Interview With MFP Alum Kermit Crawford P2 Treating Trauma Globally P4 News and Views P4 Circling Recovery P5 Olympians Speak Out for Youth Mental Health P6 News From the Fellows P6 Grant Announcements P6 Professional Development Opportunities P7
Treating Trauma on a Global Scale
by Florence Saint–Jean, Ph.D., NCC, ACS
Florence Saint–Jean with Global Trauma Research staff in New York City
I am a Haitian–American woman! I say this with pride. However, there have been times when I was ridiculed for my heritage. The name-calling started in the third grade of my American school. Back then I wondered what it was about Haiti that was so shameful. As I began to learn more about my country, I discovered it was one of the poorest in the Western Hemisphere, with a long history of violence and political turmoil. Yet, when I visited my homeland for the first time, I witnessed one of the most beautiful places I had ever seen.
How a place so exquisite could cause such great pain was something I was all too familiar with in a personal context. My parents, who were born in Haiti, witnessed firsthand the violence that was culturally accepted in their country. Violence begets violence, and it led to the abusive nature of my father's relationship with my mother. I was young when I first recognized these troubles, but it sparked a lifelong interest in mental health and global issues.
While working at community organizations, I realized how language and culture play a vital role in mental health services. With the right kind of intervention, I saw families tangibly benefit from counseling—a service my household was not able to receive.
My family, my cultural background, my work experience, and my volunteer service have all driven me into the field of trauma care for underrepresented groups. Today I am the executive director of Global Trauma Research (GTR) Inc. I have earned degrees in psychology, mental health counseling, and counselor education and supervision. I am also a Minority Fellow of the National Board for Certified Counselors because I believe in expanding access to culturally competent trauma counseling.
I founded GTR to ease the pain I saw not only in my Haitian people, but around the world. When I started the organization, I wondered if I was doing the right thing. Where would the money come from? What would people think? I chose to move forward despite my fears and had faith God would direct me, even if I made mistakes.
Running an organization like GTR has constant challenges. Sometimes I wish I had a regular 9-to-5 job, like many people. Then I meet someone who needs our help, and I remember I'm not like everyone else, as the yearning in my heart to do this work is not only a passion but also a responsibility.
My passion is poured into GTR's mission to help people around the world affected by psychological trauma. Through education, counseling, support, and the integration of spirituality in health practices, we help them create a secure and maintainable lifestyle. We believe in developing and implementing comprehensive services using innovative techniques.
GTR has two main initiatives: the Haiti Trauma Project and the Trauma Center at the Haitian–American Community Coalition in New York City. At the Trauma Center we see cases of undiagnosed mental illness, stress, anger, grief, domestic violence, and assault. Many of these complex issues stem from life in our clients' native countries. The assumption that problems diminish when people immigrate to the United States is a great misperception, as the responsibility of caring for loved ones back home only deepens the burden. To provide a holistic approach to care, we partner with local churches, community centers, and community-based organizations. We also provide satellite fellowship groups throughout the community for people who are not yet ready for one-on-one counseling.
GTR's 2016 Haiti Trauma Project training participants
Scarred by past political violence and the aftermath of the 2010 earthquake, Haitians are still grappling with extraordinary trauma. The Haiti Trauma Project has trained native medical providers, teachers, and religious leaders to challenge stereotypes surrounding mental health and build a comprehensive system of psychosocial support in the country. These professionals learn the various components of effective trauma assessment and intervention, focusing on pathways to care, barriers to treatment, and engagement strategies that influence service use. When Hurricane Matthew hit Haiti on October 4, 2016, hundreds of lives and homes were lost. The Haiti Trauma Project joined with the Haitian American Nurses Association and Mandoo Foundation to be the first to respond with medical and mental health relief.
At this point in my life, I know I am doing exactly what I've been called to do. I wake up every morning happy to provide even a small amount of hope to another person or family. Maybe I cannot change the world, but I want to look back years from now and know I made historical contributions to trauma counseling.
To learn more about Global Trauma Research and how you can get involved, visit www.GTRInc.org.
News and Views
Employers Pledge to Reduce Workplace Stress Employers who were recently surveyed about prioritizing behavioral health said finding more timely and effective treatment will take precedence over the next 3 years. Responding to a questionnaire from Willis Towers Watson—a global risk management company—the businesses reported their intentions to address root causes of workplace behavioral health issues, with 36 percent noting they had already made changes to lower stress and improve resiliency. Another 47 percent are planning or considering similar action in the next 3 years. Employers said they want to provide better support for complex behavioral health conditions and expand access to care.
