Project Lead(s): Eddy Eustache
This novel model helps reach those most in need, as the team helps develop a national mental health plan for Haiti. Neuropsychiatric disorders, such as bipolar disorders constitute 10% of the overall disease burden in Haiti but largely go undiagnosed or untreated.
The mental health infrastructure in Haiti consists of a single psychiatric hospital and health centre in Port au Prince — capital of a country with 10.3 million citizens.
Building on experience using community-based approaches to treat diseases such as HIV and tuberculosis, Zanmi Lasante — one of Haiti’s largest non-governmental health care providers — developed the “5x5 Model” to help people suffering depression, bipolar disorder, psychosis, epilepsy, as well as child and adolescent disorders.
Mental health services are delivered by professional and lay workers in the existing public health system trained and supervised across four mental health care pathways. The model is being integrated into the services provided at 11 public primary care facilities serving 1.3 million people and co-managed by Zanmi Lasante in collaboration with the Ministère de la Santé Publique (Minister of Public Health) et de la Population and the Ministry of Health.
In a three-year proof of concept project, roughly 10,000 individuals received mental health treatment at 11 sites — 1,935 with depression, 1,360 with epilepsy and 1,004 with suicidal thoughts. Of these, an estimated one third have already experienced improved clinical outcomes as a result of positive diagnosis and treatment.
During its 15-month transition-to-scale, Zanmi Lasante will refine and strengthen its model, provide refresher mental health care training to 100 staff, and improve monitoring and evaluation and supervision systems. The organization anticipates treating another 3,500 patients.
Another fundamental goal: development of a national mental health plan for Haiti based on the model, assisted by collaborators, including the Pan-American Health Organization.