Does the Messenger Make a Difference? Religious and Traditional Leaders’ Role in Improving Access to Mental Health Services in Liberia Open Access

Slotta, Christopher (Spring 2018)

Permanent URL:


There are many mental health challenges, and opportunities, that are being addressed in Liberia in the wake of two civil wars, the last of which ended in 2003, and the 2014 Ebola crises. The civil wars are in the living memory of most of the population, and participants in the conflict live alongside survivors. This has caused trauma and political challenges, and slow rebuilding of trust among the parties to the conflict. The Ebola crisis also contributed to mental health challenges in another form, as the illness decimated the health workforce. This has caused further strain on an already resource strapped national healthcare system and workforce. While these conditions are more than unfavorable, they create opportunities to strengthen health systems, and they identify a “call to action” for mental health practices in the Ministry of Health’s broader strategy.  This follows action in 2011, where academic experts called on international organizations and national governments to place a stronger emphasis on global mental health.

The current research evaluates a strategy for promoting mental health services in Liberia via a scaling up approach using existing religious and traditional leaders.  The aims of this research are to explore the efficacy of the use of religious and traditional leaders using Key Informant Interviews (KIIs). Results showed that training and incorporating religious and community leaders into collaborative mental health care is feasible and advantageous. Next steps include adopting recommendations for continuing mental health education for religious and traditional leaders, bolstering the collegiality and collaboration between religious and traditional leaders and county mental health teams, working to address access to medications and medication supply chains, and working to address transportation issues around seeking mental health support and treatment.   

Table of Contents


Abstract 2.

Acknowledgements 3.

Table of Contents 4.

List of Figures 6.

Introduction and Literature Review 7.

Liberia Context 7.

Previous Calls and Responses to Address Global Mental Health 9 .

Incorporating Religious and Traditional Leaders for Improved Access to Mental Health Services 14.

Study Aims 16.

Methods 18.

Participants 18.

Sample 18.

Informed Consent and IRB 18.

Measures 18.

Multi Part Survey Tool 18.

Likert Statements 19.

Researcher-Prioritized Skills Identification 19.

Leader Provided Effective Skills 20.

Procedure 20.

Participant Training 20.

Researcher Training 20.

Recruitment and Data Collection 21.

Data Analysis 21.

Results 22.

Demographic Information 22.

Survey Results 22.

Likert Statements 22.

Researcher-Prioritized Skills Identification 24.

Leader Provided Effective Skills 25.

Discussion 25.

Key Informant Interviews (KII) 25.

Limitations 27.

Implications and Recommendations 29.

Task Sharing 29.

Engagement and Communication 31.

Conclusion 33.

References 35.

Annex 37.


About this Master's Thesis

Rights statement
  • Permission granted by the author to include this thesis or dissertation in this repository. All rights reserved by the author. Please contact the author for information regarding the reproduction and use of this thesis or dissertation.
  • English
Research Field
Committee Chair / Thesis Advisor
Partnering Agencies
Last modified

Primary PDF

Supplemental Files