SOS Children’s Villages: mental health support in Haiti – lessons and future hopes (part two)

Guest blog by Jess Price, Head of Programme Funding for SOS Children's Village UK.

As we mark this World Mental Health Day, we’re highlighting two perspectives on delivering mental health care first from the PM+ Helpers on the ground and second from SOS Children’s Villages as programme developers

Part 2 – Hear from Jess Price, Head of Programme Funding for SOS Children’s Villages UK, reflect on adapting the PM+ training, measuring success and learnings from the project.

What were the primary considerations when adapting the PM+ training for Haiti’s unique cultural and socio-political environment?

In Haiti, mental health is often viewed through a complex spiritual and social lens, and against a backdrop of the severe security situation. Introducing Problem Management Plus (PM+), a psychological intervention developed by the World Health Organisation, required far more than a straightforward linguistic translation – it demanded cultural sensitivity.

We trained local staff as PM+ Helpers who understand the social fabric and have trusted relationships within communities.

Our Global Expert Group on Mental Health and Psychosocial Support (MHPSS) based in Milan, Italy collaborate with specialists from Brazil to adapt the programme. Due to travel restrictions (airports shut down just as the project was due to begin following a spike in security problems in early 2024 and all land, sea and air borders closed to Haiti’s neighbouring Dominican Republic), it became clear getting our Trainers safely into Haiti or trainee Helpers into a safe country to attend in-person training was going to be all but impossible.

So, we fully adapted PM+ Helper training for online delivery; to our knowledge the first time this method has been attempted.

Our Trainers adapted the nuance of their delivery to resonate with local idioms and beliefs, without jeopardising the core principles of PM+. Study materials were translated into Haitian Creole, and we incorporated culturally relevant language and metaphors.

Flexibility was crucial, given the ongoing security risks and daily challenges in Haiti. The team also acknowledged the impact on trainee Helpers of the daily challenges Haiti’s socio-political instability brings. These include personal safety and security risks, daily exposure to fear, trauma, and PTSD, not being able to travel to offices at certain times, and internet connectivity being unreliable. We agreed in advance that we expected such stressors to have an impact on trainee Helpers, and that flexibility in our training model was key. This sometimes meant supporting trainees to catch up with missed content, or introducing complementary activities such as role play exercises to embed learning.

What has been the most significant change you’ve observed in the trainers after they completed the PM+ program, both in their professional capacity and their approach to mental health?

The most significant change observed in Helpers was a newfound confidence in addressing mental health issues openly and with a reduced sense of stigma. Some Helpers shifted from being hesitant to discuss mental health to actively initiating conversations about it, reporting a deeper understanding of self-care and professional boundaries which had a positive effect on their resilience. They also adopted a more client-centred approach, focusing on empowerment rather than prescriptive advice.

Can you share insights on the scalability of the PM+ model beyond Haiti? What are the key factors that make this model successful in high-severity settings like Haiti?

Having delivered PM+ fully online for the first time, SOS Children’s Villages are actively reviewing which of the many high severity settings in which we work may also benefit from PM+.

The model is highly scalable, and its low-intensity, structured approach can be effectively delivered by appropriately trained lay workers without pre-existing MHPSS experience or credentials.

The model’s flexibility allows it to be culturally tailored to the delivery context without compromising its core principles. However, successful scale-up will depend on establishing strong local partnerships, ongoing support where necessary, and ensuring Helpers are well-versed in managing complex emotional responses. It is also crucial to have clear mechanisms for continuous supervision, along with any necessary translation services if supervisors who speak the local language are not immediately available.

What are the anticipated long-term impacts of integrating mental health training like PM+ into humanitarian programmes, and how will you measure success?

Integrating PM+ into our humanitarian programmes is anticipated to increase community resilience and reduce stigma around mental health. By training local PM+ Helpers, we empower communities to manage psychological stressors independently, fostering a culture of local leadership, support and resilience.

Success will be measured through longitudinal assessments, evaluating reductions in psychological distress, increased mental health literacy, and the creation of sustainable community support networks.

The long-term aim is to deploy PM+ to increase the availability of MHPSS services in situations where healthcare resources are often overburdened, help normalise mental health conversations, and enhance psychosocial well-being of both Helpers and Clients as a key component of our humanitarian action.

Are there any unexpected challenges or learnings that have emerged from this program that you would consider while planning future mental health interventions in other high-severity locations?

One unexpected challenge was managing transference and countertransference – in other words how feelings may be unintentionally shared between Helpers and clients in a therapeutic setting. Helpers generally have limited experience of managing their emotions in therapeutic settings. Trainers discussed how Helper’s personal emotional responses can profoundly influence the therapeutic relationship, potentially leading to ethical dilemmas and compromised care.

These learnings highlight the importance of adaptive strategies, such as integrating remote support methods from the outset, and bolstering the supervision framework to enable Helpers to navigate emotional complexities more confidently.

;

SOS Children’s Villages underscore that to keep delivering effective mental health services in Haiti, there’s a need to expand PM+ into more communities and train more staff while helping our current team build their skills. It’s also important to strengthen group intervention skills, set up psychosocial support centres, and forge partnerships with other organisations. By working together in these ways, we can make a bigger difference and help our communities thrive!

;

;

[.slimline-cta-box][.slimline-cta_heading]Find out more[.slimline-cta_heading][.slimline-cta_paragraph]For more information on scaling and adoption for humanitarian innovations, explore our Scaling focus area, which includes research, guidance and video case studies.

Keep an eye on our funding opportunities page and sign up to our newsletters to find out about upcoming adoption challenges.

 ;[.slimline-cta_paragraph][.slimline-cta-box]