scholarly journals Mental health in Sierra Leone

2019 ◽  
Vol 17 (1) ◽  
pp. 14-16 ◽  
Author(s):  
Dawn Harris ◽  
Tarik Endale ◽  
Unn Hege Lind ◽  
Stephen Sevalie ◽  
Abdulai Jawo Bah ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Sierra Leone ◽  
Quality Care ◽  
Mental Health Policy ◽  
Sub Saharan Africa ◽  
National Budget ◽  
People With Mental Illness ◽  
Provide Quality Care ◽  
Sub Saharan

Sierra Leone is a West African country with a population of just over 7 million. Many Sierra Leoneans lived through the psychologically distressing events of the civil war (1991–2002), the 2014 Ebola outbreak and frequent floods. Traditionally, mental health services have been delivered at the oldest mental health hospital in sub-Saharan Africa, with no services available anywhere else in the country. Mental illness remains highly stigmatised. Recent advances include revision of the Mental Health Policy and Strategic Plan and the strengthening of mental health governance and district services. Many challenges lie ahead, with the crucial next steps including securing a national budget line for mental health, reviewing mental health legislation, systematising training of mental health specialists and prioritising the procurement of psychotropic medications. National and international commitment must be made to reduce the treatment gap and provide quality care for people with mental illness in Sierra Leone.

An Efficient Nurse Practitioner–Led Community-Based Service Model for Delivering Coordinated Care to Persons With Serious Mental Illness at Risk for Homelessness

2017 ◽  
Vol 24 (2) ◽  
pp. 101-108 ◽  
Author(s):  
Jeannemarie Baker ◽  
Jasmine L. Travers ◽  
Penelope Buschman ◽  
Jacqueline A. Merrill
Keyword(s):  
Mental Health ◽  
At Risk ◽  
Mental Illness ◽  
Serious Mental Illness ◽  
Nurse Practitioners ◽  
Nurse Practitioner ◽  
Quality Care ◽  
Coordinated Care ◽  
Community Based ◽  
Provide Quality Care

BACKGROUND: Access to mental health care is a struggle for those with serious mental illness (SMI). About 25% of homeless suffer from SMI, compared with 4.2% of the general population. OBJECTIVE: From 2003 to 2012, St. Paul’s Center (SPC) operated a unique model to provide quality care to the homeless and those at risk for homelessness, incarceration, and unnecessary hospitalization because of SMI. Data were available for analysis for the years 2008 to 2010. DESIGN: The SPC was developed, managed, and staffed by board-certified psychiatric/mental health nurse practitioners, offering comprehensive mental health services and coordinated interventions. RESULTS: All clients were housed and none incarcerated. From 2008 to 2010, only 3% of clients were hospitalized, compared with 7.5% of adults with SMI. Clinical, academic, and community partnerships increased value, but Medicaid reimbursement was not available. CONCLUSION: Mental health provisions in the recently passed 21st Century Cures Act support community mental health specialty treatment. The SPC provides a template for similar nurse practitioner–led models.

An anthropological demography of mental health in Senegal

2020 ◽  
pp. 153-182
Author(s):  
Véronique Petit
Keyword(s):  
Mental Health ◽  
Social Dynamics ◽  
Psychiatric Treatment ◽  
Mental Health Policy ◽  
Field Research ◽  
Sub Saharan Africa ◽  
Diverse Society ◽  
Psychiatric Intervention ◽  
Sub Saharan ◽  
Development Objectives

This chapter stems from ongoing field research on mental health in Senegal, an African country in the midst of an epidemiological transition. While mental health has been integrated into global health and sustainable development objectives, it is not a priority in sub-Saharan Africa. Few states have a mental health policy, nor specific programmes and data on the situation of mentally ill people and their families. From the time of the French colonization, Senegal has developed an original strand of psychiatric intervention, the Fann School of Cultural Psychiatry. The current supply of psychiatric care takes place in the multi-therapeutic context of this ethnically and religiously diverse society. The therapeutic pathways of patients are analysed in terms of stigmatization, relationships between patients and healers, socio-economic inequalities, poverty, and the absence of universal medical coverage for the entire population. To understand adherence to psychiatric treatment, one must take into account the family and social dynamics at work in a society increasingly marked by individuation processes and globalization through international migration. In attending to the subtleties of care as conceived by sufferers’ families and social networks, the chapter points to multiple layers of the demographic governance of mental ill health, from the state to local kin and social groups.

scholarly journals The Burden of Mental Disorder in Sierra Leone: an Evaluation of Programmatic Data From the Roll Out of Decentralised Nurse-led Mental Health Units

2021 ◽  
Author(s):  
Helen Hopwood ◽  
Stephen Sevalie ◽  
Moshi Optat Herman ◽  
Dawn Harris ◽  
Katharine Collet ◽  
...  
Keyword(s):  
Mental Health ◽  
Sierra Leone ◽  
Negative Binomial ◽  
Suicide Attempts ◽  
Medically Unexplained Symptoms ◽  
Sub Saharan Africa ◽  
Pathways To Care ◽  
Treatment Gap ◽  
Sub Saharan ◽  
Roll Out

