Liberia: Mental health problems breed violence

Liberia's only mental health specialist says the country is experiencing an increase in post-traumatic stress disorders because the country's two disarmament processes during 14 years of conflict did not address the psychosocial needs of ex-combatants, especially that of youths. Dr. Benjamin Harris said he returned to his home country of Liberia in 1996 to oversee health services for the UN-organised demobilisation, disarmament, rehabilitation and reintegration (DDRR) of fighters following Liberia's first civil war from 1989-1996. But violent political in-fighting after former president Charles Taylor took office in August 1997 ended nascent social services, said Harris. "The [DDRR] program ended without catering to the psychosocial needs of the ex-combatants," Harris said. Harris told IRIN the most recent DDRR exercise conducted after renewed fighting that ended in 2003 was another "missed opportunity." DDRR efforts focused primarily on taking guns away without addressing ex-fighters' social challenges, such as HIV/AIDS, substance abuse and sexual-based violence, according to Harris. "There was a focus on rapid demobilisation and the psychosocial needs of the ex-combatants were not cater[ed] to," Harris told IRIN. "The focus of the [DDRR] program was to get the arms away from the ex-combatants and now we are beginning to experience the repercussions of a failed demobilisation program relating to the psychosocial needs and mental well-being of the ex-combatants." Liberia's Minister of Information, Lawrence Bropleh, told IRIN the government is trying to fill the potentially deadly social service gaps revealed in previous DDRR efforts: "There were lots of problems during the 2003-2004 disarmament process. What this government is trying to do is to take care of the flaws. As a society, we have not been placing a focus on it [mental health needs]. I think we have a better appreciation of the problem today than before." Bropleh said the government is finalising a draft of a nationwide mental health policy. Mental health specialist Harris said such services are urgently needed: "Granted the [past DDRR] program was successful in getting most of the arms away, but what are the repercussions? The repercussions… include sexual and gender-based violence and aggressive and violent behaviour are being manifested all over the society, and [we are seeing] substance abuse on a wide scale." Drugs Harris said in the absence of mental health services, some Liberians are turning to readily available illicit drugs. Cocaine can be bought for as little as US$5 and marijuana for less than 50 US cents in the capital, Monrovia, according to a draft of the country's substance abuse prevention policy. Harris said drug abuse complicates mental health treatment, and requires more community intervention to save youths, who are at higher risk for drug abuse, based on World Health Organization (WHO) research conducted in Monrovia earlier this year: "There is lots of work that can be done in the various communities at the church levels, among religious and traditional leaders, among others, who can play a major role in providing mental health services to the young people," he said. He added that as the country's only clinically-trained mental health provider, he cannot serve more than three million people emerging from conflict. "My concern now is to provide training, guidance and direction to others in society [who] have been able to acquire a certain amount of training in the community to provide services at their level of professional expertise." Harris said Liberians have learned to live with mental illness during and immediately following brutal years of conflict. "People have been able to cope with the problem at a certain level, but that was during the war and they did it just for survival. But now they realise the difficulties caused by the war and they cannot cope any longer and so some are beginning to take their lives." Survival skills have their limits, Harris warned.