly, only 3 patients (5%), reported earthquake-related distress. Conclusions: Our clinical data reinforce the need for provision of standard psychiatric and neurologic services in LMICs. Such services ought to accompany interventions targeted specifically at disaster-related problems. Clinical situations falling outside existing mhGAP modules inspired the development of supplemental treatment protocols. These observations informed coordinated efforts at Zanmi Lasante to build a sustainable, integrated mental health system in Haiti that may be relevant to other resource-limited settings.
format	article
author	David J. Grelotti Amy C. Lee Joseph Reginald Fils-Aimé Jacques Solon Jean Tatiana Therosmé Handy Petit-Homme Catherine M. Oswald Giuseppe Raviola Eddy Eustache
author_facet	David J. Grelotti Amy C. Lee Joseph Reginald Fils-Aimé Jacques Solon Jean Tatiana Therosmé Handy Petit-Homme Catherine M. Oswald Giuseppe Raviola Eddy Eustache
author_sort	David J. Grelotti
title	A Pilot Initiative to Deliver Community-based Psychiatric Services in Rural Haiti After the 2010 Earthquake
title_short	A Pilot Initiative to Deliver Community-based Psychiatric Services in Rural Haiti After the 2010 Earthquake
title_full	A Pilot Initiative to Deliver Community-based Psychiatric Services in Rural Haiti After the 2010 Earthquake
title_fullStr	A Pilot Initiative to Deliver Community-based Psychiatric Services in Rural Haiti After the 2010 Earthquake
title_full_unstemmed	A Pilot Initiative to Deliver Community-based Psychiatric Services in Rural Haiti After the 2010 Earthquake
title_sort	pilot initiative to deliver community-based psychiatric services in rural haiti after the 2010 earthquake
publisher	Ubiquity Press
publishDate	2016
url	https://doaj.org/article/340fa6339aa843eca533d2682e3b4ecf
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A Pilot Initiative to Deliver Community-based Psychiatric Services in Rural Haiti After the 2010 Earthquake

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