Haiti’s misfortunes – extreme poverty, political crises, natural disasters – are more than just material. They’ve also led to mental health issues. And until recently those were rarely adequately addressed in Haiti. That’s changed – and Guerda Nicolas is a big reason why.
Nicolas is a professor of psychology at the University of Miami’s School of Education and Human Development, and the American Psychological Association just awarded her its international humanitarian award for her work promoting mental health services in Haiti.
WLRN’s Tim Padgett spoke with Nicolas about her efforts there – and in the Haitian community here in South Florida.
The following is an excerpt of their conversation:
WLRN: You were born in Haiti, but you came to New York as a teenager. What drew you back to Haiti as a psychologist?
NICOLAS: Well, for me, no other place like Haiti is more in need of addressing the mental well-being of the population.
Visiting Haiti 22 years ago, I began to recognize there weren’t a lot of people in Haiti talking about psychological issues. There were a number of people, at least in the neighborhoods and communities I was visiting, that clearly were exhibiting a number of signs of mental health problems. In Grand Goave there was a young lady who was in need of services. I found out that there was not one psychologist or psychiatrist in that town or the area. And that’s really what sparked the idea of creating a mental health program in the country.
So how big a challenge was it then to raise mental health awareness in Haiti?
It was incredibly challenging at first. We went throughout the country building community awareness about what is a moun fou – somebody who is mentally ill. And we wanted to make sure that the terminologies were going to be relevant. Depression, for example, is not a word that we use in [Haitian] Creole. In English we might say somebody has an anxiety disorder. But when you translate that to Creole it means ke sous bisket, which means something like “my heart is overly fluttering.”
I recall the chance to visit a family who had a young woman who had exhibited classic symptoms of schizophrenia. But to them, they felt like this particular individual had been possessed, right? And the way they figured to work on some of those delusions and hallucinations was to tie this young lady to a tree during the day. They weren’t being malicious; they felt that they were doing the right thing for [her]. They just didn’t know that there was a disorder called schizophrenia – and that there were medications one could take for it.
(Nicolas then related that Haiti’s catastrophic 2010 earthquake, which killed more than 200,000 people, was a turning point in her work there. A note to readers: One case she recalls is disturbing.)
[The earthquake] was an opportunity for people to recognize for the very first time in the country, that issues of mental well-being – it is something that affects everyone.
Meaning everyone is susceptible to moun fou…
Moun fou can now be used for everyone, right.
What were some of the more acute disorders that you saw as a result of the earthquake itself?
There was a woman who lost her daughter. The only thing she found in the rubble was the leg with the shoe and the sock of her daughter. She took the leg, went home with it, washed it – and put it in bed.
The community of course became very concerned about her. And that allowed us the opportunity to talk with the family and the larger community about how [to] manage post-traumatic stress disorder.
Shortly after the quake you helped create organizations such as the Haitian Mental Health Network and Rebâti Santé Mentale, or Rebuilding Mental Health. How have those helped build a mental health services infrastructure – and culture – in Haiti?
We wanted to make sure that we engaged the Minister of Health in this process. And as a result, we were successful in getting a psychologist, for the very first time, to be part of the Ministry of Health – who now oversees the federal mental health program.
The title of one of the books you’ve co-authored is “The Psychological Consequences of Extreme Poverty in Haiti.” What are its most important conclusions?
The key thing we want people to understand is the impact that extreme poverty has on one’s ability to dream, right? Your ability to think of what will tomorrow give me.
Here in the U.S. you’ve done a lot of work in the Haitian immigrant community. What are the most urgent needs there?
The same work that we’re doing in Haiti, about helping people recognize the signs and symptoms of mental illness – and how mental illness should not be stigmatized – are exactly the same issues that I’m facing in the Haitian community here.