Introducing Problem Management plus (PM+) to Haiti

WHAT HUMANITARIAN NEED IS BEING ADDRESSED?

Haiti is faced with numerous humanitarian crises including long-running political and economic instability, pervasive gang violence, and the impacts of successive major disasters. Such unstable circumstances have serious impacts on mental health with both specific traumatic events and ongoing stress increasing the prevalence of PTSD, depression and anxiety. Psychological distress is highly prevalent in Haiti’s slum communities, with 86% of people assessed reporting distress (Tymejczyk et al, 2020). Despite this clear need, mental health services in Haiti are extremely scarce, with only 23 psychiatrists and 124 psychologists to support a population of 11 million.

WHAT IS THE INNOVATIVE SOLUTION AND HOW WILL IT IMPROVE EXISTING HUMANITARIAN PRACTICE?

Team members from SOS Children’s Villages Haiti will be trained to deliver Problem Management + (PM+) to young adults and caregivers they work with in existing social and humanitarian programmes. By integrating this mental health service into ongoing programmes, the service will reach those who need it more quickly.

PM+ has been developed and verified by WHO to provide mental health support for people in humanitarian settings. This programme will aim to demonstrate that it is possible to replicate, contextualise and scale PM+ in a new high severity setting.

The programme aims to train up 50 existing SOS Children’s Villages’ staff to deliver PM+, 10 of whom will become trainers of trainers, and collectively they will provide mental health support to over 300 people within the 12-month programme.

The model is scalable as the trainers of trainers will be equipped to deliver PM+ training within Haiti after the programme.

EXPECTED OUTCOMES

We will contextualise PM+ for Haiti, producing resources for the training and delivery of PM+ that will be appropriate for use across Haiti, and a pathway for similar replication of PM+ in other countries.

Non-mental health specialists will be trained as PM+ Trainers who will train a wider pool of SOS Children’s Villages’ staff in PM+. This will enable community management of low-level mental health conditions such as depression and anxiety. This will reduce the burden on the public health system and address the resource gap for clinical management of more severe mental health conditions.

Young people and caregivers in Haiti will demonstrate improved mental health outcomes. A cascaded training model for non-mental health specialists will enable SOS Children’s Villages to implement PM+ in other high-severity locations both within Haiti and in other countries.

An evaluative research paper will assess the effectiveness and efficacy of the cascaded, task-shifting model.