No abstract

for their support of this research. I would especially like to thank my committee chair, Dr. Elizabeth Vera, both for her encouragement throughout this project and throughout my time in the doctoral program; your mentorship has been the most significant aspect of my academic experience, and I appreciate the time and energy you have kindly offered to me. I am grateful to the participants of this study. This dissertation could not have been completed without the openness and generosity of the nine professionals who gave of their time to discuss their experiences in global mental health. Each of your stories and experiences is inspiring to me, and I am confident that learning from your examples will directly my impact to engage meaningfully in our field. Most significantly, I am deeply appreciative of my family, including my parents, Mike and Tricia Hook, and my sister, Kristina Hook. It is from all of you and from our experiences together as a family that my interest in the global community first developed, and it is through all of your examples that my commitment to underserved individuals grew. Throughout my entire life, you have freely given me your love, encouragement, and support. This project is a reflection of the ways that you have invested in my life, and I am fortunate to come from a family who has a solid foundation of loving each other well. iv TABLE OF CONTENTS

No abstract

No abstract

No abstract

No abstract

Background: The Republic of Liberia recently experienced several events that resulted in wide-ranging societal impacts, including long-term civil war and an outbreak of Ebola. These types of events are linked to higher prevalence of mental disorders and psychosocial distress. As a result, it is likely that there is an increased prevalence of mental health disorders in the population.Aim: To assess and review the recent mental health literature in order to provide insight into existing mental health needs and effective or recommended interventions in post-conflict Liberia.Setting: Articles included in this study enrolled Liberians living in Liberia.Methods: A search of four databases was conducted for studies of any type that assessed mental health in Liberia between 01 January 2003 and 27 March 2019. After reviewing 363 articles, 21 articles were included in the final analysis. Articles were coded to identify common themes and needs.Results: The majority of studies used qualitative designs and were conducted in Monrovia, the capital city of Liberia. Common topics included adolescent mental health, intervention and assessment and post-conflict impacts. One article focused on mental health impacts after recovery from Ebola.Conclusion: Overall, there is a dearth of mental health literature that focuses on Liberia. This suggests ample opportunity for researchers to investigate mental health needs amongst the Liberian population and effective psychiatric interventions. Existing recommendations often focus on addressing adolescent health needs, including substance use practices. Opportunities for future research particularly related to needs of adult populations and to mental health impacts of Ebola, abound.

Low-and middle-income countries have few mental health professionals, and efforts to increase access to treatment are a global priority. A key gap is the lack of integration of psychotherapy interventions as a part of accessible evidence-based care. Current recommendations suggest that the integration of mental health treatments, including psychotherapy, into existing primary care pathways may serve as a means to address this disparity. Understanding the cultural and contextual factors that affect this process supervision. Lauren C. Ng served as the lead for supervision, funding acquisition, and project administration and in a supporting role for conceptualization and formal analysis.