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Connecting People in Sierra Leone

Our next seminar in the International Centre for Mental Health Social Research (ICMHSR) on 26th September will discuss our work in Sierra Leone.

Funded by the Wellcome Trust and the University of York via the Centre for Chronic Diseases and Disorders (C2D2), Meredith Newlin and Dr Susie Whitwell from King’s Centre for Global Health visited Sierra Leone in July to explore how social interventions can help to meet the needs of people with mental health problems. During their visit, Meredith and Susie conducted interviews, focus groups and observations in a variety of mental health service settings and with a number of key stakeholders in the three largest cities, Freetown, Makeni, and Bo.

University of Makeni

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Like many post-conflict societies, Sierra Leone lacks capacity in its health and social care workforce. Where an estimated 13 per cent of the adult population suffers from a mental disorder and there exists only one trained psychiatrist for a population over 4 million, the lack of mental health training and supervision represents a significant barrier to addressing mental health needs.

Although training has begun for 21 psychiatric nurses, focus has been placed on the medical model, which is problematic in a country with poor access to medications. Upon graduating this autumn, the nurses will be based in district hospitals across the country with referral pathways reaching into the rural communities. Training in psychosocial approaches is greatly needed both at district and community levels in order to strengthen the care available to adults with mental health problems.

Psychiatric nurse training at Enabling Access to Mental Health (EAMH)

Meredith and Susie joined the psychiatric nurses for three days of training where they discussed principles of social capital and strategies they currently use to build relationships with patients, and spent time reviewing difficult cases. This gave them an opportunity to analyse the difference between actual symptoms of mental disorders and stereotypes associated with unusual behaviour in a context where people with mental health problems are highly stigmatised and vulnerable. Time spent with the nurses also enabled them to better understand the manifestations of illness from a sociocultural perspective. For example, the nurses explained they see young women suffering more from “frustration” (Krio for depression) due to the immense pressure placed on them to marry and have children, which may be over-diagnosed as psychosis given the prevalence of stigma in the community.

Susie discussing case studies with the psychiatric nurses

Feedback from stakeholders on the adaptation of the Connecting People intervention model was positive, highlighting specific elements of social capital within the cultural context:

  • Building of trusting relationships between the health worker and service user
  • Deepening connections in the community, particularly with family members
  • Enhancing public awareness of mental health thereby minimising stigma
  • Traditional beliefs of mental illness impacting perceptions of recovery

From the data collected in this feasibility study, we will continue to collaborate with stakeholders in Sierra Leone to enhance the psychosocial skills of mental health workers through adaptation of the intervention model and development of a training programme.

We are pleased to announce that the next stage of the project will be funded by the Maudsley Charity, which enable the piloting of the new social intervention training programme in Sierra Leone in 2014.

If you are interested in finding out more about this project, please come along to our free seminar on 26th September from 4-5pm at the University of York. More information can be found on the ICMHSR website.

 

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