<b>Invisible Scars: Exploring the Prevalence and Causes of Unexplained Psychological Trauma Among Youth in Post-Conflict Liberia</b>

Background: Post-conflict Liberia is dealing with a rapidly swelling mental health crisis, especially among its young populations. Even though visibility to violence has decreased since the civil wars, young people continue to present psychological symptoms that have no physiological explanation. Invisible scars have manifested in symptoms of fatigue, sleep difficulties, mood disturbances, and social withdrawal while drawing from both present trauma and current socioeconomic uncertainty. Methods: A cross sectional study was conducted between February to May in the year 2025 with 377 young people aged 15–30 in five counties across Liberia using stratified random sampling. A structured questionnaire was created to collect information on participants’ psychological symptoms, level of conflict exposure, current life stressors, styles of coping, and access to mental health resources. Data were analysed using SPSS v26, employing descriptive statistics, Pearson's correlation, and binary logistic regression in order to identify pivotal associations. Results: Table 1 indicates that 61.8 % of young people reported having at least two trauma-related symptoms over the last six months. The most frequently reported symptoms were unexplained fatigue (67.1 %), mood swings (52.5 %), and sleep problems (43.7 %)(Table 2). There had been only 14.3 % access to mental health services (although 71.1 % demonstrated a willingness to access support) (Table 3). There was a significant correlation between insecurity and lifetime frequency of trauma symptoms (r = 0.47, p < 0.01) (Table 4). From Table 5, we note that young people reporting three or more symptoms were 2.9 times (OR = 2.9, 95 % CI: 1.8–4.6) more likely to have educational or social interruptions. Conclusion: Unexplained psychological trauma is commonplace among young people in Liberia, shaped by the legacy of war and current uncertainty regarding socioeconomic status. While there was a generally high level of willingness to engage on their mental health needs, systemic fractures and cultural stigma inhibit pathways for access to mental health services. There remains an urgent need to consider the intersection of mental health and youth development through a policy lens.