Abstract Background: In sub-Saharan Africa the treatment gap for mental disorders is high. In 2009, 98·0% of people with mental illness in Sierra Leone were not receiving treatment, partly due to the absence of public psychiatric facilities outside the capital. In response, the Ministry of Health and Sanitation rolled out nurse-led mental health units (MHU) to every district. Methods: We evaluated the roll out of MHU using summary data from all units between 1st January 2015 and 1st January 2017, to establish the burden of diagnoses among service users, pathways to care, treatments provided, and treatment gaps. Negative binomial regressions examine bivariate relationships between diagnoses, treatments, and medication inaccessibility with demographics (age and sex), location (Freetown vs the rest and Ebola endemic regions vs the rest) and year. Results: We collected data from 15 MHU covering 13 districts in 24 months. There were 2401 referrals. The largest age category was 25-34 (23·4%). The prominent diagnoses were epilepsy (43·5%, associated with children) and psychosis (17·5%, associated with males). Reported depression (8·6%) and suicide attempts (33 patients) were low. Ebola endemic regions reported higher rates of grief, trauma, and medically unexplained symptoms. In 24·7% of cases where medication was required, it was not accessible.Conclusions: Nurse-led MHU can have a modest effect on the treatment gap in resource constrained environments such as Sierra Leone, particularly in epilepsy and psychosis.

scholarly journals Attitudes towards mental illness in Uganda: a survey in 18 districts

2007 ◽  
Vol 4 (1) ◽  
pp. 19-21 ◽  
Author(s):  
Vuokko Wallace ◽  
Jed Boardman ◽  
James Walsh
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Health Workers ◽  
Mental Healthcare ◽  
Traditional Healers ◽  
Capital City ◽  
Sub Saharan Africa ◽  
Psychiatric Nurses ◽  
Poor Access ◽  
Sub Saharan

Uganda, in common with many countries in sub-Saharan Africa, has many population risk factors predictive of high levels of mental disorder but poor coverage of mental healthcare (Kigozi, 2005). Recent population studies conducted in Uganda have shown rates of disorder in excess of 20% (Kasoro et al, 2002; Bolton et al, 2004; Ovuga et al, 2005) and the survey by Kasoro et al (2002) showed a high prevalence of patients with severe mental illness and poor access to services. There are 19 psychiatrists for 24.8 million people in Uganda, all but one of whom is based in the capital city, Kampala (Kigozi, 2005). The provision of mental health services relies on the use of psychiatric clinical officers (a cadre of trained mental health workers, similar to community psychiatric nurses, who currently cover 18 of the 56 districts in Uganda), primary care personnel, non-governmental organisations and members of the community. Liaison with traditional healers is encouraged (Ovuga et al, 1999).

scholarly journals Participants’ experiences of engagement in community-centred mental health and psychosocial support programmes in conflict-affected communities within sub-Saharan Africa: a qualitative systematic review

2021 ◽  
Vol 6 (12) ◽  
pp. e005388
Author(s):  
Cleothia Caroline Alford ◽  
Yuko Otake
Keyword(s):  
Mental Health ◽  
Sierra Leone ◽  
Low Income ◽  
Psychosocial Support ◽  
Well Being ◽  
Sub Saharan Africa ◽  
Policy And Practice ◽  
Middle Income ◽  
Republic Of The Congo ◽  
Sub Saharan

BackgroundSub-Saharan Africa (SSA) experienced a burden of organised violence within 18 low-income and middle-income countries and hosted over 33 million displaced persons in 2019. Community-centred mental health and psychosocial support (cc-MHPSS) programmes may provide insights to address the psychosocial well-being of conflict-affected individuals, though literature is mixed on community impact. This review aimed to synthesise qualitative evidence to understand the kind of experiences conflict-affected participants have and how these experiences occur during cc-MHPSS programme engagement in SSA.MethodsWe searched Global Health, MEDLINE, Psychological Information Database, Embase Classic+Embase, Social Policy and Practice, Web of Science, Africa-Wide Information, PubMed and Global Index Medicus databases. Eligible publications qualitatively reported on conflict-affected participants’ experiences of engagement in cc-MHPSS programmes. Data were extracted to summarise publication characteristics. The results were synthesised using a thematic synthesis analysis.ResultsThe search yielded 953 records, of which 20 publications were included in the review. Included publications were located in Rwanda (n=8), the Democratic Republic of the Congo (n=3), Mozambique (n=3), Sierra Leone (n=1), Ghana (n=1), Uganda (n=1), Zimbabwe (n=1) and South Sudan (n=1); one publication included three countries (Sierra Leone, Liberia and Uganda). Findings include the themes of (1) the experience of change in time and space, and (2) the sharing and silence of participants’ experiences. Findings demonstrate that elements transferred by participants from a cc-MHPSS programme to a natural community, and vice versa, contribute to participants’ healing. Elements’ transfer, or non-transfer, was often related to participants’ disclosure, or non-disclosure, of experiences.DiscussionFindings suggest that there are elements from a cc-MHPSS programme and a wider community which aid participant engagement and work therapeutically. More rigorous research is needed concerning how participants experience change during cc-MHPSS programme engagement in proximity to their relationship with the wider community.PROSPERO registration numberCRD42020197300.

