Focusing on mental health
When talking about global health activity here in Atlanta, we typically focus on diseases like malaria, Guinea worm or river blindness. We also talk about access to clean water, sanitation and essential medicines.
Rarely, however, do we talk about mental health. But think about it: people who live in impoverished communities suffer from oppression, conflict and violence, all of which can take a toll on mental health. They are assaulted by various stresses associated with surviving in conditions of deep poverty. Those with diagnosable forms of mental illness in these communities generally lack access to treatment.
Mental illness may be one of the most neglected aspects of global health – but not by everyone.
While traveling in Liberia recently, I spent some time with the director of the Carter Center’s mental health initiative in that West African nation. Dr. Janice L. Cooper is a native Liberian and health services researcher specializing in children’s mental health. She has worked in the private, public, and nonprofit sectors in the United States and Liberia.
“In Liberia there is a high burden of disease for several neuropsychiatric disorders including major depressive disorders, epilepsy, and schizophrenia,” Janice wrote to me after our visit at her office in Monrovia. “In addition, the prevalence of depression (40 percent) and post-traumatic stress disorder (45 percent) is high. More than 14 years of civil war have compounded this problem.”
In a country of nearly four million people who experienced years of brutal civil war, there are only two psychiatrists, she said. Thanks to the work of the Carter Center over the past two years, however, the mental health workforce is growing. Janice and her team are supporting the national government to train 150 local mental health clinicians to provide services across Liberia. To date, the program has graduated four classes of 79 clinicians who work in all of the nation’s 15 counties.
While the numbers are still small, this is huge progress in a country with so few resources. Janice gave the Liberian Ministry of Health a great deal of credit for focusing on mental health and developing a National Mental Health Strategy.
“It is very encouraging that Liberia, a nation with extremely limited resources and infrastructure has committed to improving mental health because the government realizes that mental health can have a tremendous impact on Liberia’s economic development,” she said.
The Carter Center has been working on mental health issues since 1991, when former First Lady Rosalynn Carter launched the program. The Liberia work, however, is the only program of its kind in a developing country.
Janice and her team have made great progress so far. One of the success stories is Margaret Ballah, who was trained as a new mental health worker. Margaret lives hundreds of miles away from her family so she can treat Liberian patients and Ivory Coast refugees at a rural health center in southeastern Liberia. You can read her story here.