3. 3
Global Mental Health
Global burden of mental illness
1 in 4 people are affected by a mental illness
at some point in their lives
Mental illness and substance use disorders
are the leading cause of disability – 23% of
all years lost because of disability
Between 76%-85% of people with mental
disorders in lower and middle income
countries receive no treatment
Globally, there is an estimated shortage of
1.18 million specialist mental health
personnel
4. 4
Liberia – History and Challenges
Fast Facts:
Founded in 1847 by freed American
slaves
Population: 4.5 million
2 civil wars in 14 years led to over
250,000 deaths, with peace reached in
2003
2014-2016 Ebola outbreak in Liberia:
10,678 cases and 4,810 deaths
In 2010, there was 1 psychiatrist in
Liberia, no other trained mental health
workforce
5. 5
The Carter Center Mental Health Initiative in Liberia
Goal:
In partnership with the government and local stakeholders, build a
sustainable mental health system in Liberia.
Objectives:
Reduce stigma and empower Liberians with mental illness and family
caregivers
Assist the government to implement the National Mental Health
Policy and Plan
Train a sustainable health workforce
7. 7
Training Mental Health Clinicians in Liberia
Creation of a new cadre of health
care providers:
Lack of health care providers with training
in mental health
Task-shifting model: RN, PA, RM trained as
Mental Health Clinicians (MHCs)
6-month curriculum developed by experts
and local stakeholders, continually revised
Co-teaching model
Integrated into primary care system
8. 8
Training Mental Health Clinicians in Liberia
Post-Basic Mental Health Training:
Classroom training: lecture, discussion, role play, group projects
Clinical training in real-life settings: clinics, prisons, schools
Five courses:
Basics of Mental Health Practice
Comprehensive Assessment
Identification and Treatment of Social,
Emotional, Behavioral, Neuropsychiatric,
and Developmental Disorders
Psychosocial Interventions
Mental Health Human Rights, Advocacy,
and Education
9. 9
Training Mental Health Clinicians in Liberia
Filling in the Gaps:
Child and Adolescent Mental
Health
MHC training did not adequately prepare to
meet needs of children and adolescents
TCC developed new cadre beginning in 2016:
Child and Adolescent Mental Health Clinicians
(CAMHCs)
Based on MHC training, but with attention to
needs of C&A, emphasis on developmental
stages and impact on MH
CAMHCs work in schools as well as health
facilities
11. 11
Impact of Mental Health Workforce Development
Impact of MH Training
Over 200 MHCs and CAMHCs trained to date, with goal of 250 by the end
of 2018
MHCs and CAMHCs work in all 15 counties in Liberia
Five school-based clinics
established
MHCs and CAMHCs
participate in continuing
education through
in-service training
Increased access to MH
services for adults and
children
12. 12
Challenges and Next Steps
Challenges of Workforce Development
in Liberia
Need for increased pay with new credential
Career ladder – need for further development of
mental health field for job growth
Data collection on patient encounters and outcomes
Sustainability of trainings
Next Steps:
Transfer of training program to local control:
Phebe School of Nursing