Awoko Newspaper is a local print media newsroom in Sierra Leone. Awoko in iyts Februaty 16, 20104 news paper published news about the launch of the Sierra Leone 2014 Mental Health Care Operational Strategy by the Minister of Ministry of Health and Sanitation.
The launch of the 2014 Annual Mental Health Operational Strategy for me is a step in the right direction and an excellent initiative demonstrated by the current government towards enhancing the wellbeing and enjoyment of rights of people with disabilities including those with mental disorders in the country. Moreover this is also a proof of the continued government commitment in the implementation of the Mental health Policy and 2010-2018 Strategic Plan to increase access to health care delivery services that seeks to improve the health of the nation’s citizens.
Sierra Leone in recent past has one of the worst health indicators in the world with extremely low life expectancy rate, high adult illiteracy rates of 48% in men and 71% in women. According to the Millennium Development Goal (MDG) report, (2010), in 2005 under-five mortality rate stands at 267/1000, maternal mortality in 2000 was at 1800/100,000 births and 875/100,000 in 2008 while HIV and AIDs stands at 1.5% of the country’s population.
World Health Organization (WHO) report, (2012), stated that 715,000 people in Sierra Leone are currently suffering from mental disorders, with only 2,000 receiving treatment. This creates a treatment gap of over 99% in the country’s due to the protracted neglect in the area of mental health and the country’s limited resources. The Ministry of Health and Sanitation (MoHS) mental health needs assessment report, (2005), found the prevalence rates to be 2% for psychosis, 4% for severe depression, 4% for severe substance abuse, 1% for mental retardation and 1% for epilepsy in the population. This makes the situation 4 times higher than the estimated global prevalence of 3% for severe mental illness. The Human Rights Commission report, (2013), highlighted the shortage of qualified medical personnel being one of the problems affecting the effective operations of the national psychiatric hospital. The hospital had only three trained psychiatric nurses and one psychiatric doctor. The nurses assigned at the hospital refused to report for duty due to the stigma associated with working in a psychiatric hospital. The non-availability of a counseling unit also remains a major challenge.This situation is worsen by drug/substance abuse and high rate of alcohol consumption in the country. WHO ProMIND profile mental health report, (2012), stated that in 2008, about 90% of admissions to the Sierra Leone psychiatric hospital were drug-related while the Sierra Leone Youth Report, (2012), stated that 15% of youth in the country are engaged in drugs/substance abuse. WHO, (2012), mentioned that an average of 9.7 litres of alcohol per capita is consumed by Sierra Leoneans as opposed to 6.2 litres per capita for the rest of the WHO African region. High alcohol consumption is often associated with mental disorders, as well as physical illness, unsafe sex and increased risk of road accidents. The MDG, (2010), report indicated that the deplorable situation of the country is as a result of poor infrastructure, poor social service delivery, lack of access to primary health care facilities and services, entrenched poverty, in effective governance, corruption and a host of other issues.
An interesting bit about Sierra Leone is that, most mental disorders were treated using traditional means and religious methods. Religion attributed some of these disorders as caused by “Demons” and therefore take people suffering from some of these diseases to churches and pastors for deliverance. (See Video)
Regardless of the abysmal situation described above, the country has made significant strides towards improving the primary health care system in the country including mental health services. WHO, (2012), report highlighted that the launching of the National Mental Health Policy in 2009 led to the integration of mental health in the Ministry of Health and Sanitation (MoHS) and the launch of the 2010- 2018 National Mental Health Strategic Plan in 2010. Also, 187 mental health care workers including nurses and Community Health Officers (CHO) from across the country where trained in 2011 and 2012 with the support of Mercy Ships, i WHO & MoHS. The implementation of strategic plan contributed to the introduction of Certificate and Diploma training courses in Psychiatric Nursing at the College of Medicine and Allied Health Sciences (COMAHS) in 2012. In addition, there is also increased community awareness raising and education across the country on metal health issues by state and non-state actors to enhance early identification and treatment of persons with mental disorders.
In response to further address the mental health issues in the country, the national 2014 Mental Health Operational Strategy was launched to provide a clear direction in addressing priority areas in the National Mental Health Strategic Plan across the country. The National Mental Health Program Director, Dr. Andrew Muana, stated during the launching that the strategy is a component of the National Mental Health Strategic Plan, 2014-2018. He also noted that the operational plan marks the launch pad for implementation of teh remaining mental healthcare model in Sierra Leone that caters for the involvement of communities along side health facilities at all level of the country’s health care delivery system.
The 2014 operational plan highlighted a focus on human resource capacity development on mental health, as well as the provision of scholarships and allowances for 40 Community Health Officers and 35 Nurses to pursue relevant postgraduate diploma courses in mental health and the recruitment and training of a Mental Health Specialist and health professionals.The Sierra Leone Psychiatric Hospital, will serve as a tertiary hospital for patient management, and also as a referral, teaching and research hospital for mental healthcare.
Responding to mental health issues in Sierra Leone is not a one-day journey considering the huge mental health needs and complexities that comes with that. Nonetheless, the implementation of this plan will contribute to increase mental health care workers in the country’s labor market whose expertise can be utilized to address immense mental health issues in the country.
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