Severe depression among Haiti's internally displaced populations: Prevalence and correlates in the context of gang violence.

Résumé

This study is the first to examine the prevalence and correlates of severe depressive symptoms among internally displaced populations in Haiti due to gang violence. A cross-sectional survey was conducted among 1,545 participants (mean age = 36.5 years old, SD = 15.4; 60.5%). Findings reveal that the prevalence of clinically significant depression symptoms was 68.3% (95% CI; 66.0%, 70.6%), while the prevalence of severe depression symptoms was 38.1% (95% CI; 35.7%, 40.5%). Both outcomes were higher in women (72.9%; 40.6%) compared to men (61.1%; 33.2%), χ (1) = 23.29, p < 0.0001; χ (1) = 8.40, p = 0.004. Significant associations were also found for geographical areas, age, education, marital status, paid job, religion. Hierarchical logistic regression analyses, using adjusted odds ratio (aOR) identified community violence as the strongest predictor of severe depressive symptoms (aOR = 1.29, 95%CI: 1.22-1.31, p < 0.0001), whereas witnessing violence did not reach statistical significance. Conversely, resilience and social support (aOR= 0.97, 95% CI: 0.97-0.98, p < 0.0001; aOR = 0.77, 95%CI: 0.67-0.88, p = 0.0001) were inversely associated with depressive symptoms, highlighting their protective roles. These results underscore the magnitude of the mental health crisis among internally displaced populations in Haiti. While resilience and social support play a key protective role, they remain insufficient in the face of pervasive, cumulative, and traumatic armed gang violence. Findings highlight the urgent need for structural interventions, integrated mental health services, and community-based approaches targeting the most vulnerable populations, particularly women and rural residents.