HDI in Haiti
Working in cooperation with the University of Notre Dame d’Haiti, HDI is developing a system for community-based mental health care and treatment where there is no infrastructure. So far, about 100 children have received effective counseling services.
In a land where trauma is commonplace, where an estimated 200,000 children serve as domestic slaves, and where the 2010 earthquake displaced 1.5 million people, HDI is working with the University of Notre Dame d’Haiti (UNDH) to build a countrywide system of accessible and effective mental health services for children (and eventually adults and families) through community partnerships.
With support from the Equitas Foundation, HDI began by working with UNDH to build capacity for the care of children caught in the practice of restavek, which occurs when poor, rural families give their children to relatives or acquaintances in cities in hopes of gaining greater opportunities. These children frequently suffer physical and sexual abuse, and are more likely to become the victims of human trafficking. The Restavek Freedom Foundation estimates that 1 in 15 children in Haiti lives in slavery.
Child advocates with the Restavek Freedom Foundation often carry caseloads of 50 to 70 children.
The focus during the first year of this initiative was on cultural adaptation and validation of a spiritually-oriented treatment model for traumatized children. HDI then co-led workshops aimed at building local Haitians’ capacity to offer counseling services, partnering with the Restavek Freedom Foundation, le Centre de Spiritualité et de Santé Mentale (CESSA), and Regent University’s Child Trauma Institute. Dr. Boan said, “We found people hungry for practical skills.”
Rubinson Dorce, a social worker and theologian, says of one three-day training, “This is what my country needs . . . You cannot imagine the consequences of your teaching in Haiti. The effects will spread generations after our deaths. Maybe future generations will forget your names, but they won’t forget your work.”
The second year of the project focused on running clinical trials to test the effectiveness of the intervention. Results from this trial showed that the children demonstrated a decrease in post-traumatic stress disorder symptoms and spiritual struggles and an increase in positive spiritual practices following the intervention. The second year also involved adapting and expanding the strategy to include community NGO staff and church volunteers as counselors. Their services were also shown to be effective, providing a source for expanding the services to children.
In year three, the emphasis has expanded further to build greater local capacity and transition the management of the project over to a coalition of local Christian colleges, schools, as well as community groups led by UNDH. So far, about 100 children who would otherwise not receive care have received effective counseling services, and that number will continue to rise.
Participating community organizations have received training for their staff and incorporated elements of the program into their own portfolio of services. Starting this year, additional schools are joining the partnership and developing services for their communities. HDI will continue to play the role of providing evaluation, evidence, and training for the community and academic coalitions now providing mental health services.
Viola Valcin Psy.D. ’18 (third from left) worked with this group to develop a program for a potential extension for the counseling center in Haiti, and also collaborated with the University Notre Dame d’Haiti to build capacity for a treatment program for restavek children.