scholarly journals Metabolic syndrome among people with mental illness in sub Saharan Africa: Female gender as a factor. A Systematic review and meta-analysis

2021 ◽  
Vol 65 ◽  
pp. 102351
Author(s):  
Robel Hussen Kabthymer ◽  
Solomon Nega Techane ◽  
Solomon Hailemariam ◽  
Yibeltal Alemu Bekele ◽  
Birhanie Mekuriaw
Keyword(s):  
Systematic Review ◽  
Metabolic Syndrome ◽  
Mental Illness ◽  
Meta Analysis ◽  
Female Gender ◽  
Sub Saharan Africa ◽  
People With Mental Illness ◽  
Sub Saharan

scholarly journals The burden of mental disorder in Sierra Leone: a retrospective observational evaluation of programmatic data from the roll out of decentralised nurse-led mental health units

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Helen Hopwood ◽  
Stephen Sevalie ◽  
Moshi Optat Herman ◽  
Dawn Harris ◽  
Katharine Collet ◽  
...  
Keyword(s):  
Mental Health ◽  
Sierra Leone ◽  
Negative Binomial ◽  
Suicide Attempts ◽  
Medically Unexplained Symptoms ◽  
Sub Saharan Africa ◽  
Pathways To Care ◽  
Treatment Gap ◽  
Sub Saharan ◽  
Roll Out

Abstract Background In sub-Saharan Africa the treatment gap for mental disorders is high. In 2009, 98.0% of people with mental illness in Sierra Leone were not receiving treatment, partly due to the absence of public psychiatric facilities outside the capital. In response, the Ministry of Health and Sanitation rolled out nurse-led mental health units (MHU) to every district. This study aims to retrospectively evaluate the uptake of these services by examining the pathways to care, diagnosis, management, and treatment gap, to provide insight into the functioning of these units and the potential burden of mental health disorders in Sierra Leone. Methods We evaluated the roll out of MHU using summary data from all units between 1 st January 2015 and 1 st January 2017, to establish the burden of diagnoses among service users, pathways to care, treatments provided, and treatment gaps. Negative binomial regressions examine bivariate relationships between diagnoses, treatments, and medication inaccessibility with demographics (age and sex), location (Freetown vs the rest and Ebola endemic regions vs the rest) and year. Results We collected data from 15 MHU covering 13 districts in 24 months. There were 2401 referrals. The largest age category was 25–34 (23.4%). The prominent diagnoses were epilepsy (43.5%, associated with children) and psychosis (17.5%, associated with males). Reported depression (8.6%) and suicide attempts (33 patients) were low. Ebola endemic regions reported higher rates of grief, trauma, and medically unexplained symptoms. In 24.7% of cases where medication was required, it was not accessible. Conclusions Nurse-led MHU can have a modest effect on the treatment gap in resource constrained environments such as Sierra Leone, particularly in epilepsy and psychosis.

scholarly journals Community study of knowledge of and attitude to mental illness in Nigeria

2005 ◽  
Vol 186 (5) ◽  
pp. 436-441 ◽  
Author(s):  
Oye Gureje ◽  
Victor O. Lasebikan ◽  
Olusola Ephraim-Oluwanuga ◽  
Benjamin O. Olley ◽  
Lola Kola
Keyword(s):  
Mental Illness ◽  
Mentally Ill ◽  
Community Sample ◽  
Sub Saharan Africa ◽  
Violent Behaviour ◽  
Negative Attitudes ◽  
Social Contacts ◽  
Poor Knowledge ◽  
People With Mental Illness ◽  
Sub Saharan

BackgroundThe improvement of community tolerance of people with mental illness is important for their integration. Little is known about the knowledge of and attitude to mental illness in sub-Saharan Africa.AimsTo determine the knowledge and attitudes of a representative community sample in Nigeria.MethodA multistage, clustered sample of household respondents was studied in three states in the Yoruba-speaking parts of Nigeria (representing 22% of the national population). A total of 2040 individuals participated (response rate 74.2%).ResultsPoor knowledge of causation was common. Negative views of mental illness were widespread, with as many as 96.5% (s.d.=0.5) believing that people with mental illness are dangerous because of their violent behaviour. Most would not tolerate even basic social contacts with a mentally ill person: 82.7% (s.e.=1.3) would be afraid to have a conversation with a mentally ill person and only 16.9% (s.e.=0.9) would consider marrying one. Socio-demographic predictors of both poor knowledge and intolerant attitude were generally very few.ConclusionsThere is widespread stigmatisation of mental illness in the Nigerian community. Negative attitudes to mental illness may be fuelled by notions of causation that suggest that affected people are in some way responsible for their illness, and by fear.

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