LiCORMH

Improving mental health
outcomes through research
S. Benedict Dossen, BSW
Lead, LiCORMH
Outline
Overview

of Liberia

Perception of
LiCORMH

Mental Health Illness

as a strategy (Outcomes)
Liberia at a glance
 Geographical size:
 Independence:
 Population:

 Per

111,369 km2

1847

3.7

capita gross domest...
Liberia at a glance
 Major Depression:

40%

 PTSD: 44%
 Exposure to

sexual violence: 42-73%

 Substance Abuse

 Sex...
Idioms and Causes of Mental Illness
Social Distance from Persons with Mental Illness
(e.g. willing to work with, live nearby, be friends with, or marry a pers...
Creation of LiCORMH
LiCORMH’s Purpose and mandates
Promote evidence-based practice
Improve mental

health governance

Improve mental

healt...
Why outcomes strategy?
Ensure development and application of

outcomes measures that assess
mental

health policies
ser...
Programmatic framework

Policy

Services

Research

Practice
Major Cores for Improving Outcomes
Policy Core
 Centralized repository

for
information, data, and research
policy analysis

 Translate interventions

into...
Scientific Core
Establish

a Review Board

Increase quality of

mental health

research
Increase quantity of

relevant ...
Training & Development Core
Build local

mental
health research
capacity

Explore local

and
international training
oppo...
Fund Development/ Public Relations
Engage

in fund raising
and development

Promote publicity
Maintain a

virtual host
...
Ongoing strategies to improve
outcomes
Expected Outcomes
Short term

(0 - 5 years)

Long term (5 – 10 years)



Increase evidence-based practice



Expand loca...
Challenges

Governance

Social

 Limited funding

 Stigma and

 Poor regulations

(i.e. services,
ethics, practice
etc....
Challenges
Treatment

Education & Information

Lack of

psychotropic
medications

Lack of

Reduced confidence

Limited...
Concurrent research
 Mental

Health Beyond
Facilities (GCC): To develop
and evaluate a Comprehensive
Community Based Ment...
Future research
 National prevalence

of
mental health and substance
use disorders

 Enhancing referral

 Community bas...
Acknowledgements:
Janice L. Cooper, PhD
Rodney D. Presley, MSW
Research Committee of the Technical
Committee for Mental He...
Sources
Brandon Kohrt & TCC MHP-L Program, 2012
National Mental Health Policy, 2009
Essential Package of Health Services, ...
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LiCORMH GMH Forum Fresentation

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A presentation for Liberia made at GMH

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LiCORMH GMH Forum Fresentation

  1. 1. LiCORMH Improving mental health outcomes through research S. Benedict Dossen, BSW Lead, LiCORMH
  2. 2. Outline Overview of Liberia Perception of LiCORMH Mental Health Illness as a strategy (Outcomes)
  3. 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. 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. 5. Idioms and Causes of Mental Illness
  6. 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. 7. Creation of LiCORMH
  8. 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. 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. 10. Programmatic framework Policy Services Research Practice
  11. 11. Major Cores for Improving Outcomes
  12. 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. 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. 14. Training & Development Core Build local mental health research capacity Explore local and international training opportunities for mental health workers and researchers
  15. 15. Fund Development/ Public Relations Engage in fund raising and development Promote publicity Maintain a virtual host Research collaboration
  16. 16. Ongoing strategies to improve outcomes
  17. 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. 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. 19. Challenges Treatment Education & Information Lack of psychotropic medications Lack of Reduced confidence Limited in psychotherapy accurate information data/information
  20. 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. 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. 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. 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

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