Tag Archives: Ebola

Mental Health is the centre of attention at the World Bank this year: “Out of the shadows; making mental health a global priority”

Momenta's Project Sierra Leone 2015

The human toll of mental illness has started to be widely recognised for its impact on individuals and families. There is now much more awareness of, for example depression, due to stories in the media about famous people who are talking openly about their problems. Even the once taboo subject of suicide is now more openly acknowledged in society.  When someone like the comedian Robin Williams dies by suicide, it has the effect of reminding us that at least 1,000,000 people die in this way every year around the world. In many countries suicide is one of the top three causes of death in young people, but is often ignored or even denied as an issue.

CBM, along with many other partners in global development have long pointed out that mental illness and psychosocial disability also has an important impact on communities and broader society. Mental illness does not only cause personal suffering, but often results in social exclusion and lack of opportunity for large sectors of the population to contribute to the economy and community development. Since 85% of the people with mental conditions live in the poorest countries in the world, the impact is particularly marked on these fragile economies.

By 2030, depression is expected to become the single largest contributor to disease burden globally, and even today, 350 million people around the world are affected by depression. The sheer scale of this issue, and the well documented impact on people’s ability to work and actively engage in the economic life of a country has led the World Bank to focus on mental illness at their annual Spring Meeting in Washington in April. At last year’s World Economic Forum, careful analysis in a report by a Harvard group resulted in an estimate that the annual global costs of mental illness to the economy was 2.5 trillion dollars in 2010, a staggering number that was expected to rise to 6 trillion dollars by 2030.

The joint meeting, called ‘Out of the shadows, making mental health a global priority’ will be run by the World Bank and WHO, from April 13th to 15th in Washington. It will be a forum to examine how the major financial actors in global development can address this issue. These key funders and politically powerful groups can hopefully start to play their role, joining development organisations like CBM, and other groups like service user organisations and activists, so make more resources available and raise prioritisation of mental health.

CBM will be well represented at the meeting. Carmen Valle will be sharing our experiences of working in Sierra Leone with partners to build resilience and reduce the psychological impact of the Ebola epidemic. This is a part of Disaster Risk Reduction that is often not sufficiently recognised. Information about this project with our partners in Sierra Leone is here. She will also be talking about how our partners ensured that access to important public health messages, for example during an epidemic like the 2014/15 Ebola outbreak, can be accessible to all people, including people with disabilities.

I will be speaking during a panel discussion on the topic of mental health and people with sensory impairments. The main points are that

  • Mental ill health is much more common in people with sensory impairments, but is often not recognised.
  • Mental health components should be integrated into services for people with sensory impairments, for example ensuring that service users themselves, and health and education personnel, are made sensitive to these needs and are aware of how to address them
  • The barriers that people with sensory impairments face should be specifically addressed in messaging relating to mental health by paying attention to accessible formats (as in any other awareness and public health work).

Carmen and Julian will be Tweeting and Blogging from the meeting. Follow our our blog, Twitter and Facebook to get all the latest news about the WHO meetings in Washington DC (the hashtag for this event is #mentalhealthnow). You can also follow Dr. Julian Eaton and Dr. Carmen Valle on Twitter who will be tweeting live from the events.

Additional information on the Innovation Fair can be found here.


Julian Eaton

Mental Health Advisor, CBM

Building Back Better from West Africa’s Ebola Outbreak

Earlier this month, the Government of Liberia and the WHO hosted  the “Technical Consultation Meeting on the Mental Health and Psychosocial Support of People Affected by Ebola Virus Disease.” The purpose of this 2 day meeting was to collect lessons learnt and establish how to “build back better” from the Ebola virus disease outbreak in West Africa. The meeting brought together key mental health and psychosocial support stakeholders from Sierra Leone, Guinea and Liberia. Included amongst these participants were representatives from CBM’s mhLAP programme. The mhLAP Country Representatives from both Liberia and Sierra Leone were active participants in the event and will hold an important role in supporting rolling out the plans made during the meeting. Below is a full description of the event:

Mental Health and Psychosocial Support for People Affected by Ebola Virus Disease

In Monrovia, Liberia on June 10th and 11th, 2015, stakeholders in mental heath and psychosocial support (MHPSS) came together to discuss, learn and make plans to ‘Build Back Better’ from the regional effects of the West African Ebola virus disease outbreak.

Ebola virus disease was first detected in Guinea in March 2014, spreading across the porous borders to Sierra Leone and Liberia by May 2014. While Liberia has recently been declared ‘Ebola Free,’ Sierra Leone and Guinea continue to wage battle against the outbreak. To date,  it is estimated that over 27,000 people have been infected by the virus while over 11,000 people have died. Beyond the loss of human lives, we are only beginning to understand how Ebola virus disease has impacted the Liberia, Guinea and Sierra Leone.

From an MHPSS perspective, we know that the outbreak has led to significant impact on the mental and social health of people in the region.  In addition the experience of loss and fear, many people have been exposed to distressing situations and images, potentially leading to stress, anxiety and mood disorders. Social problems continue to emerge within the 3 countries, including challenges faced by survivors of Ebola virus disease, health care workers and other support workers who are experiencing stigma and discrimination from their within their own families and communities. In addition, due to travel and work restrictions put in place during the outbreak as well as loss of community members, there has also been a drastic decline of income generation within communities.

