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Implementing Problem Management Plus (PM+) in Haiti: qualitative study.

Michela Marchetti1,2, Ana Carolina Molina3, Marcio Gagliato3,4

  • 1Department of Dynamic and Clinical Psychology and Health Studies, https://ror.org/02be6w209University of Rome La Sapienza, Italy.

Bjpsych Open
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PubMed
Summary
This summary is machine-generated.

Problem Management Plus (PM+) is feasible in Haiti, but requires cultural adaptation and economic support. Task-sharing interventions can improve mental health access despite significant barriers like safety and cost.

Keywords:
HaitiHumanitarian settingsMHPSSProblem Management Plus (PM+)qualitative research

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Area of Science:

  • Global Mental Health
  • Public Health Interventions
  • Task-Sharing Models

Background:

  • Haiti faces a severe humanitarian crisis, leading to significant mental health challenges.
  • Limited access to psychological support due to a shortage of professionals exacerbates mental health issues.
  • Problem Management Plus (PM+), a WHO intervention, trains non-specialist helpers to address this treatment gap.

Purpose of the Study:

  • To explore the implementation of PM+ in Haiti.
  • To identify barriers and facilitators influencing PM+ delivery and accessibility.
  • To understand contextual factors and participant experiences for potential adaptations.

Main Methods:

  • A qualitative study was conducted in three Haitian cities.
  • Data collected via the PSYCHLOPS tool with end-users and cognitive interviews with stakeholders.
  • Thematic analysis used social determinants of mental health and ecological systems theories.

Main Results:

  • Economic constraints and safety concerns were key implementation barriers.
  • Community engagement, adaptive strategies (flexible scheduling, remote supervision), and organizational support were facilitators.
  • End-users reported significant difficulties managing everyday problems and emotional distress.

Conclusions:

  • PM+ is feasible in Haiti, contingent on cultural adaptations, economic considerations, and sustained support.
  • Addressing systemic barriers and integrating task-sharing into health structures can enhance long-term impact.
  • Task-sharing interventions show promise for improving mental health service delivery in crisis settings.