Expert Commentary: Mental Health and Haiti

Article excerpt

The disastrous earthquake that hit Haiti in January not only illuminated the remarkable resilience of the Haitian people. It also galvanized medical efforts. Doctors and nurses, orthopedic surgeons, infectious disease specialists from the military as well as from civilian life, have given of themselves brilliantly.

But what about the population's psychiatric and psychological needs? As we know, these needs also must be addressed (see "In Haiti, Mental Health System Is in Collapse," The New York Times, March 19, 2010, p. 1).

Providing mental health care to Haitian patients requires particular sensitivity. After all, the world view of Haitians is unique. We must try to understand, for example, the extent to which spiritual beliefs and practices shape attitudes about mental illness and compliance with treatment in Haiti (Am. J. Psychother. 2002;56:508-21).

Considering the devastation Haitians have experienced--and continue to experience--we can be sure that countless Haitians are suffering from posttraumatic stress disorder. PTSD can lead to depression, suicide, and aggressive and homicidal behavior, in addition to flashbacks, nightmares, and unbridled anxieties.

Medication management and supportive therapy, including group therapy, are helpful in treating PTSD. But it is my experience that some form of relaxation therapy, coupled with guided imagery using behavioral techniques such as reciprocal inhibition and systematic desensitization, generally works best in treating this disorder.

These behavioral techniques can be taught to many groups of nonpsychiatric health care providers. Just as surgical and general medical care tries to reach as many people as possible, by instructing health care professionals in these psychological techniques, we would be providing a broad-based psychiatric/psychological approach to the many who will be in need and will be helped.

My understanding is that only a small number of mental health professionals were in Haiti before the disaster, and I would guess that few are in the country today. But there are ways we can help some patients. I would propose teaching those interested medical personnel who want to offer care for PTSD a basic hypnotic/relaxation technique, as described in The New York Times piece. It's straightforward, and it uses deep breathing exercises and a focus on simply learning how to relax one's muscles or muscle groups. This approach would be quite similar to those used by yoga instructors or meditation experts for years in classes and seminars to help control anxiety. …