COMMITMENT TO ACTION

Strengthening Post-Disaster Mental Health in Puerto Rico

Commitment by Hispanic Federation

In 2019, Hispanic Federation committed to fund the development, implementation, and evaluation of a two-year interdisciplinary mental health pilot program in Puerto Rico. The effects of Hurricanes Maria and concomitant outmigration and economic destabilization have had a serious impact on the psychological and emotional stability of island residents. Today, there is a high demand for free and low-cost mental health services, and a need to better prepare the local mental health sector to respond to future disasters. In partnership with the University of Puerto Rico at Río Piedras,100 graduate students in interdisciplinary teams will train to become experts in disaster mental health through a new curriculum and service model, while offering direct services to impacted communities across 12 geographically diverse municipalities. This program will not only serve to build disaster mental health expertise in Puerto Rico, but will also mitigate against the dearth of mental health services currently available outside the San Juan metropolitan area.



Overview
Summary

Commitment

Strengthening Post-Disaster Mental Health in Puerto Rico

Launched

2019

Est. Duration

1 Year

Estimated Total Value

$2,438,000

Region

Latin America & Caribbean

Countries

PUERTO RICO

Commitment by

Hispanic Federation

Partner(s) of the Commitment Maker(s)

University of Puerto Rico
Details

In partnership with the University of Puerto Rico (UPR)- Río Piedras, Hispanic Federation will fund the development, implementation, and evaluation of a two-year interdisciplinary prevention and intervention mental health pilot to deal with the aftermath of Hurricane María, mitigate mental health impacts in the event of future natural disasters, and address the ongoing lack of specialists by increasing the quantity of mental health professionals specialized in post-disaster services on the island.

The directors of UPR’s Departments of Social Work, Rehabilitation Counseling, and Psychology, in collaboration with Hispanic Federation, have developed an interdisciplinary mental health services project to provide both direct and indirect services to people affected by Hurricane Maria and those that may be affected by another natural disaster in future.

Services will be offered at three types of settings: three university campus clinics (Río Piedras, Humacao, and Arecibo), nine community- based-organizations, and individuals' homes if needed. By bringing services to 12 geographically diverse sites, the project also mitigates against the dearth of services in regions beyond San Juan.

Interdisciplinary teams of second- and third-year graduate students will train together in the field to become experts in disaster mental health through the new curriculum and service model, and upon graduation become leaders in the sector. The project will train an estimated 100 graduate students over the two-year pilot. This cadre of professionals specialized in post-disaster mental health, an expertise currently lacking in Puerto Rico, will be able to directly attend the needs of the population and better prepare the sector to organize and respond effectively in the future.

Students, under the supervision of licensed professionals, will offer mental health services for the treatment of varying symptoms related (though not exclusively) to the aftermath of disasters (i.e., major anxiety, major depression, PTSD, conduct disorder, suicidal ideation, etc.). The project will also develop and conduct a Voluntary Census (VC) of people with mental health and physical (chronic illnesses and disabilities) needs to assess and monitor participant’s needs and disaster preparedness.

The following activities will take place during each quarter of the commitment during the implementation of the curriculum, spanning from Q1 2019 through Q4 2020:
An average of 2,437 hours of direct service appointments (both individual and group) with most vulnerable participants, reaching an average of 162 people per quarter.

An average of 657 individual psychoeducational interventions (73 per month, per region across three regions).

An average of 504 people will be served in group psychoeducational interventions, community-school educational activities, and professional development activities.

Approximately 900 people per quarter will participate in community-school education activities.

Background

Hurricanes Irma and Mari´a devastated the US territory of Puerto Rico. The storms left the entire population of 3.3 million people without electricity for months, compromised access to clean water, and damaged over 80 percent of the island’s homes. As a result, an estimated 3,000 people lost their lives, and hundreds of thousands of families were separated and displaced. An already weak economy worsened.

The effect of these natural disasters and the concomitant outmigration and economic destabilization of many sectors of the island has had a serious effect on the psychological and emotional stability of island residents. Following the hurricanes there was an increase in people seeking mental health services after having experienced a variety of symptoms that were diagnosed as anxiety disorders, agoraphobias, and panic attacks. Meanwhile, depression and suicide rates increased significantly, especially among vulnerable children and the elderly. The island’s limited number of professionals specifically trained to deal with stressors of the magnitude of Hurricane Maria lacked capacity and coordination.

Today there is a high demand for free and low-cost mental health services and a need to better prepare the local mental health sector to respond to future disasters. The complex and diverse needs of those severely affected by the hurricanes requires a comprehensive service delivery approach best served by an interdisciplinary team of professionals offering a variety of direct and indirect services. The development of coping skills should accompany the direct treatment of psychological trauma, anxiety and other mental health conditions. In addition, mental health services should also focus on better preparation of individuals to contend with traumatic events. This may require developing and revising support systems, as well as making sure that others are knowledgeable of needs and vulnerabilities or liabilities. A comprehensive approach also entails developing rehabilitation plans targeting vocational goals, employment and interdependent living skills. Such a comprehensive approach must include the professional services from psychology, social work and rehabilitation counseling fields.

Partnership Opportunities

The partners seek additional an additional $1.2 million to fully fund the pilot project for year two. Additionally, the partners are seeking in-kind contributions of other partners/professionals/interns/volunteers seeking to collaborate with project’s objectives in different areas: voluntary census of most vulnerable population, adherence to treatment, development of effective support systems, also in-kind contributions on best practice information to increase capacity in trauma mental health. Through this project, Hispanic Federation and UPR-RP will provide capacity building training to participant CBOs through continuing education, development of program evaluation skills, consultation, development of work plans to prioritize their needs, promotion of self-mobilization to increase the community’s socio-economic development, sustainability of projects, and development of better practices in human resources. Such practices include psycho-educational workshops for human resources, especially as it relates to preventing employee burnout and improving wellness post-disaster. In addition, each of the nine participant CBOs will receive $15,000 per year for them to use for their own priorities.

Progress Reports