VOCES Resilientes: Supporting Mental Health of Families

Commitment by Coalición de Vacunación de Puerto Rico (VOCES)

In 2019, VOCES committed to launch an in-home therapy pilot program to build the psychological resilience of children, youth, and their families in Santurce, Puerto Rico. Hurricane Maria triggered a mental health crisis on the island, with families experiencing trauma and parents less able to manage adverse situations facing their children. Meanwhile, Puerto Rico does not have an adequate number of mental health professionals to address population needs. To address these issues, VOCES will train mental health counselors to provide in-home therapy to at-risk children/youth and their families, empowering them to understand and manage emotions and their families to cope with daily stressors and conflicts and build resilience in order to manage a future disaster or life change. At the same time, this work will allow these counselors to fulfill the work hours needed to obtain their licenses in Puerto Rico, eliminating the need for them to leave the island for professional opportunities.



VOCES Resilientes: Supporting Mental Health of Families



Est. Duration

1 Year

Estimated Total Value



Latin America & Caribbean



Commitment by

Coalición de Vacunación de Puerto Rico (VOCES)

Partner(s) of the Commitment Maker(s)


To address the mental health crisis in Puerto Rico after Hurricane Maria, VOCES will launch Voces Resilientes, a pilot program to address the emotional wellbeing of children, youth and their families in San Juan, Puerto Rico. Using culturally sensitive counseling, family therapy, and training, the program will focus on children and youth between the ages of four and 21 who have presented risk behaviors or emotional and behavioral problems since Hurricane Maria that are affecting their functioning at home, at school, or in the community. Priority families will be referred from community and church leaders.

VOCES will recruit 10 counselors who will manage family cases over a one-year period, reaching a total of 210 families during the pilot. The program will utilize In-Home Therapy, and counselors will provide direct services to children and youth to enable them to understand and manage their feelings and emotions.

Counselors will utilize Skills for Psychological Recovery (SPR), which was developed by the National Center for PTSD and the National Child Traumatic Stress Network. Counselors will be trained with e-learning program offered by National Child Traumatic Stress Network to help children, adolescents, and families gain skills to reduce ongoing distress and effectively cope in the weeks and months following disaster and trauma. This model will not only address family's current needs, but will build resilience among families, allowing them to seek support and recover faster in the case of a future natural disaster. The program will also provide specialized assistance to their families in order to support the children's mental health in an integrated way, enabling families to better manage basic daily stressors and conflicts, as well as unexpected life changes and crises. Counselors will begin by assessing family needs and developing a treatment plan to be implemented over a three-month duration. Each family will receive a minimum of two hours of services per week for a three-month period.

Additionally, to address the shortage of opportunities for mental health professionals in Puerto Rico, this program will serve as an opportunity to fulfill the hours needed as per the Board of Examiners of Professional Counselors of Puerto Rico, without the need to emigrate to accumulate their experience, practice their profession, and help the progress of the country, both professionally and economically. VOCES will also hire a director and two supervisors to coordinate the program and oversee the counselors.

February-March 2019
Recruitment of personnel:
Recruit administrative personnel
Recruit Professional Counselor with Provisional License

April-June 2019
1st Trimester
Program Launch
Contact community leaders, churches and community
Referral receipts
Start of Interventions: Initial evaluation with the family. Service duration time will depend on the need of the participant. Minimum 3 months with each family.

July-September 2019
2nd Trimester
Participation and evaluation phase, which ends with the development of a treatment plan.
Work and action phase, which ends with the achievement of the treatment plan objectives.
Completion and recapitulation phase, which develops discharge recommendations.

October- December 2019
3rd Trimester
Participation and evaluation phase, which ends with the development of a treatment plan.
Work and action phase, which ends with the achievement of the treatment plan objectives.
Completion and recapitulation phase, which develops discharge recommendations.

January- February 2020
IHT project evaluation
Final Report


Families in Puerto Rico, especially those living in poverty, were impacted severely by Hurricane Maria in 2017. Loss of homes and property, separation from family, prolonged time without basic needs, and fear of future disasters, among other things, led families to experience despair, sadness, and anger. Since the hurricane, there has been evidence of an emerging mental health crisis. In the aftermath of Hurricane Maria, there were 3,050 calls to Puerto Rico's mental health crisis hotline by people who had attempted suicide, representing a 246% increase in suicide attempts from the previous year. Unfortunately, 253 were successful in their suicide attempt. Other shocking statistics reveal that on average, Puerto Rico will see a suicide every 28 hours; as of July 2018, there had been 80 more suicides than the previous year.

A study by the Youth Development Institute (YDI) noted the long-term effects of disasters on mental health, stating that "numerous studies have shown how natural disasters cause post-traumatic stress disorder, and that this disorder and other mental health conditions can persist for years. This is compounded by the fact that the ability of parents and guardians to manage these situations may also be compromised by their own experiences" (Rivera Flores, 2017). These facts highlight the dire need to restore and strengthen Puerto Rico's healthcare system in supporting mental health and preventing suicide.

However, Puerto Rico is also experiencing an exodus of mental health professionals from the island due to the lack of opportunities. As a consequence, the island has a shortage of staff who can address the mental health needs of the population. Puerto Rico needs to create opportunities that will allow its mental health professionals to stay on the island, acquire their licenses in Puerto Rico, and help overcome the current mental health crisis, as well as to prepare for future disasters.

Partnership Opportunities

VOCES seeks grant funding for the program, which will be distributed among trained personnel, staff training, participant recruitment, administrative processes, and home interventions to offer an integrated, easy-access service to VOCES is offering culturally sensitive mental health services for children, youth, and their families.

Progress Reports