There is an obvious need to learn and document the experiences of addressing MHPSS needs in the region and for countries to make plans on how they will strengthen their mental health systems to best meet the needs of their residents. It is for this reason that Liberia’s Ministry of Health and Social Welfare with the support of WHO Liberia hosted last week’s ‘Technical Consultation on Mental Health and Psychosocial Support for People Affected by Ebola Virus Disease.’ The meeting brought together over 75 representatives from the three countries, including members of the Ministries of Health and Social Welfare, national and international NGO partners and donor agencies, in addition to WHO MHPSS staff from Headquarters, the AFRO Regional office and the three WHO country offices.

Participants at the workshop

Participants at the meeting


There were three objectives for the meeting:

  1. To identify achievements, challenges and lessons learned in relation to the Ebola-related mental health and psychosocial emergency response in the three countries
  2. To produce a roadmap of mental health system recovery/development for the three countries
  3. Identification of a minimum response framework for mental health and psychosocial support that can be rolled out in case of similar future outbreaks in other countries based on the experience of Ebola mental health and psychosocial response in the three countries.

Representatives from the Ministries of Health and Ministries of Social Welfare presented lessons learned and challenges faced in addressing MHPSS needs. Presentations were also made to highlight the priority MHPSS activities in each of the countries.  Extensive amounts of time were allocated for group discussions, providing opportunities for participants to share experiences and learn from each other.  A draft of “Mental Health and Psychosocial Support (MHPSS) Considerations in Ebola Virus Disease Outbreaks: What should public health officers know?,” a minimum response framework for addressing MHPSS in future Ebola outbreaks, was also shared and discussed amongst participants.  The feedback received from the participants will be integrated into the final draft of the document.


The feedback from participants attending the meeting was extremely positive. Many participants expressed that the meeting set a positive momentum for mental health and psychosocial support in their countries:

“I think the meeting is a potential game-changer for mental health service delivery and policy implementation in Liberia and most likely the region.  In my experience for mental health in Liberia this is ‘truly huge’!” -Janice Cooper, Country Lead for the Liberia Mental Health Initiative, The Carter Centre, Liberia

Others participants conveyed the priceless opportunity to share experiences from such a broad range of stakeholders from the region, recommending that such meetings take place annually:

“There is no better moment than meeting with other delegates in such a great gathering, sharing experiences with great minds.  The sessions provided a forum where shared ideas were analyzed, processed and reproduced to meet felt needs of the EVD stoked Mano River Union countries; thus laying a solid foundation to building back better. Bunch of thanks to the organizers and facilitators.  I recommend that such meetings be held annually.” – Joshua A. Duncan, Coordinator Mental Health Coalition, Sierra Leone

In addition, there was a sense of morale boosting amongst participants:

“For me, the impact on our team (international and national) was huge; partly so because we could see the difference between the countries in terms of resources, which gave some context for us. For one of my counterparts present, it was so helpful to her that another person in Liberia offered ideas on how they could collaborate (Guinea/Liberia) on women’s issues relevant to effects of Ebola. For her, French speaking only, this was a huge sense of collaboration and camaraderie. That last piece was also part of the morale boost for the team. Guinea is difficult because of the acute situation of Ebola transmission, the lack of budget for mental health, and on the other hand, the intense commitment and motivation of host country nationals working with us and trying so hard to change things. As one told me, “I feel motivated now!” and eager to talk to others so they too become engaged in a national agenda to support the implementation of mental health services.” – Laurie Lopez Charlés, Mental Health and Psychosocial Support, WHO Guinea

Overall, the consensus from participants and organizers was that the meeting was worthwhile. It is anticipated that the discussions that took place will support the governments and mental health and psychosocial support stakeholders to ‘Build Back Better’ in Liberia, Guinea and Sierra Leone.

For further information contact: Heather Pearson

Related site – Mental Health Innovation Network


Finally we are looking beyond Ebola in Sierra Leone

CBM has been working with partners throughout the Ebola outbreak in West Africa, which has seen over 10,000 people lose their lives, communities decimated, and the economies collapse. In Sierra Leone, where I have just finished a week-long visit, the schools have just re-opened and the numbers of new cases are now very few. The Ebola Treatment Centres are mostly on stand-by, and life is slowly returning to normal. It felt strange not shaking hands or touching people, and having to wash hands and have your temperature taken every time you enter a building.




I was here to facilitate a national consultation on rebuilding mental health services organised by the WHO, as we emerge from emergency response to recovery and rebuilding. I also used to opportunity to visit our well established mental health programme, Enabling Access to mental Health in Sierra Leone, and the two Ebola response projects that our partners have been running over the last year.

I was extremely proud to hear the essential role that the psychiatric nurses trained by our programme placed in all districts in the country played in supporting the people affected by Ebola, including survivors, orphans, health workers, and other members of communities who experienced loss of loved ones and fear of this terrible disease. Because the Enabling Access programme had been in place for 4 years, they were able to provide this essential service when the disease arrived, and our partner staff showed remarkable dedication in the face of great personal risk to themselves. Sadly one of our dedicated nurses died from Ebola, and one survived the infection.




As the epidemic took hold, CBM decided to start two new programmes focused on the Ebola response. Our partner West Africa Medical Missions worked to ensure that the key messages about safety and protection from infection were made available to community of persons with disabilities. They worked with national groups of persons with visual and hearing impairments, and physical and mental disabilities, to create relevant and accessible messages through posters, music and video, as well as visiting special schools and disabled persons’ organisations with people who could communicate through sign language. The Mental Health Coalition, a new and strong voice for mental health that emerge from the Enabling Access programme, led an initiative to ensure that emotional needs were addressed for those affected by Ebola. Without these CBM partners, these vulnerable groups would have been neglected.




During my visit there, many people thanked CBM for the support provided during the outbreak. I left immensely proud of our partners’ work, and it is exciting now to be embarking on establishing stronger services for the long term.