A presentation for Liberia made at GMH

1. LiCORMH
Improving mental health
outcomes through research
S. Benedict Dossen, BSW
Lead, LiCORMH

2. Outline
Overview
of Liberia
Perception of
LiCORMH
Mental Health Illness
as a strategy (Outcomes)

3. Liberia at a glance
 Geographical size:
 Independence:
 Population:
 Per
111,369 km2
1847
3.7
capita gross domestic product: 247USD (2010)
 Poverty status:
76.2% living on less than 1USD/day
 Life expectancy:
59 years (2010 UNDP)

4. Liberia at a glance
 Major Depression:
40%
 PTSD: 44%
 Exposure to
sexual violence: 42-73%
 Substance Abuse
 Sexual violence
 Suicide: 11%
among ex-combatants: 12% - 44%
of ex-combatants: 42%, female; 32%, male
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

5. Idioms and Causes of Mental Illness

6. 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
Social Distance (Mean, 95% CI)
25
ANOVA, F=4.70, p=.001
20
*
15
10
5
0
Health
Worker
Pharmacy
Religious
Leader
Police
Community
Health workers, n=45; Pharmacy workers, n=45; Religious leaders, n=38; Police, n=45;
Other community members, n=179; Total=352
* Religious leaders differ from police and community.
No association between correct identification and perceived functioning.

7. Creation of LiCORMH

8. 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
Measure access
ethical research
and quality
Develop standards and guidelines

9. Why outcomes strategy?
Ensure development and application of
outcomes measures that assess
mental
health policies
services
practice
research
Strengthen the health care delivery system

10. Programmatic framework
Policy
Services
Research
Practice

11. Major Cores for Improving Outcomes

12. Policy Core
 Centralized repository
for
information, data, and research
policy analysis
 Translate interventions
into locally
supported and sustainable mental
health programs
 Develop
strategic plans

13. 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

14. Training & Development Core
Build local
mental
health research
capacity
Explore local
and
international training
opportunities for
mental health workers
and researchers

15. Fund Development/ Public Relations
Engage
in fund raising
and development
Promote publicity
Maintain a
virtual host
Research collaboration

16. Ongoing strategies to improve
outcomes

17. Expected Outcomes
Short term
(0 - 5 years)
Long term (5 – 10 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
 Establish outcomes-based
Support MH indicators/target
development
 Establish MH repository
Increase awareness of MH
research
 Improve quality of


 Increase access and
availability of MH
information and services
 Enhance adherence to
ethical standards and
guidelines
monitoring systems for MH
services
MH

18. Challenges
Governance
Social
 Limited funding
 Stigma and
 Poor regulations
(i.e. services,
ethics, practice
etc.)
 Poor integration in
PHC
 Inability to
adequately
measure access
and quality
discrimination
 Diminished interest
in the profession
 Lack of
confidence
in outcomes based
strategies for LMICs
 Limited
professionals

19. Challenges
Treatment
Education & Information
Lack of
psychotropic
medications
Lack of
Reduced confidence
Limited
in psychotherapy
accurate
information
data/information

20. Concurrent research
 Mental
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 socialcultural norms?

21. Future research
 National prevalence
of
mental health and substance
use disorders
 Enhancing referral
 Community based
 Efficacy of Crisis Intervention
mental
health care
 User advocacy and
information dissemination
programs (radio)
 Psychotropic drugs
effect
determination
 National prevalence
of open
mole (cultural bound
syndrome)
among
traditional healers and
religious leaders
Teams in reducing stigma and
discrimination and improving
care
 Maternal depression
and
improved child outcomes
 Suicide in
youth
 Peer support
Liberia
models in

22. Acknowledgements:
Janice L. Cooper, PhD
Rodney D. Presley, MSW
Research Committee of the Technical
Committee for Mental Health, MOHSW
LiCORMH Governance Board
Thank You!!

23. 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