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Liberia at a glance
Geographical size: 111,369 km2
Independence: 1847
Population: 3.7
Per capita gross domestic product: 247USD (2010)
Poverty status: 76.2% living on less than 1USD/day
Life expectancy: 59 years (2010 UNDP)
Liberia at a glanceMajor Depression: 40%
PTSD: 44%
Exposure to sexual violence: 42-73%
Substance Abuse among ex-combatants: 12% - 44%
Sexual violence of ex-combatants: 42%, female; 32%, male
Suicide: 11% contemplation; 6% unsuccessful
Epilepsy: 45% of all outpatient MH cases
Proximity to health facility: 41% located more than one hour away from nearest health facility
0
5
10
15
20
25
Health Worker
Pharmacy Religious Leader
Police Community
Soci
al D
ista
nce
(M
ean
, 95
% C
I)
Social Distance from Persons with Mental Illness (e.g. willing to work with, live nearby, be friends with, or marry a person with mental illness)
More
Distance
Less
Distance
Health workers, n=45; Pharmacy workers, n=45; Religious leaders, n=38; Police, n=45;
Other community members, n=179; Total=352
ANOVA, F=4.70, p=.001
*
* Religious leaders differ from police and community.
No association between correct identification and perceived functioning.
LiCORMH’s Purpose and mandates
Promote evidence-based practice
Improve mental health governance
Improve mental health data/information
Increase mental health researchers
Foster culture of ethical research
Measure access and quality
Develop standards and guidelines
Why outcomes strategy?
Ensure development and application of outcomes measures that assess
mental health policies
services
practice
research
Strengthen the health care delivery system
Policy Core
Centralized repository for information, data, and research policy analysis
Translate interventions into locally supported and sustainable mental health programs
Develop strategic plans
Scientific Core
Establish a Review Board
Increase quality of mental health research
Increase quantity of relevant ethical mental health studies
Develop impact monitoring system
Develop scholarly activities
Training & Development Core
Build local mental health research capacity
Explore local and international training opportunities for mental health workers and researchers
Fund Development/ Public Relations
Engage in fund raising and development
Promote publicity
Maintain a virtual host
Research collaboration
Expected Outcomes
Short term (0 - 5 years) Increase evidence-based practice
Expand local MH research
Establish MH-IRB
Establish Virtual MH library
Increase interests in MH
Identify training opportunities for MH workers and researchers
Support MH indicators/target development
Increase awareness of MH research
Long term (5 – 10 years)
Increase access and availability of MH information and services
Enhance adherence to ethical standards and guidelines
Establish outcomes-based monitoring systems for MH
Establish MH repository
Improve quality of MH services
Challenges
Governance Limited funding
Poor regulations (i.e. services, ethics, practice etc.)
Poor integration in PHC
Inability to adequately measure access and quality
Social Stigma and
discrimination
Diminished interest in the profession
Lack of confidence in outcomes based strategies for LMICs
Limited professionals
Challenges
Treatment
Lack of psychotropic medications
Reduced confidence in psychotherapy
Education & Information
Lack of accurate information
Limited data/information
Concurrent researchMental Health Beyond
Facilities (GCC): To develop and evaluate a Comprehensive Community Based Mental Health Services package for persons with severe mental disorders and epilepsy
Adolescent girls psychosocial development (ReBuild): To determine the extent to which MH services are informed by context, gender and social-cultural norms?
Future research
National prevalence of mental health and substance use disorders
Community based mental health care
User advocacy and information dissemination programs (radio)
Psychotropic drugs effect determination
National prevalence of open mole (cultural bound syndrome)
Enhancing referral among traditional healers and religious leaders
Efficacy of Crisis Intervention Teams in reducing stigma and discrimination and improving care
Maternal depression and improved child outcomes
Suicide in youth
Peer support models in Liberia
Acknowledgements:
Janice L. Cooper, PhDRodney D. Presley, MSW
Research Committee of the Technical Committee for Mental Health, MOHSW
LiCORMH Governance Board
Thank You!!
Sources
Brandon Kohrt & TCC MHP-L Program, 2012
National Mental Health Policy, 2009
Essential Package of Health Services, 2012
Essential Package of Social Services, 2012
Country Situational Analysis (GOL), 2011
Health Seeking Behavior Survey (GOL), 2008
Johnson, K. et al., 2008
Lee et al., 2011
BPHS Accreditation Final Results Report., 2011
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