The Caribbean islands are prone to natural disasters like hurricanes and earthquakes, which increases the risk of stress, anxiety and other psychological symptoms—in much the same way as the pandemic. An innovative regional campaign by the Pan American Health Organization (PAHO), powered by a catchy jingle, supports communities to build resilient, adaptable populations.
(PART 1 of 5) Re:solve Global Health’s new Q&A series explores strategies to improve mental wellbeing. We asked five experts from diverse backgrounds (health promotion, social media strategy, public health, suicide prevention and international advocacy) to answer this key question: How can we prevent mental health problems at a population level?
What were the main messages of the campaign?
Dr Claudina Cayetano, PAHO mental health regional advisor: There is a close relationship between mental health and physical health, especially in an emergency context. In addition to saving lives and treating physical injuries, it becomes very important to have a good understanding of the mental health reactions of populations during disaster situations.
With this background, in 2019, PAHO developed a sub-regional communication and awareness campaign for the Caribbean islands in preparation for the hurricane season. During the height of the covid-19 pandemic, we adapted the campaign messages to suit the new circumstances.
Under the slogan ‘Stronger Together’, we provided information and strategies to assist communities in the region promote mental wellbeing and positive coping strategies, reduce the stigma about seeking mental health and psychosocial support, and convey the basic principles of psychological first aid. The key messages are to stay safe, protect each other and do everything possible to reduce stress and anxiety.
We created a website, evidence-based illustrated booklet, video, social media graphics and more. The most popular element was, definitely, the jingle, which was played on radio and shared on social media. It’s catchy and something that Caribbean people really like. We also developed training and resources for healthcare professionals.
How did the campaign impact mental health care in the Caribbean?
Cayetano: During a disaster, human resources are limited and, often, specialists are not available. People often think that they need to see a specialist, but most don’t. When someone experiences a loss, like that of a home or family member, it's normal to have an adverse reaction—but that doesn't mean they need to see a specialist like a psychiatrist or psychologist. Some people need some kind of support, and that's where psychosocial support components, like our campaign, come in.
One of the other things that will tend to happen after a disaster is that the immediate focus is on physical concerns like reducing loss of life and property. There is less immediate attention and focus on psychological concerns. We wanted to highlight the importance of mental health very clearly when dealing with preparedness and response to disasters.
As a result, people are now seeing the importance of boosting their mental health. The campaign drew attention to the need to include mental health and psychosocial support (MHPSS) as part of disaster management.
How successful was the campaign?
Lisa Bayley, PAHO communications for health promotion specialist: The campaign performed so well that we continue to use the materials any time there’s a crisis or people are worried.
Certainly, during covid-19, people were stressed and they were looking for materials that they could share. The real success was seeing how different countries adapted the campaign. In Jamaica, there’s a reggae version of the jingle and Suriname created a Sranan version. We also have the jingle in Dutch and the materials have been translated into French, Spanish, Dutch and Creole. In particular, the jingle was a different and effective way to connect with our audience.
Cayetano: At a regional level, when we started the training with health professionals, we had a few countries with MHPSS plans. Now more than half of the countries have integrated MHPSS into disaster response. There has been improvement in incorporating mental health into the discussion.
What has been the impact on mental health stigma?
Cayetano: There’s a lot of conversation about mental health these days. People are talking about their mental health openly much more than they would before—about stress, about burnout, about anxiety. There’s recognition that one is not weak by doing that. Our campaign has helped to make the conversation easier.