Taskshifting: translating theory into practice to build a community based mental health care system in rural Haiti. Issue 3 (November 2015)

• Record Type: Journal Article
• Authors: Legha, Rupinder; Eustache, Eddy; Therosme, Tatiana; Boyd, Kate; Reginald, Fils-Aime; Hilaire, Gertruna; Daimyo, Shin; Jerome, Gregory; Verdeli, Helen; Raviola, Giuseppe
• Is Part Of: Intervention. Volume 13:Issue 3(2015:Nov.)
• Publication Date: 2015-11
• Subjects: Haiti -- capacity building -- health care: integration of mental health in general health care; Psychiatric social work -- Periodicals; Refugees -- Mental health services -- Periodicals; Mental health counseling -- Periodicals; Armed conflict; Mental Health Services -- Periodicals; Refugees -- Periodicals; War -- Periodicals; Counseling -- Periodicals; Social Work, Psychiatric; Service social psychiatrique -- Périodiques; Réfugiés -- Santé mentale, Services de -- Périodiques; Counseling -- Santé mentale -- Périodiques; Mental health counseling; Psychiatric social work; Refugees -- Mental health services; Periodicals; 362.20425
• DOI: 10.1097/WTF.0000000000000099
• Languages: English
• ISSNs: 1571-8883

Abstract

Abstract : In 2012, Zanmi Lasante, a Haitian nonprofit organisation, along with its sister organisation, Partners in Health, developed a mental health plan intended to go beyond the immediate post earthquake context by building capacity for mental health and psychosocial services within primary care services at 11 Zanmi Lasante sites throughout Haiti's Central Plateau and Artibonite regions. This paper describes laying the foundation for a community based, mental health care system through the articulation of a 'depression care pathway', in which patients are identified and treated within the community, but referred to clinics and more specialised care when required. We emphasise taskshifting clinical, service delivery, systems building, and quality improvement responsibilities to psychologists, the central players in the Zanmi Lasante mental health model. By describing challenges and providing practical, implementable solutions, we highlight how this fundamental theory in global mental health translates into daily practice in a health care setting with limited biomedical services, clinical training and human resources. We also provide recommendations for optimising taskshifting when initiating community based mental health services in similar resource limited settings.