SEATTLE, Washington — The people in Liberia have suffered through or were witness to multiple devastating horrors during the country’s two civil wars. It has been 13 years since the last one ended; however, Liberians today still carry with them unforgettable scars of the past. These scars that have either healed naturally over time or, more often, continue to darken their lives and loom overhead. The aftermath of war has significantly increased the need for mental health in Liberia.
The Carter Center
War-induced trauma has haunted hundreds of thousands of citizens across Liberia for years since the wars. This reality has no doubt been made worse by both the lack of a mental health workforce and the presence of strong cultural stigmas towards mental illness. Furthermore, only 25 percent of the population has access to healthcare. Thanks in part to the Carter Center, however, that’s all starting to change.
The Carter Center is a non-profit seeking to advance human rights and alleviate suffering in more than 80 countries worldwide. Dr. Janice Cooper, a native Liberian, is the project lead for the Carter Center’s mental health initiative in Liberia. In an interview with the Borgen Project, she mentioned that there had only been “one psychiatrist in the country and no recently trained psychiatric nurse” back in in 2010 when the Carter Center initially began working there. Since then, Cooper says that Liberia has trained 268 mental health clinicians and made mental health practices available in every county.
Issues Surrounding Mental Health
The situation is improving with rapid speed, but there are still some difficulties, such as combating the shaming and discrimination against mental illness. Dr. Cooper explained how, at the root of this issue, there is a fundamental lack of knowledge. Most people don’t know what mental illness is, where it comes from or what can be done about it. Increased efforts for education through people like Dr. Cooper and her team are helping the public to answer these sorts of questions.
“We have focused on understanding stigma and trying to address different types,” says Cooper, speaking more on the situation, “[Stigma] is exacerbated, in our context, by the beliefs that mental illness may be caused by participation in the war and, consequently, ‘just deserts’ or ‘retribution,’ that there is a spiritual component to mental illness, that someone becomes “witched” because of deeds done or who they are.” Combatting these stigmas is an essential part of dealing with mental health in Liberia
Improving Conditions for People with Mental Illness
Not surprisingly, this stigma comes at the detriment of the mentally ill who struggle to feel protected, understood and counted both in society and by the laws. One of the Carter Center’s many goals includes improving conditions in each of these areas. Already in place is the “Cultivations for Users Hope,” an organization that advocates for people with mental illness, works towards the reduction of stigma and focuses on economic development. But, according to Dr. Cooper, there’s still work to be done. For example, police encounters with people in vulnerable mental states can quickly become dangerous in an environment fogged by misconceptions.
Currently, the Carter Center is helping to mitigate this confusion by teaching crisis intervention techniques to members of the force. “[…] they have the referrals for all mental health clinicians who they can call or can take persons to the facility with the nearest mental health clinicians. We are working with the Liberia National Police to include this training in the National Police Academy for the training of new recruits.“ As a result, officers from more than 30 precincts are learning to deal with mental health emergencies more appropriately.
Addressing Poverty and Mental Illness
While the Carter Center’s efforts have undoubtedly helped sew the seeds of change, the work of other humanitarian organizations, such as Mercy Corps, is attempting to lift people out of severe poverty, which, by catering to their most essential needs, may indirectly affect their mental health. Furthermore, those who still need services may be more likely to seek out the mental health services that Dr. Cooper organizes.
Dr. Cooper’s goals for the future include providing better educational opportunities for the mentally ill, further growing the “Cultivation for Users Hope” and figuring out ways to sustaining overall funding. “In the West, persons with mental illness, when they are in wellness, can attend schools, work and lead productive lives.” Dr. Cooper discussed. “This is true for only a small fraction of persons with mental illness in Liberia.” Living productive lives with mental illness should be possible for everyone.
Indeed, there are still many challenges, but thanks to the efforts of Dr. Cooper and other dedicated and talented Carter Center members and nonprofit organizations working in the country, a glimmer of light is guiding mental health in Liberia towards a better future with possibilities for even more important change on the horizon as issues of poverty are addressed.