Overview:
The mental health crisis in Haiti is a silent epidemic, exacerbated by ongoing violence and a lack of adequate healthcare services. As the country grapples with this invisible enemy, the need for a comprehensive public mental health policy and increased support for mental health services has never been more critical. Without intervention, the psychological scars left by the current crisis will continue to affect generations to come.
PORT-AU-PRINCE — Haiti, a nation long troubled by political instability and natural disasters, is now facing a severe mental health crisis as a result of escalating gang violence and socio-political turmoil. Since the latest escalations, the situation has deteriorated to the point where ordinary citizens, especially the youth, are experiencing profound psychological distress.
Cynthia Charles, a 29-year-old nursing student, embodies the plight of many young Haitians. Displaced from her home by invading gangs, she struggles with despair and insomnia, a direct consequence of the fear and trauma that have become her daily companions.
For Charles, the constant fear and trauma have led to sleepless nights and a deep sense of despair. “I am traumatized, I don’t go out anymore today, not even in the streets of the area where I live,” she confided. The pervasive climate of terror instilled by the gangs has left her feeling overwhelmed and helpless.
Chased from her home in Carrefour Feuille, a suburb within Port-au-Prince, she confessed to the Haitian Times having “sunk into despair” since the violence started escalating. The young woman, currently residing in the commune of Delmas, is haunted by the insecurity that has become a pervasive part of everyday life in Haiti. “It’s tough for me to find sleep at night,” she said.
The resurgence of armed violence in Port-au-Prince has led to a dramatic increase in killings, injuries, and kidnappings, with an estimated 3.5 million people living in gang-controlled areas. The use of sexual and gender-based violence by gangs as a weapon to terrorize and control the population has further exacerbated the mental health crisis.
Psychologist Haitian Ronald Florestal confirms that the level of violence and socio-political upheaval can lead to serious mental health issues. “There are more people who have died from depression in Haiti than from being shot,” says Florestal, emphasizing the hidden toll of the crisis on the emotional well-being of Haitians.
Florestal has observed a surge in mental health pathologies among Haitians, with many suffering from a deficit in emotion and well-being as they navigate the fine line between survival and death. The impact is particularly devastating for the youth, who are vulnerable to forced recruitment into gangs due to the lack of socio-economic alternatives.
The psychological toll is not limited to those directly affected by violence; it extends to the entire community, as the constant threat of gang activity spares no one, regardless of social class or neighborhood.
Carène Similien, a young woman living in a gang-controlled area, is a testament to the indirect victims of this violence. Her daily life is marred by fear, anxiety, and physical symptoms that are indicative of severe mental distress. Similien lives with constant fear.
“I have to face the intimidating stares of armed men just to purchase daily essentials. The situation has caused me severe distress, leading to rapid weight loss and difficulty breathing,” she explains.
Lucie Belizaire, a resident in an area yet untouched by gang activities, nevertheless lives in a state of constant apprehension. “I’m currently safe because the gang hasn’t attacked my area yet,” Belizaire shared. However, she admits that her mind is never at peace, especially after the recent loss of a friend – a police officer who was killed by the gangs in Bon Repos, situated a little northeast of Port-au-Prince, the country’s capital.
Belizaire’s worries about her family’s safety and her future amid the current turbulence in Haiti have had a profound impact on her life. She has become reclusive and fears the day she might receive distressing news about her mother or brother. The persistent insecurity continues to cause her distress, and she confesses to being uncertain about when or if the situation might improve.
“My mother lives in Fort National and is reluctant to leave the area. Every time I hear about gang trouble there, my heart races,” Belizaire said. Adding to her worries is the fact that her brother is a police officer currently on duty. The ongoing violence and his risky profession only compound her fears and anxieties.
A healthcare system in crisis
Haiti’s healthcare infrastructure is ill-equipped to handle the mental health needs of its population. With only two hospital centers providing psychological and psychiatric care– one in Port-au-Prince and the other in Croix-des-Bouquets– both of which are dysfunctional due to insecurity and lack of state funding, the country is unable to offer adequate support to those in need. These two centers have a total of 180 hospital beds for a population of about 12 million inhabitants, according to Florestal. The absence of a public mental health policy further compounds the issue, leaving many without access to essential services.
In 2022, the World Health Organization (WHO) highlighted the significant mental health burden faced by individuals in conflict zones. Their review found that one in five people who experienced conflict will suffer from depression, anxiety, post-traumatic stress disorder, or bipolar disorder. This is consistent with the 2015 Global Burden of Disease study, which found a positive association between conflict, depression and anxiety disorders.
The WHO indicated that crises like the one Haiti is facing often lead to mental disorders such as anxiety, sadness, despair, and sleep disturbances. According to the organization‘s review of several studies, approximately 22% of individuals experiencing conflict situations will suffer from mental disorders.
In Haiti, there are no precise figures on the number of people suffering from mental disorders. However, the problem is palpable, with some Haitians resorting to suicide. With only two hospital centers providing psychological and psychiatric care, the country is ill-equipped to deal with this burgeoning mental health crisis.
Mental health professionals like Florestal deplore the lack of a public mental health policy in the country and recommend those feeling unwell to seek psychological help from professionals or relevant organizations. Engaging in leisure activities such as dancing, singing, watching series, and movies, playing games, physical activities, relaxation techniques, and joining support groups can also provide some respite.
However, the escalating violence continues to leave a trail of trauma. As gangs brazenly attack stores, banks, ports, government offices, and even residences, the citizens live in constant fear. The prospect of their neighborhood being the next target hangs like a “Damocles sword” over their lives.
The escalating violence and political crisis, with a split between those supporting the installation of a presidential council and those opposing it, suggest that the situation may not improve soon. As the country teeters on the brink of chaos, its citizens are also battling an unseen enemy – a mental health crisis.
To mitigate the mental health crisis, experts like Florestal urge those affected to seek help from professionals or organizations such as the Haitian Psychology Foundation “Fondhaipsy”, an association based in Port-au-Prince which provides support. Engaging in leisure activities is also recommended as a coping mechanism to distract the mind and provide temporary relief from stress.
The World suggests that in conflict or post-conflict situations, developing programs to protect and improve people’s mental health and psychosocial well-being should be a priority. However, effective responses require adaptation to specific contexts and the integration of services and support at community and facility levels.
Despite the ongoing turmoil, there are limited resources available for mental health support in Haiti. Fondhaipsy has been cited as one of the institutions assisting, but the challenges remain significant.
The constant threat of violence has left many Haitians living in fear, with no semblance of peace or safety. The persistent attacks by gangs have created a pervasive climate of terror, with every resident living with the idea that their neighborhood could be the next target.
As the country grapples with this mental health crisis, it is imperative to address the immediate and long-term needs of the population. The call for increased support, resources, and a public mental health policy to address the mental health challenges in Haiti has never been more urgent. The impact of the escalating violence and insecurity on the mental well-being of the Haitian people cannot be overlooked, and concerted efforts are needed to provide the necessary support and care for those affected.