@article{ref1,
title="A pilot initiative to deliver community-based psychiatric services in rural Haiti after the 2010 earthquake",
journal="Annals of global health",
year="2015",
author="Grelotti, David J. and Lee, Amy C. and Fils-Aimé, Joseph Reginald and Jean, Jacques Solon and Therosmé, Tatiana and Petit-Homme, Handy and Oswald, Catherine M. and Raviola, Giuseppe and Eustache, Eddy",
volume="81",
number="5",
pages="718-724",
abstract="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. <br><br>OBJECTIVE: The aims of this study are to describe clinical characteristics of the patients served during a pilot project to deliver community-based psychiatric services in rural Haiti and to show how this experience complements the Mental Health Gap Action Programme (&quot;mhGAP&quot;), a tool developed by the World Health Organization to support mental health care delivery by nonspecialists in LMICs. <br><br>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. <br><br>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. <br><br>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.<br><br>Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.<p /> <p>Language: en</p>",
language="en",
issn="2214-9996",
doi="10.1016/j.aogh.2015.08.028",
url="http://dx.doi.org/10.1016/j.aogh.2015.08.028"
}