By Jenna Fitzgerald | Copy Editor
There may be over 5,000 miles between Waco and Rome, but that didn’t stop Dr. Jocelyn McGee, an assistant professor in the Garland School of Social Work, and the Rev. Dr. Wismick Jean-Charles, a Haitian-born Roman Catholic priest, from collaborating to implement the first telepsychology initiative in Haiti in response to COVID-19.
In 2010, the seeds for the initiative were sown as Jean-Charles founded the Center for Spirituality and Mental Health (CESSA) in Haiti in response to the magnitude 7.0 earthquake.
“Haiti is a diverse and culturally rich country; it’s the first Black republic in the Western Hemisphere and the first independent Caribbean state,” McGee said. “Haiti has experienced numerous natural disasters as well as sociopolitical upheaval. As many people know, in 2010, there was an earthquake that resulted in the deaths of almost 300,000 persons, numerous injuries, and almost a million people lost their homes. CESSA was developed by Father Wismick in response to the earthquake to offer psychological services to traumatized people, marginalized groups and disadvantaged communities affected by natural disasters, violence, insecurity, social exclusion and poverty.”
In 2014, McGee established what would become a long-standing relationship with Jean-Charles, CESSA and the people of Haiti, supporting their spirituality and mental health educational mission and offering a workshop at their annual summer conference. Then, with the onset of the pandemic and the introduction of a whole new set of obstacles in 2020, Jean-Charles reached out to McGee about creating the multi-stakeholder initiative.
“Father Wismick contacted me in March of 2020 to let me know that the counselors and psychologists from his organization were extremely concerned about the degree of stress and emotional impact that the COVID-19 pandemic was having in Haiti,” McGee said. “He asked if I would collaborate with him and our Haitian colleagues to develop and pilot telepsychology services for the purposes of safely giving out information and providing emotional support to the people of Haiti.”
While planning took place from March to April of 2020, McGee said the actual case study ran from May to November of 2020. During the six-month period for which they received funding, they had 12 counselors who provided services from 9 a.m. to 6 p.m. Monday through Friday, offering a confidential place people could call into for emotional support and up-to-date information on the pandemic.
“All of the counselors chosen to participate in the telepsychology initiative were professionals with excellent technical training and cultural and emotional competence,” McGee said. “Everyone was Haitian, and most of them had been serving as counselors since the earthquake, if not before. Before they went into the field, we worked closely with the counselors to provide information on best practices for telepsychology and had many discussions about ways to adapt these best practices for use within the unique Haitian context.”
McGee said services were open to anyone, although they were primarily geared toward front-line health care workers and community members. She said they publicized the opportunity through grassroots efforts and communication.
“CESSA got the word out about the telepsychology services by posting flyers at churches and temples and schools,” McGee said. “In talking to Father Wismick, it seems like word of mouth is how people started to feel comfortable participating in or receiving services.”
According to Emerald, the counselors provided 701 sessions, with 193 of those being for front-line health care workers and the other 508 being for community members. McGee said the community members who received services were largely teachers and women.
“We found out that community members were more likely to ask for help than front-line health workers, and the reason is probably pretty obvious,” McGee said. “The front-line health workers were having to rally to meet the needs of the community because of the pandemic, so it was really hard for them to allow themselves to break away to get the support, even though I would say they probably needed more support than anybody.”
McGee said services dealt with a wide variety of needs. Topics included information on how to prevent COVID-19, ideas for self-care, techniques for empowerment and strategies for how to reduce fear, stress and anxiety. McGee said services were also uniquely tailored to Haitian culture, particularly regarding the difficulties of dealing with social isolation.
“In Haiti, it’s a collective society, and people are around each other much of the time in community,” McGee said. “All of a sudden, you are being asked to be isolated and alone, and it’s so counter to their culture that there was a lot of suffering over social isolation.”
However, McGee said they faced several barriers when implementing the initiative, such as the initial reluctance of people to be vulnerable and ask for support.
“There’s a stigma around asking for psychological or emotional support, and I think that was another issue,” McGee said. “But what was remarkable is that week after week, more and more people called, and they kept calling, so people really were hungry to have counselors listen to them and provide them support.”
Above all, McGee said the initiative taught them that the service was culturally acceptable and logistically feasible. She said using a multi-stakeholder approach — which involves members of local and international governmental and non-governmental organizations — was a vital part of its success.
“It has to be the community, the people, who are developing the services in the ways they think will be most helpful within their context,” McGee said. “It is important that services be based on what the community states they need, rather than someone coming in from the outside and telling a community, ‘This is what you need help with and what’s going on in your community.’ Although outside organizations can walk alongside communities, in order for services to be effective and sustainable, the community needs to be intimately involved with all aspects of project development.”
The findings of the initial case study were published in the Journal of Mental Health Training, Education and Practice in February of 2022. McGee said the initiative was able to reach people who had never considered mental health services before — something she said she hopes can be further implemented in Haiti and even adapted to other countries.
“We think that this case study provides some valuable lessons for mental health training and program development in other countries that have limited mental health resources,” McGee said. “However, it is very important that careful work is carried out that is context-specific for each country and the diverse people groups within a country.”