In many parts of Haiti, specialized mental health services remain difficult to access. Distances are long, resources limited, and families often find themselves alone when faced with complex situations.
In this context, the mental health system relies heavily on work carried out directly in communities. Community health workers play a central role in identifying situations of distress, referring patients and maintaining the link between families and clinical teams.
At Zanmi Lasante, this work is coordinated through a structured network of community activities. Edmé Robès Pierre, responsible for coordinating and supervising community mental health activities, has been involved in this organization for several years.
Edmé has been part of Zanmi Lasante since 2008. He began as a social worker at Cerca-la-Source and Lascahobas, where he accompanied TB/HIV program patients in their psychosocial follow-up. This experience gave him an early understanding of the role played by human accompaniment in the care process.
Today, he coordinates community mental health activities across several network sites and supervises the work of the community health agents who collaborate with the clinical teams.
These agents work as close as possible to the communities. They organize education sessions, take part in awareness campaigns and accompany patients in their follow-up. Their presence makes it possible to identify situations of concern and quickly refer people to the appropriate services.
For Edmé, this organization is one of the pillars of the mental health system.
“The best outcome in patient care is achieved around the perfect cooperation of a multidisciplinary team.”
An experience at Cerca-la-Source in 2013 remains particularly memorable for him. At that time, the site was without a psychologist for several months. As a social worker in the TB/HIV program, he was also involved in the psychological follow-up of some patients.
During a mobile clinic, a 22-year-old woman arrived accompanied by her father. He had tied her arms behind her back because she was a danger to herself and others. According to the family, she was hitting people, throwing stones and destroying objects in the house.
The young woman’s body bore the marks of the ropes used to restrain her.
The mental health team immediately began emergency assessment and intervention. The priority was to stabilize the situation and ensure the safety of the patient and those around her.
After several hours of intervention, the situation calmed down. The young woman was able to leave the mobile clinic calmly, alongside her father, to return home.
For Edmé, this experience reinforced his understanding of the essential role community activities play in mental health. Crises often arrive far from care structures. Teams must therefore be able to intervene quickly and maintain a link with families.
Community health workers play a decisive role in this set-up. They know the communities, identify situations of concern and facilitate communication between patients and clinical teams.
This mediation contributes directly to continuity of care and adherence to treatment.
“Community activities are the driving force behind the mental health system in Zanmi Lasante,” Edmé explains. “Health workers play a mediating role between the clinical team and patients.”
For him, it’s essential that this work is recognized for its true value.
“I want to take this opportunity to appeal to all community sectors, all programs and services at Zanmi Lasante, to highlight the work that health workers do and what they represent alongside patients at the sites. “
Every day, this community work enables patients living in sometimes very remote areas to access integrated mental health services. Support Zanmi Lasante’s work to strengthen access to mental health care in Haiti and enable teams to intervene as close as possible to communities.