Integrating mental health into primary health care settings after an emergency

Abstract

Following the 2010 Haiti earthquake, there was a need for specialist services for severely mentally ill people whowere presenting to the emergency medical clinics set up for displaced people. That need was unmet. Using guidelines drawn up by the InterAgency Standing Committee (IASC), and piloting theHealth Information System(HIS) ofdiagnostic categories in mental health, weekly mental health clinics were begun in eight mobile clinics. A psychiatric liaison service was also started in the main casualty hospital. Haitian general practitioners and psychosocial workers, who received on-the-job training and supervision from the authors, ran these services. This integrated mental health/primary health care modelwas successful in engagingseverely mentally ill patients in treatment; however, the scale of the disaster meant that only a relatively small proportion of the displaced population could access help. This limitation raised a number of questions about the practicality and sustainability of the IASC model in resource poor countries, with poorly developed community services, hit by large scale emergencies, which the authors address.