Implementation, Cultural Acceptability, and Impact of a Mental Health Program for Haitian Healthcare Workers Developed after the 2010 Earthquake

Sunday, 27 July 2014: 10:50 AM

Rosina Cianelli, PhD, MPH, RN, FAAN1
Nilda (Nena) Peragallo, DrPH, RN, FAAN1
Carole Wilkinson, DNP, RN2
Emma Mitchell, PhD, RN2
Victoria B. Mitrani, PhD2
Debbie Anglade, BSN2
Marie Guerda Nicolas, PhD3
(1)Schol of Nursing and Health Studies, University of Miami, Coral Gables, FL
(2)School of Nursing and Health Studies, University of Miami, Coral Gables, FL
(3)Educational & Psych Studies, University of Miami, Coral Gables, FL

Purpose: The purpose of this presentation is to describe the implementation, the cultural acceptability, and the impact of a Mental Health Training Program conducted in the north of Haiti after the 2010 earthquake.                                                                                                         

Methods: A qualitative descriptive approach was used to elicit information from 2 focus group (n=15) with Haitian health care workers who had participated in the Mental Health Training Program (MHTP).  The researchers obtained information through group discussion using a semi-structured guide. Two focus groups were conducted with eight (8) MHTP trainers in one group and eight (8) MHTP trainees in the other group (in total 113 health care workers participated in the MHTP). Discussions centered on the cultural factors related to the design and implementation of the MHTP training as well as professional impact and acceptability of the training program. This study used qualitative content analysis to identify and define the major themes that emerged from the focus groups. Content analysis is used to recognize code and categorize patterns from text data. More specifically, when analyzing the transcripts directed content analysis was used. This approach is recommended when there is prior literature related to the phenomenon of interest that can benefit from further description. NVIVO (9) was used to conduct the analysis and to facilitate data storage. Two research team members, working independently, read through and coded each transcript. A codebook and coding sheet were developed to facilitate coding.                                                                                                              

Results: The majority of the 16 participants were women (83.3%), with a mean age of 36 [1] 10.0 years (range = 24–54 years). Eight participants (50%) were single, 5 (31.3%) were married and 3 (18.7%) were in a relationship. Two participants (12.5%) reported working with no salary, 3 (18.7%) worked part-time, 8 (50.0%) worked full-time and 3 (18.7 %) worked in multiple locations or sites. Eight (50%) participants were nurses, 6 (37.5 %) were physicians and 2 (12.5%) were in other professions. Only one of the participants had formal training in mental health. All participants recognized the need for increasing MH services and the barriers that exist to implement mental health programs in Haiti. Especial consideration was given to stigma and culturally influenced perceptions of mental health. Personal impact of the MHTP was described not only in terms of HCWs’ personal lives, but also in terms of their personal development as healthcare providers. The training allow the HCWs to give quality service to the population by providing them with more specialized skills in identifying and addressing mental health issues. Many changes have been made were the MHTP trainers now focus on dialogue, support, and follow ups with the patients. Participants were not only motivated to participate actively in the MHTP but also were readily engaged to apply knowledge in practice.            

Conclusions: The study findings contribute to the knowledge base on mental health training among HCWs in Haiti. Given the lack of research on mental health in Haiti, it is indispensable to improve our understanding of the personal and professional impact and acceptability of the MHTP. This knowledge will help us implement the MHTP in other parts of Haiti as well as in other countries. The MHTP changed the HCWs perceptions about MH issues and provided them with the knowledge and skills to respond to growing community MH needs. The interdisciplinary nature of the MH calls for collaborative research efforts nationally and internationally. The MHTP can be applicable to other countries in the region and can prepare nurses to recognize and address the immediate and longer term mental health needs arising from catastrophic events. By increasing disaster response awareness, nurses can develop appropriate interventions to combat the negative mental health effect of natural disaster.