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Realizing Haitians’ other needs

Quake affected mental health

Myrtise Kretsedemas (left) and Edna Laruent-Tellus arranged services for Haitians in Boston. Myrtise Kretsedemas (left) and Edna Laruent-Tellus arranged services for Haitians in Boston. (Essdras M Suarez/ Globe Staff)
By Carolyn Y. Johnson
Globe Staff / March 1, 2010

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In the days after the Haiti earthquake, Gemima St. Louis was engulfed in a sense of powerlessness.

Like others in Boston’s large Haitian community, St. Louis waited for word of her relatives’ fate. Her father, a minister, was traveling to various churches in Haiti when the earth shook on Jan. 12. She frantically tried to reach her brother, who had recently returned there with his two small children, with the dream of starting a business and moving his family back to the island.

But as a psychologist at Boston Medical Center’s SPARK Center, St. Louis also felt a more profound helplessness. She recognized in the images on television a tremendous psychological burden. When she found out that her family had survived, she felt great relief, but also realized that the support and healing they - and thousands of others - would need was just beginning.

“I knew that when my brother and his kids and father came back, they would not be the same people they were when they went down there. It was just not possible for them to not be touched or affected by this in some capacity,’’ St. Louis said. “And then I started thinking about what can we do. . . . As mental health providers - what can we do to be empowered, what can we do to respond.’’

In the weeks since the earthquake, St. Louis and more than a dozen other Haitian mental health providers in the Boston area have begun to draw on their unique blend of personal experience and professional knowledge to found the Haitian Mental Health Network, a group dedicated to providing services and resources to the Haitian community here - and in Haiti.

The psychologists, psychiatrists, and social workers want to ensure that services are informed both by an understanding of mental health and knowledge of the specific psychological, cultural, and spiritual needs of the Haitian community. They are beginning a formal assessment of the mental health needs of the community, organizing support groups at churches, and setting aside on-call times so clinicians here will be available to consult by phone with workers on the ground in Haiti. A delegation of about 35 people from the local Haitian community - most of them mental health professionals - plans to visit Haiti this spring.

The network members emphasized the resilience of Haitians, many of whom have endured previous natural disasters and years of poverty. But Berthonia Antoine, a mental health counselor at the Center for Community Health, Education, and Research in Dorchester, said she has seen earthquake survivors who are in Boston and suffering from acute stress that she fears will turn into full-blown posttraumatic stress disorder.

They are anxious, easily startled, irritable, and haunted by nightmares or fears of being in tall buildings or in an elevator.

“Some said they can’t do the laundry, because on the drying cycle it makes the noise [of the earthquake] and they cannot hear that noise,’’ Antoine said.

Mel Schmid, team leader of the Haitian Mental Health Program at Cambridge Health Alliance, said referrals have increased since the earthquake, and people are showing symptoms of everything from trauma to depression. Some survived the quake and returned to Boston, and others in need of care were affected from afar - by their inability to help family and friends who suffered or died.

Dr. Mathieu Bermingham, a Haitian-American psychiatrist who is medical director of behavioral health services being developed at Children’s Services of Roxbury, and others are working to train providers other than mental health specialists because his research suggests that for Haitians, mental health problems such as depression or anxiety might manifest as vague aches and pains that have no apparent physical cause, drawing people to primary care physicians first. Haitians express grief differently from Americans, too, so another risk would be that intense grieving that might be culturally appropriate could be seen, incorrectly, as a symptom of mental illness, he said. Bermingham feared the worst when his family could not reach his uncle.

“We didn’t have the ability to go quickly to the refuge of any explanation or certainty,’’ Bermingham said.

Given the cultural differences, Haitian caregivers think it essential to ensure diagnoses, support, and treatment are customized for the Haitian community.

“We know that in Haiti, mental health issues are certainly not at the center of the wheel - even in our community here, there are existing stigmas around mental illness and mental health,’’ St. Louis said. “A lot of our fellow brothers and sisters are still going through this trauma so we know the long-term impacts are going to be tremendous, but we want to understand them from their own perspective.’’

Carolyn Y. Johnson can be reached at cjohnson@globe.com.

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