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Liberia Ramps Up Resources to Improve Mental Health for Children and Adolescents

249 clinicians are now trained in mental health, with 83 specializing in the needs of children and adolescents

ATLANTA…Nineteen clinicians specializing in child and adolescent mental health graduated today in Monrovia, Liberia, from a training developed by the Carter Center’s Mental Health Program in partnership with the Liberia Ministry of Health, Ministry of Education, and Ministry of Gender, Children and Social Protection. These graduates, the fourth cohort of clinicians focused on children and youth will provide mental health and psychosocial care in schools, clinics, and other child and youth-centered settings.

These graduates bring the total number of professionals trained to 249 through a collaboration between The Carter Center Mental Health Program in Liberia and the Liberian government to improve access to mental health services in Liberia. Those clinicians now work in primary care facilities, hospitals, daycare centers and schools, across all 15 counties to provide much needed care as the country seeks to strengthen its mental health services. This group of 19 Liberian nurses, and registered midwives completed a free, six-month, Child and Adolescent Post-Basic Mental Health Training Program at Kakata Rural Teacher Training Institute in Margibi County, Liberia. Almost 60 percent of the graduates come from hard-to-reach areas like Grand Kru, Maryland and Rivergee in the Southeast, and Gbarpolu, Cape Mount and Bomi in Central and Western Liberia, respectively.

"Liberia is making a brighter future for all of its citizens by investing in the mental health of adults, children, and adolescents," said former U.S. First Lady and Carter Center Co-founder Rosalynn Carter.

Liberia is on course to reach its goal of expanding access to mental health care to 70 percent of the population within the next few years. In addition to the clinicians, this nation with a current population of 4.6 million has three psychiatrists to meet the needs of at least 300,000 Liberians suffering from mental illnesses.

Graduates of The Carter Center program passed a credentialing exam earlier this month administered by the Liberian Board of Nursing and Midwifery and the Liberia National Physician Assistants Association to practice as licensed mental health clinicians. This allows them to return to their counties of practice as child and adolescent mental health specialists and to practice in primary care settings that focus on children and adolescents, or to begin working in school-based clinics. These graduates also are critical to Liberia's post-Ebola and post-war recovery.

Attendees at the graduation program received congratulatory messages from many Liberian government officials: the acting deputy minister of health of Liberia; Minister of Health Dr. Wilhemina Jallah; the Speaker of the House of Representatives, Honorable Bofhal Chambers; and Honorable Jewel Howard-Taylor, Liberia’s vice president. Dr. Najeera Chowdhury, a psychiatrist in the Child and Adolescent Mental section of the WHO’s Department of Mental Health and Substance Abuse in Geneva, also sent a congratulatory message.

Since 2010, mental health clinicians trained by The Carter Center have made a lasting impact in their communities by establishing new services at the ground level. Clinicians have opened 14 clinical practices in prison systems, treated refugees from the Ivory Coast conflict, supported the nation's first mental health consumer organization, worked in Ebola Treatment Units (ETUs), and provided psychosocial supports to individuals and families affected by the Ebola virus. In addition, midwives have been trained to screen for maternal depression. This new cohort of child and adolescent mental health clinicians is assisting in these efforts by providing specialized care to Liberian youth. Over 20 schools now have clinicians in their clinics or have regular visits by mental health clinicians.

"With every group of clinicians trained, there is enthusiasm around how they will contribute to filling gaps in the emerging mental health system. As someone who has worked in child and adolescent mental health for many years, it is personally fulfilling to have child and adolescent health mental health providers in our workforce. We are proud to add to this group that can support children and adolescents all over the country," said Dr. Janice Cooper, a native Liberian and project lead for the Carter Center's mental health initiative in Liberia.

The training is part of a three-year initiative to address the psychological effects of Liberia's Ebola crisis and to promote psychosocial health in the country. The project, Supporting Psychosocial Health and Resilience in Liberia, is funded by the Japan Social Development Fund, a trust fund administered by the World Bank. Through collaborative efforts with the county health teams, the project has supported access to mental health services for over 19,000 beneficiaries in Montserrado (including Monrovia) and Margibi counties.

In addition to promoting long-term health and resilience through the newly credentialed child and adolescent mental health clinicians, the project provided support to respond to the intermediate psychosocial impact of Ebola. The Carter Center, in collaboration with Liberian stakeholders, trained Ebola first responders in self-care, facilitated community healing dialogues for Ebola-affected families, and trained health and social workers to provide community-based mental health care and family psycho-education. These and other efforts through this project offer support and capacity-building for individuals and communities, but especially those affected by Ebola. Six school-based health centers have also been established, with one more currently under construction.

The psychological impact of more than a decade of civil conflict, which ended in 2003, has contributed to a mental health crisis in Liberia that has been intensified by: misconceptions, stigma, and the resulting discrimination surrounding mental illnesses; lack of mental health care training for health professionals; and inadequate supplies of necessary medications. The Ebola crisis exacerbated these needs.

While every Liberian county now has at least three mental health clinicians, there remains a need to build up services in places with immense treatment gaps. The largest concentration of Carter Center-trained clinicians, 81, serves a population of more than 1 million in Montserrado County, where the capital, Monrovia, is located. Remote areas in some counties like Sinoe, Grand Gedeh, Lofa, Maryland and Grand Kru have mental health clinicians leading and shaping mental health services.

The Carter Center's Mental Health Program in Liberia is supported by contributions from individuals, governments, multilaterals, corporations, and foundations such as the UBS Optimus Foundation and the John P. Hussmann Foundation.

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