Presented during the 2017 Presidential Peace Conference in Atlanta. Track D, Session 3: Vocational Training Teams: Inbound and Outbound Exchanges

1. Vocational Training for Mental Health
in Liberia
Vocational Training Teams Inbound and Outbound
Sarah Yoss, MPH
June 10, 2017

2. 2
Background

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

6. 6
Mental Health Workforce Development

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

10. 10
Impact and Challenges

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

13. 13
Questions?