By Gloria Wleh with New Narratives
Women serving fighters during the 2003 conflict. Credit Tim Hetherington.
In a two-part series with New Narratives, Gloria Wleh looks at the mental health crisis that experts say is the legacy of the war and impacts almost every Liberian. We explore solutions and ask what impact the looming war and economics crimes court will have on Liberia’s mental health.
St. PAUL BRIDGE, Montserrado County – Musu sits in a circle in a small community office here. Dozens of community members – mostly women – listen as she tells her story.
Musu was just 15 when a commander with the National Patriotic Front of Liberia took her from her home in Lofa County to be a “war wife”, like thousands of Liberian girls during the wars. For almost a year he forced her to cook, clean and have sex whenever he wanted. She says he murdered, raped and tortured many people. Ever since Musu has been unable to trust any man.
“I just feel la how all man looking,” Musu tells the group. “So to just trust man, it’s very hard for me.”
The group is one of dozens that are taking place in two counties across the country. Staff with the Liberia Association of Psychosocial Services, are going door to door in communities to encourage people to come to these group sessions in a program designed to help address the silent mental health crisis that experts say is still plaguing the country more than twenty years since the end of the war.
Musu is just one of millions of Liberians that experts say are suffering mental health problems as a result of Liberia’s long civil conflicts that began with the coup d’etat by Samuel Doe in 1980 and ended 23 bloody years later with the exile of then-president Charles Taylor. Estimates say the death toll was 250,000 people but millions more were impacted.
Most Liberians saw and endured extraordinary brutality. This has left the country with significant trauma that could lead to trouble if there is a trigger.
“It’s almost like we’re just sitting on a time bomb,” says Seidu Swaray, head of the Association. “The moment any little thing is triggered, you will see it escalate beyond our imagination.”
Messaging designed to break the stigma against mental health treatments. Credit: World Health Organization
Musu first came to this group a year ago after counsellors came to her door and urged her to come. She agreed to come, she says, because she wanted to stop being angry with men. A year on she tells the group that she is seeing some changes in her life and is feeling stronger.
“This session is helping me to go around people and not to keep by myself,” Musu says. Her real name is withheld because of stigma. “I’m cooling down on my anger and I’m starting to feel fine.”
Musu, who struggles with war-related trauma, refuses to live with a man as a result. Credit: Gloria Wleh with New Narratives
According to the World Health Organization, one in five people exposed to trauma will have post-traumatic stress disorder, depression, anxiety, bipolar disorder, and schizophrenia in the next decade. That would equate to more than a million Liberians. Evidence shows trauma can be passed down through DNA so it is likely even children born after the wars are impacted too.
Untreated from the wars have left Liberians psychologically numb and quicker to anger, violence, despair and other destructive behaviors than non-impacted populations, according to experts.
And yet there has been no major effort to address Liberia’s national trauma. Experts warn it is a mistake to think that the only people who are impacted by mental illness are those with obvious problems.
“To the public out there, stop thinking that it is only people who are roaming the streets in dirty clothes, who are mentally ill,” says Mr. Swaray. “You can be a banker, you can be a businessperson, you can be a manager, or even a minister, but you’re not mentally healthy.”
True State of Liberia’s Mental Health is Unknown
Since the war, with so many crises facing the country, successive governments have not assessed the number of Liberians who are struggling with their mental health. The government made mental health support a basic human right in 2017 by passing the Mental Health Act, but there has been no survey of the size of the problem and the only support that has been available has been funded by donors.
“As a country we do not have any existing data on national prevalence of mental disorders,” says Dr. Moses Ziah, Director of the Health, Health Ministry’s Mental Health Division. He says the data coming from the WHO and others are all estimates.
Mental health experts say this is making their job more difficult.
“The implication of this is that we are having the problem, but we do not know the size of it,” says Mr. Swaray. “We don’t know what we are fighting, and this is scary.”
Dr. Benjamin Harris is Liberia’s first psychiatrist, a doctor specializing in treating mental health issues. He completed his training in England in 1982, choosing the specialty because the country did not have its own psychiatrists at the time. Today the country has just eight psychiatrists serving its over five million population. That’s one psychiatrist for every 625,000 people. The WHO recommends one psychiatrist per 10,000 people.
The lack of help is taking a toll on huge numbers of the population according to mental health experts. Dr. Harris says he sees a wide range of mental health problems every day. He named anxiety and depression as the most common. He says mental health problems show up in the growing use of alcohol and drugs which, he says, people take to numb their pain. People don’t realize they’re suffering from mental health problems and so they medicate themselves. The impact on the brain and body of alcohol and drugs can actually make the depression worse.
“Depression is not just a feeling of sadness, it’s an illness. Those affected by it think negatively,” Dr. Harris said. Sufferers of mental illness will have a range of symptoms that can make things worse. “They have sleep difficulties. They don’t experience pleasure they used to experience before, and some of them think that there’s no point in living.”
Mr. Swaray blames escalating violence in the country on the legacy of untreated trauma from the war. “You can see how violent our streets are,” he says. “Children these days no longer fight without using weapons on each other.”
People flee Lurd forces on Bushrod Island, 2003 Credit: Tim Hetherington.
Some Liberians Are Getting Help, But Stigma is Still An Obstacle
Musu is one of the few Liberians getting help. For almost a year she has been attending therapy sessions here at the Liberia Association of Psychosocial Services. (Clients needing medication are referred to a partnering medical clinic.)
In today’s session counsellor Sarah Paye tells the participants that they are not responsible for what happened to them.
“Don’t blame yourself for what happened to you,” says Madam Paye. “Be assured that you can feel better from the services we will be providing if you take charge of your healing.”
But while some are seeking help voluntarily, many, like Musu, are only benefiting from therapy sessions because the association reached out to them.
Many Liberians are still reluctant to seek mental health care.
“I think the reason is that a lot of people don’t know and understand the importance of mental health,” says Mr. Swaray. “More often, people only regard physical health to be something to look after.”
Sessions like this as well as a national conversation will be crucial in coming years says Mr. Swaray.
“It’s very, very important because our country has passed through war and too many traumatic experiences,” Swaray says. “So the war is the first huge one. Ebola, Covid, all these things have created extreme psychological wounds.”
Experts are urging that mental health services be given priority by policymakers to reach the larger population, especially as wounds are triggered by the War and Economics Crimes process.
The 2025 national budget for mental health in the country fell by 20 percent from US$500,000 in 2024.
Mr. Swaray says that is not nearly enough to address the size of the problem that he worries will only get worse as another generation becomes embittered by the horrors of the civil conflict and rising poverty makes them more desperate.
Part two of this series will look at the impact of the WECC on Liberians’ mental health and what experts say people should do to protect themselves.
This story is a collaboration with New Narratives as part of the West Africa Justice Reporting Project. Funding was provided by the Swedish embassy in Liberia. The donor had no say in the story’s content.
This story was written by our student Gloria Wleh for New Narratives; Varsity Pilot takes no credit for the brilliance or ingenuity in the production of the content, including graphics used.