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. National and international commitment must be made to reduce the treatment gap and provide quality care for people with mental illness in Sierra Leone.
Mental health and substance use disorders constitute a high burden of disease. The gap is attributed to human resource constraints, stigma, weak technology and infrastructure, lack of political commitment, culture and traditional beliefs, and lack of research to guide policy formulation and implementation.
The prevalence of mental health problems is likely to have been adversely affected by the 1991–2002 civil war, economic problems, gender based violence, poor health outcomes including high rates of maternal and child mortality, and the recent Ebola epidemic.
The World Health Organization estimates that 10 percent of the seven million Sierra Leoneans have mental health problems. But due to the unknown number of unreported cases, the scourge of depression, anxiety, or post-traumatic stress disorder (PTSD) is likely to be much bigger. For decades, there was only one psychiatrist practicing in the country (now there are two) but this is rather unfortunate for a country of over seven million people only boast of having two psychiatrists and are only based in the capital city Freetown living the remaining fourteen Districts with none.
Sierra Leone may be home to the first and oldest mental health (MH) clinic in Africa, established in 1872, but the country still battles with deep-seated challenges associated with mental health conditions. This is as a result of the lack of infrastructure, inefficient and ineffective human resources backed up inaccessible treatment for mental health patients is killing a greater majority of the citizens.
According to a joint Ministry of Health and Sanitation and WHO survey in Sierra Leone, “more than 700,000 people have severe mental health problems needing medical treatment; more than 350,000 psychotic case are caused by drugs and alcohol abuse, as well as by severe infections like cerebral malaria; more than 20,000 have severe Bipolar manic depressive disorders; more than 175,000 are mentally scarred; and more than 175,000 suffer from epilepsy or schizophrenia.” The scars that don’t heal an assessment conducted by the International Medical Corps (IMC) suggested that during the Ebola crisis the country’s overstretched health system was unable to deal with the psychosocial legacy of the outbreak.
Many people lost entire families and their hope for the future. Fear, panic, stress, shame, uncertainty and isolation are increasingly common feelings among survivors, the organisation added. The IMC warned that psychosocial interventions need to be considered as part of the Ebola response and that the country’s health sector should integrate mental health into its health service provision for the long term.
But no effort has been made to address this issue because a the government fail to encourage young people who found themselves in the medical field to special in mental health so this has led to lack of personnel to handle this menace.
The heightened sense of frustration, poverty, economic inequalities and unemployment are leading causes of depression in Sierra Leone and that if mental health problems are not seriously considered and treated with urgency, the country’s peace and security will continue to be threatened. Depression and other mental health conditions are serious threats to the country’s stability and development. Mental health problems can lead to brain drain, untimely deaths, which can seriously hamper the country’s human capital and development aspirations.”
Mental Health issues are not given prominence in Sierra Leone. As the inadequacy of financial and human resource allocated to tackle the condition.