Capacity Building for a Mental Health System of Care in Liberia

Abstract

Liberia endured 14 years of brutal civil wars. The psychological impact of the civil conflict contributed to a mental health crisis exacerbated by misconceptions, stigma, and resulting discrimination surrounding mental illnesses. Lack of training to deliver robust mental health care by health professionals and inadequate supplies of necessary medications have contributed to poor mental health status among the population. Trauma from the war was further exacerbated by the freedom of movement and even appointment to high positions of perpetrators of extreme violence. Even now, close to 30 years later, some perpetrators of mass murder and torture are just being brought to justice, not by the Liberian government whose truth and reconciliation process remains incomplete but by foreign governments. These proceedings, as well as regular sightings of perpetrators in the public space, constantly conjure up and resurface difficult memories, fear, guilt, internal angsts, and deep-seated emotional pain. The Ebola crisis further exacerbated these fears and trauma. Since 2010, The Carter Center has assisted Liberia’s Ministry of Health to build a mental health system of care. Together they have trained a sustainable mental health workforce, strengthened and supported the implementation of the national mental health policy and plan, and supported the empowerment of mental health service users and their family/caregivers at the individual and community levels. This chapter outlines the evolution of a mental health system in Liberia through the lens of persons working at various levels with The Carter Center, an international nongovernmental organization operating in Liberia.