American Counseling Association member and first-generation Haitian-American Florence Saint-Jean is striving to bring better mental health care access and awareness to the people of Haiti. In particular, Saint-Jean is working to create a trauma intervention curriculum to be used by professionals within Haiti.

Saint-Jean, a counselor and Ph.D. student at Duquesne University’s Executive Counselor Education Program, collaborated with mental health associations in the United States and Haiti to create a curriculum that will be taught to doctors, nurses, teachers and religious leaders.

A member of ACA’s International Counseling Interest Network and Trauma Interest Network, Saint-Jean also volunteers with the Haitian American Caucus (HAC) and oversees HAC-U.S. program operations. Saint-Jean says that volunteering, along with the January 2010 earthquake that devastated the country, helped spur the idea for the curriculum. With an epicenter 16 miles west of the capital of Port-au-Prince, the earthquake measured a 7.0 magnitude, had 52 aftershocks and resulted in more than 230,000 deaths. Three million other Haitians were impacted in various ways, including their mental health.

Though Saint-Jean was born in the U.S., her parents were born in Haiti and she has always felt a strong tie to the country. Its culture deeply influenced her upbringing, and she still has a lot of family living there, including four nephews and several aunts, uncles and cousins.

“Many of my nephews and cousins who went to school in Port-au-Prince were affected by the earthquake because they had to return to the countryside where the education system is limited for teens and adults,” Saint-Jean says. “Therefore, many of them still aren’t attending school. “

A few of Saint-Jean’s family members who were present during the earthquake are still so traumatized by the event that they refuse to return to the city.

“One of my aunts only goes to the city when she has to go to the airport,” Saint-Jean continues. “In addition, my other aunt, who is a pastor’s wife, has been sleeping in the church building since the earthquake. Her home, the church and a school are all in the same yard. My aunt is so scared of being crushed in her home that she sleeps in the church.”

Some of Saint-Jean’s relatives also died in the earthquake.

The trauma her own family members endured, coupled with the fact that many of her counseling clients in the U.S. are Haitian immigrants, made the news of the earthquake hit close to home.

Saint-Jean became increasingly interested in the mental health efforts after the earthquake in particular, “especially after hearing testimonials, reading the literature and realizing how limited mental health [care] is in Haiti,” she says. “I then began collaborating with the director of our HAC-Haiti compound [about how I could help].”

Several months after the earthquake, Saint-Jean traveled to Haiti and found it “crushing to see the collapsed buildings and despair. Port-au-Prince, a city that was once filled with rich landscapes, was covered in debris.”

Saint-Jean says she also found a troubling lack of mental health services and literature available.

Saint-Jean points to a 2012 issue of the Journal of Black Psychology that cites Haiti as having the lowest number of mental health workers of all Caribbean countries and among the lowest in the world. Haiti has between 20 and 23 psychiatrists, between nine and 30 psychiatric nurses and no professional counselors available in the entire country, according to that issue of the journal. A 2003 Pan American Health Organization report counted two psychiatric hospitals in the public sector as being responsible for serving more than 10 million Haitians.

“After the 2010 earthquake, the world realized how vulnerable and unprepared Haiti was to responding to natural disasters and the mental health issues that would surface,” Saint-Jean says. “Since the earthquake, there is still unresolved trauma.”

Nonetheless, she says, Haiti is taking “baby steps” toward providing mental health services, and the U.S. is helping out.

“Since the earthquake, mental health professionals in Haiti and the U.S. have established a psychological association called L’Association Haitienne de Psychologie, and [they] had their first conference in 2010,” Saint-Jean continues. “In addition, many nonprofits in the U.S. have been implementing mental health training to professionals. Popular [non-governmental organizations] are also providing mental health support. However, their time is temporary and their multicultural training is limited.”

Saint-Jean believes the best strategy is to train professionals who are native Haitians. “Though we are trying,” Saint-Jean says, “there is still so much to be done.”

After examining the history, education and religious views of Haitians, Saint-Jean found a stigma against mental illness within the country.

“Many natives are not likely to seek help from a mental health professional, and there is a recognized high prevalence of psychological trauma and adverse consequences of trauma,” she says. “Therefore, I suggested introducing a culturally competent trauma intervention curriculum consisting of basic techniques that can be implemented by professionals such as teachers, doctors, nurses and religious leaders who are readily accessible by Haitian natives.”

The curriculum, currently in a pilot stage, will be implemented at the HAC-Haiti compound in Croix-des-Bouquet in December.

The curriculum will use basic learning methods to achieve the following objectives:

• Develop a foundation for psychoeducation and challenge stigmatized mental health ideologies
• Teach professionals basic trauma assessment and intervention skills

 “I want counselors to be aware of the state of counseling around the world,” Saint-Jean says. “I know that we are very interested in global counseling these days, however many of us in the profession do not realize the extent to which we need counseling around the world.”

She believes the idea of developing multicultural competence has become increasingly popular over the years, and the need for it is great.

“The counseling profession is aiming to be an inclusive and diverse practice,” Saint-Jean says. “However, how do we do that when we are not aware of what is happening with counseling around the world? If a physician heard that there was a cure for HIV/AIDS in Asia, would he or she not want to know about it? Or if an engineer heard that buildings were collapsing in Africa with some of the same materials that are being used in the U.S., would he or she want to investigate this? The same applies for counselors. If we are a caring and helping profession, then that can’t be limited to the four walls of our office.”

Heather Rudow is a staff writer for Counseling Today. Contact her at hrudow@counseling.org.