Trauma May Have Lifelong Impact on Adolescent Girls A study published in the Journal of Clinical Psychiatry says women who experience two or more traumatic events in their teens are at greater risk of developing major depression during perimenopause and menopause. Researchers say the link between trauma and depression lies at the molecular level—stress, reproductive hormones, and increases in markers of inflammation, like cytokines. A group of 243 women ages 35 to 47 were studied over a 16-year period, with regular testing for mood and cognitive problems, as well as hormone levels. The women also completed questionnaires about the kinds of stresses and traumas they had experienced in their younger years. Most cases involved emotional abuse, living with someone battling addiction, or parental separation or divorce.
Bleuel's Indelible Mark on Mental Health Amy Bleuel, founder of Project Semicolon, passed away on March 24. Bleuel used social media to spread the message that having mental illness is not an end-all or sole defining factor. She asked people to photograph a semicolon drawn on their wrist, symbolizing that life can go on with and after mental illness. Millions have shared photos of semicolons on their bodies, some permanently tattooed, as part of an ongoing effort to end discrimination against people with mental health conditions.
What Climate Change Means for Mental Wellness With the potential for radically different climate change policies comes a warning from the American Psychological Association, who says warming trends and natural disasters could have a drastic effect on the country's mental health. According to a new report co-produced with ecoAmerica, climate change threatens the well-being of Americans. The psychological effects may be harder to quantify than physical effects. Still, the report points to natural disasters like Hurricane Katrina, after which suicide and suicidal thoughts among Gulf Coast residents more than doubled. Nearly 15 percent of those affected by Hurricane Sandy in 2012 showed symptoms of post-traumatic stress disorder. When natural disasters force people from their homes and jobs, there is a sense of great loss—of control, security, identity, and autonomy. But it isn't always extreme weather that affects mental health. Poor air quality, drought, heat-related stress, and famine all take their toll.
WHO Opens Up Conversation on Mental Illness The World Health Organization (WHO) is addressing misconceptions about mental illness with a campaign called "Depression: Let's Talk." An estimated 322 million people suffered from depression in 2015, according to a report by WHO. On average, only about 3 percent of government health budgets go toward mental health. Even in high-income countries, nearly 50 percent of people with depression do not get treatment. But for every U.S. dollar invested in scaling up treatment for depression and anxiety, there is a return of $4 in improved health and ability to work. WHO says greater global investment in services, support, and treatment is needed, but the first step toward recovery is opening up to a trusted family member or friend.
Adherence Poor in Drug-Only Therapy When a mental health provider relies solely on drug therapy, people are more likely to refuse or stop treatment. That's according to a Psychotherapy article based on a meta-analysis of 186 studies in which patients sought help for mental health issues. In the reviewed studies, patients were recommended pharmacotherapy, psychotherapy, or a combination of the two. The authors noted that treatment-refusal rates were about two times greater for drug therapy alone compared with psychotherapy only—particularly for social anxiety disorders, depressive disorders, and panic disorders.
NHPI Population Surveyed on Health Measures The first large-scale U.S. survey on the health of Native Hawaiian and Pacific Islanders (NHPIs) looked at 3,000 households with at least one NHPI resident. In general, NHPI adults reported poorer health and greater serious psychological distress compared with single-race Asian adults. NHPIs were also more likely than U.S. adults to be in fair or poor health, to have diabetes, and to have suffered from asthma. Few reliable health statistics have been available for the NHPI population up to this point because they constitute such a small percentage of the U.S. population.
Improving Services for the Homeless Population The mortality rate among people who are homeless is three to four times that of the general population. Chronic illnesses and disabilities are often at play, as well as substance use disorders. A new report from the Joint Commission was recently produced to help behavioral healthcare organizations improve their housing support and treatment services. Effective services can change how homeless individuals care for themselves. With better health comes less need for medical treatment and fewer emergency room visits, resulting in significantly lower costs. The report addresses new accreditation standards for housing support service programs.
New Blood Test Could Improve Schizophrenia Detection A study published in Analytical Chemistry showcases a new technique for detecting and diagnosing schizophrenia. Researchers from the University of Maryland College Park and Baltimore campuses developed a test to identify oxidative stress in the blood, which is commonly linked with schizophrenia and other psychiatric disorders. Using the novel testing method, the researchers were able to separate samples of individuals who had been diagnosed with schizophrenia from those without the disease.