By Macollvie J. Neel and Rachele Viard
BROOKLYN — Sohamy Pinard, a psychiatric nurse practitioner, launched her mental health services practice in November 2019 specifically to help Haitians and other black people. After being in the field for more than a decade, she knew that certain groups would be more receptive to receiving care while in their element.
Coronavirus proved Pinard right. Since the pandemic emerged, she has received more calls per week for the virtual therapy sessions, consultations, and medication services she provides through her practice, AWRNSS.
“People called because they felt alone, and anxiety was the number one [reason],” said Pinard, adding that many ask for Creole-speaking providers. “With mental health, it is a lot. We’re going to need programs for all age groups, more therapists, and Creole-speaking resources.”
“We’re going to need practices, partners, non-profits,” Pinard said. “Each has to put on some type of program and work together [to meet the need].”
For most Haitian-Americans, life was already stressful for a plethora of reasons, practitioners said. With COVID-19 and Black Lives Matter comes heightened stress, anxiety, depression and other conditions — a trend that aligns with a Census Bureau finding that a third of all Americans show signs of clinical anxiety and depression.
Still, within a community that has traditionally dismissed certain behaviors as a phase, kept sensitive health issues under wraps, or relied on prayer to resolve emotional and mental challenges, seeking professional help is a significant change. Now, many said, the onus is on leaders and allies to equip providers to help those in need currently and to address upcoming challenges in the long term.
“These issues will be with us and they will eat at us,” said Dr. Georges J. Casimir, a psychiatrist with SUNY Downstate and NYU Langone Medical Center. “As individuals, we have to take better care of ourselves. Then we have to look at our families, how we raise our children, how we treat each other.
We have to do it as a community.”
Ruth Jean-Marie, an advocate who ran a city mental health initiative targeting Haitians, recommends more culturally nuanced outreach, partnerships, and services for the long term response.
“City government should be pouring money into local organizations that can address these issues in ways that are effective,” Jean-Marie, of Brooklyn, said. “It’s easy to say this person needs a translator. But if the approach is not part of their culture — which could be talking to their pastor, ougan (vodou priest), [and others]— even if the program is useful, they might not use it.
“Ultimately, we need to evolve into different models,” Jean-Marie said.
Going through it to get grounded
Within the community, the trauma of COVID-19’s toll and pervasive racism affects generations in unique ways, the experts said. Feelings of uncertainty, guilt, helplessness, or lack of closure, for example, may manifest as disobedience in children and youth, unhealthy social behaviors among working adults, or and psychosomatic aches and pains in older adults.
For Perpetua Auguste, 29, it was her anxiety that spiked along with the rise in coronavirus cases.
As a hospital nurse, Auguste was caring for COVID-19 patients and handling the taxing process of protecting her health at work and at home. She saw two coworkers fall ill with the disease. Unable to see her family while in quarantine alone, she also worried about her parents, grandmother, sister, and aunt — all of whom had coronavirus symptoms.
Auguste reached out to her therapist, a provider who had helped her the year prior.
“I was fearful to be at work, hearing that ‘cardiac arrest’ [announcement] overheard,” Auguste said. “I literally felt lonely. I felt like I was out of control. I couldn’t get a grip.”
Then, her grandmother Simone Innocent, 91, died from COVID-19.
While grieving the death, the heinous killing of George Floyd sparked anti-racism protests across the country, bringing to the fore microaggressions that Auguste has experienced in the workplace.
“It’s been quite the roller coaster, and I can’t seem to get off,” Auguste said. “The physical, emotional, and mental demands of COVID was just so much. With [the protests], I couldn’t even get to work without dreading it. My anxiety again was through the roof.”
Now, with regular therapy sessions by phone, meditation, yoga, running, hiking and other physical exercises, Auguste said she manages her anxiety. Hanging out with friends and family, albeit while observing social distance precautions, participating in virtual prayer groups, or binge-watching shows all help her feel more grounded.
Her positive experience with therapy has made her more vocal about encouraging her family to talk things out, instead of keeping things bottled up.
“In our community as Haitians, there are a lot of the things that we don’t talk about that is stunting our growth. It’s almost a hindrance,” Auguste said. “It’s hard to get my family on board. We know better, so we try to do better.”
