Liberia, with a history of post-traumatic stress disorder, has one practising psychiatrist for 4.6 million people

Liberia, with a history of post-traumatic stress disorder, has one practising psychiatrist for 4.6 million people

Greater attention needed on mental health in Liberia

Ebola killed 4,810 Liberians and 1 in every 375 people contracted the virus. The disease left “enlarging circles of victims” – people who faced emotional turmoil due to their loved ones being infected or having died – including 4,500 orphaned children who may still face stigmatization and discrimination.

Lund and Breen, 2010, found that in 73 to 79 per cent of the 115 studies they examined, there is an association between poverty and mental disorders; the poorer an individual is, the greater the chance that they experience a common mental disorder. A lack of education makes people most susceptible. In countries like Liberia — places that have witnessed considerable trauma and face pervasive poverty — efforts mitigating the psychiatric effects of a crisis such as Ebola are crucial.

Today in a country of 4.6 million people, there is just a single practicing psychiatrist, several dozen mental health nurses and approximately 100 trained paraprofessionals. To put these numbers in perspective, there are 2,582 mental health outpatient facilities in the UK – a rate of 4.94 for every 100,000 people. How can Liberians get support for the psychological implications of trauma with so few resources available to them?

Although the government has made progress by creating a strategic plan for mental health, and President Sirleaf has asked the legislature to pass the bill, it remains unapproved. Dr. Janice Cooper from the Carter Center’s Mental Health Initiative said “certain things cannot be done by us for persons with mental disorders in the absence of the passage of the mental health legislation.

BRAC has been working in Liberia since 2008. As a result of working closely with local people, BRAC understood the need for physiological assistance in communities recovering from Ebola. Using the advantage of experience working with local groups BRAC launched a physiological project in collaboration with the Ministry of Health and WHO, funded by USAID.

The project built on the capacity of government mental health clinicians, social workers, BRAC staff, and Ebola survivors to provide psychological first aid and support to the community. Group and individual counselling gave survivors and orphans the chance to share experiences and adopt coping strategies and skills. The project improved the community’s attitudes and perceptions about Ebola survivors and educated affected communities about the risks presented leading to 67 per cent of survivors reporting having attended a social gathering, a party, or a wedding ceremony and 61 per cent being engaged in civic matters. The psychological first aid programme showed a marked improvement in society’s acceptance of the individuals whose lives, in one way or another, were scarred by Ebola. However, a significant amount remains to be done, 60 per cent of survivors and 42 per cent of orphans experience anxiety that hampers their daily activities.

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