Treating the Psychological Scars of Liberia’s Conflict

Wednesday on the NewsHour special correspodnent Kira Kay reports on the Carter Center’s work on mental health capacity building in Liberia. Watch her report on the political situation in Liberia from Tuesday’s NewsHour.

Monrovia, LIBERIA–In this West African nation still struggling after 14 years of a brutal civil war, the task of rebuilding remains daunting. Although the conflict ended in 2003, Liberia’s challenges are many: an economy in shambles, a fragile infrastructure and a population ravaged by disease and poverty.

But ask Dr. Janice Cooper, a native Liberian, to name one of the greatest impediments to peace and prosperity in her country and she’ll speak of a silent but devastating adversary: mental trauma.

It’s estimated that 40 percent of Liberia’s population of 4 million suffer from post-traumatic stress disorder, Cooper says. With only one practicing psychiatrist and one inpatient mental health clinic, many are left with nowhere to turn.

The statistics are staggering, and just one of the reasons Cooper decided to return to Liberia.  As project lead for a pioneering mental health program supported by the Atlanta-based Carter Center and Liberia Ministry’s of Health and Social Welfare, Cooper aims to train 150 certified mental health workers to fan out across the country into areas where locals have never seen mental health workers

For Cooper — the half-sister of journalist Helene Cooper — the decision to return to Liberia did not come easily. Ten years earlier she left the country fleeing with her family during the height of the civil war with little more than the clothes on their backs. Cooper settled in the United States and built a successful career in public health.

In 2010, Cooper was asked to consult for the Carter Center on mental health issues in Liberia. Then came a job offer, and before she knew it, Cooper was touching down in Monrovia for the first time since 1990, filled with a mix of trepidation and excitement.

“A colleague of mine once told me, as I was ranting about my own story of having to flee, that everyone in Liberia has the same kind of story,” Cooper says. “That realization and knowledge really fuels my desire to be here and work in this environment.”

Cooper recently paid one of her weekly visits to Monrovia Central Prison, where the mental health program has launched a groundbreaking initiative to support prisoners. The prison was so overcrowded and dirty it was singled out by Amnesty International for human rights violations. Cooper and her staff have converted a cinder block building there into a small, modest mental health facility where prisoners can now attend psychotherapy sessions and meet with family members.

Cooper is often asked “why mental health” in a struggling, fledgling democracy with so many priorities – from poverty and unemployment to malaria, HIV and gender-based violence.

Mental illness, Cooper explains, must be understood in order to treat the host of other serious illnesses in the country, like HIV.

“Our clinicians are trained to be primary care physicians with an expertise in mental illness, because we don’t forget for one moment that when we need to address HIV, we need to address depression, too,” she said.

And that’s just what her clinicians are doing. One of her newly trained clinicians treated a mother who came into a health clinic because one of her three children was failing to thrive. The mother, and all three of her kids, tested positive for HIV. The clinician caring for them was able to support the mother, who experienced such shock at the news she became suicidal.  Slowly, the mother regained her mental health and was able to return home and to care for her kids.

Cooper’s new program supported by the Carter Center will spend five years training 150 nurses and physician’s assistants as certified mental health workers, eventually reaching more than 70 percent of the country’s population.

“We think this program can be a model, not just for post-conflict African countries, but any country in the world where the quality and quantity of mental health care needs to be improved,” Cooper says. “We came here to create a program that is sustainable. One the Liberian government can replicate when we’re no longer here. And we intend to make good on that promise.”

Reporter Molly Raskin is working on a forthcoming documentary on Liberia’s mental health program.


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