Similarly, painter Garry Mabour had persistent feelings of panic, stress and anxiety while following news of the pandemic. Unable to work out at his gym or to paint, the Pompano Beach, Fla., resident pulled back.
“At first, I couldn’t focus on my art because I was so panicked and stressed,” Mabour, 59, said. “We tried to maintain space and respect social distancing in the house, even eating separately.”
Being sedentary meant Mabour also began to put on weight.
To cope, he now reaches out to friends and other artists and meditates. Slowly, he is resuming painting and trying to check in more with his son and daughter-in-law since they cannot be together.
Combatting old fear and taboo with new outreach tools
While people like Auguste and Mabour are reaching out for support, many more Haitian-Americans are not. Stories abound about parents telling their children to “go to God” and not to share family problems with strangers.
Fear and taboo, for the most part, still keeps a significant number of people who need help from seeking it.
To reach that population, organizations from Boston to New York to South Florida are going online with the resources available, virtual counseling and other services.
“It’s really thinking outside the box,” said Pinard. “What do people engage in right now and how can I incorporate mental health into it at the same time.”
Having video sessions with a client from the comfort of their home, which Pinard does, is one example of meeting people in their element. Tapping into popular trends, such as ‘sip-and-paint’ events, is another way to draw her primarily young clientele. During such events, she gives information and encourages participants to share their emotions and coping strategies.
With social distancing, Pinard is doing more with social media games and apps to engage. Mental health charades, for example, lets players act out how they feel.
Community service groups such as the Haitian-American Community Coalition in Brooklyn and Rebati Sante Mentale in Pembroke Pine, Fla., have promoted their free services online, including on social media.
From June 17 to Aug. 28, HCC will host a mental health forum via Zoom in Haitian Creole to share coping mechanisms. Participants can also speak one-on-one with the therapists after each session, said Dr. Andre Peck, executive director of HCC. Webinars, group counseling sessions and teletherapy, or video counseling, are also available.
Rebati Sante Mentale has provided such webinars as “Haitian Black Men Speak: We Listen” aimed at de-stigmatizing mental health.
“We’re all feeling the same thing and people may be open to share with more family and friends,” said Dr. Guerda Nicolas, a psychologist with the University of Miami and co-founder of Rebati Sante Mentale.
Signs to look for include changes that interfere with everyday tasks and functions — anything from not showering to eating or answering the phone.
“When it affects your mood, when you’re snappy and agitated, and people notice it, then it may be time to intervene on their behalf to get further help,” Nicolas said.
If someone is resistant to professional help, one meaningful way anyone can help a friend, relative, or coworker is by talking with them, Pinard said. Start with a simple, ‘How are you doing?’
“You have to be willing to talk [to them],” Pinard said. “If you’re not able to have that conversation with a or that person, then be willing to take them to someone who can.”
Finding new approaches for the road ahead
Moving into a post-pandemic world, the experts are concerned about the range of challenges the community will face. They wonder about young children left orphaned or traumatized by police killings, business owners who have died and left a void in the enclaves, and essential workers who have watched people die daily. Older Haitian-Americans too will likely present everything from additional chest pains to tingling and numbing to poor concentration.
“We’re not in our natural environments, we have to learn how to swim in it,” Casimir said.
As individuals and collectively, Haitians have to first take care of their health to minimize their vulnerabilities if another health crisis strikes, Casimir said. Then, they should prioritize any political, social, and economic opportunities to make meaningful connections to help with the crisis.
“Ultimately, we need to evolve into different models,” said Jean-Marie, who organized a Sisters Thrive & Brothers Thrive — Kreyol Edition mental health forum with the NYC Department of Health and Mental Hygiene.
Using existing community infrastructure, including on-the-ground leaders, makes sense because people already trust their local leaders, Jean-Marie said. Training those leaders to recognize and refer people in need can advance education and awareness of mental health services.
“Making sure you’re putting money in the hands of people that know how to effect change, without putting their livelihoods at stake.”
For mental health assistance, reach out to the following organizations as a starting point to locate a provider appropriate for you. New York — Haitian Community Collation (HCC) at 1-718-940-2200 or [email protected]; or the NYC Well program at 1-888-NYC-Well (692-9355), to speak, text or chat 24/7. Florida — Rebati Sante Mentale at 1-954-432-3800 or [email protected] Boston — Haitian Mental Health Network at [email protected].