Stigmatized Issues, Divergent Meanings: The Entanglement of Meaning-Making and Forms of Power Among Stakeholders in Liberia’s Mental Health Program

Abstract This article uses Liberia’s national mental health program to explore how stakeholders make meaning of their work and how those meanings intertwine with various powers to shape program outcomes. We use interview data to analyze how the Carter Center (an INGO), Liberian government, and local mental health practitioners understood the program to address this stigmatized, often-ignored health issue. INGO officials emphasized personal connections, virtuous actions, and expertise in meaning-making, ideas intertwined with network, moral, and epistemic powers. Liberian government officials understood the program to be government directed but financially unaffordable, illustrating the government’s institutional authority but low economic power. Mental health clinicians perceived the program as a virtuous opportunity to gain expertise and economic advancement, although they used the power to exit when these aspirations were unrealized. This article illustrates that meaning-making cannot be divorced from actors’ various powers and that stakeholders’ failure to align meanings can undermine program outcomes.