Mental Health in Sierra Leone? What is it?

(PainOct. 10 et al., 2018)

My mental health experience.

People say that “The feeling of being rejected by people you consider as a family is one of the greatest disappointments in life.” I never understood the full meaning of this phrase till when I got older. Every letter traveled its way through hypnosis of thoughts to make a clear sense of understanding. My transition journey from high school to university demonstrated itself through a series of challenges that shaped the theory I now perceived about life.

I just turned 18 when I got admitted into medical school. So full of life and resilience, for me, that was a dream come true. Eager to see the world beyond the lenses of teenage life. Above all, so enthusiastically ready to explore this my newfound direction. Fancy as it may sound, the efforts needed to make one stay in medical school were more than usual. You have to go the extra mile in doing everything related to your school life.
Nevertheless, this was an adventurous trip worth embarking on, because???? Now pause. Let’s take a deep breath, shall we? Close your eyes and take my hand into yours. As you close your eyes, refresh, and position your mind as I take you through my depression journey.

In 2018, I was wrongly diagnosed and re-diagnosed with a severe illness while studying for my final exams. Mind you, and I was just in my first year of premedical school battling this unprecedented trial. I immediately informed the faculty about my condition, but they exhibited no form of empathy. Meaning if I didn’t write the exams, then I would have to repeat the class.
My mind began to process these two events taking place at the same time. My health or my education? A question I asked myself. But the state I was in couldn’t compliment this definition of being healthy. Mental health determines how we perceive, act, and respond to daily life challenges. It also helps decide how we cope with tension, interacts with others, and make decisions. I needed to choose my health. First, I could neither read nor sit in an exam room with the condition I had. I kept asking myself the “why me” questions. Since the faculty chose not to empathize with me, I decided to write the exams despite the state I was in, so I traded my nights with intensive studies.

Then it happened,

Well! Well! Well! Newsflash, after a series of sleepless nights, unfortunately, I failed the class. I got withdrawn from medical school with a percentage that was slightly below the passing mark. Can you imagine the pain of being withdrawn from school? I mean withdrawn! It hurts so bad. I was emotionally unstable, not knowing what to feel or how to react, just hoping to wake up from that dream. As time unwavering stayed calm with no the effect of changing its function, I battled each day with the truth. Depression was calling out to me in the most unlikely places, now withdrawn from the only hope I had. I have never encountered failure, and this was a whole package that came with intended mixed feelings. My mind was blank from the worries of my well-being; no one understood what I was going through; I felt like I was losing my sanity. It affected me so badly that I started questioning my existence.

Image source: Pinterest

If not for the people I was surrounded by, I would have easily given up on life, mainly because of the fear of judgment and stigma. Staying alone was one of my recommendations. I kept all this pain inside, not wanting to have others get a share in it. But help came when I decided to open up about my feelings.

Unlike me, The percentage of citizens suffering from mental illnesses in Sierra Leone is substantial. It is estimated that 715,000 people have a mental illness, with just 2,000 seeking care(World Health Organization, 2012). There is a significant treatment shortage in Sierra Leone because of its inadequate resources for providing mental healthcare. I was lucky enough to get my life back because of the kind of people I was surrounded with. These were the type of people who cared and loved me unconditionally and checked up on me. Not everyone would be lucky like me when our mental health system is in shambles. Poor care is administered to patients with severe mental health disorders because it remains highly stigmatized, as it is mostly associated with supernatural interventions. Professional help is not given to people with mild cases(Esliker, 2017).


The ongoing Ideology of mental health in Sierra Leone(based on facts and figures)

Image source: Pixabay

Sierra Leone may be the home of Africa’s first and oldest mental health (MH) clinic, founded in 1872 (Fitts et al., 2020). However, the country still struggles with deep-seated mental health challenges. With alarming mental health disorders, Sierra Leone is among the world’s poorest countries, exacerbated by incidents such as the recent pandemic. Patients suffer tremendously, with little information about the conditions and far less assistance(Harris et al., 2019).
A significant concern is the stigma against mental illness, and mental health awareness is extremely poor. Mental disorder is seen as a product of spiritual intervention or as something brought upon oneself. An individual with mental illness symptoms can be referred to as crezman or full full (regarded as someone who has lost their mind/ crazy or a fool). A 2005 evaluation suggested that up to 88 percent of people with mental illnesses would see a traditional healer before receiving medical treatment ((Harris et al., 2019). These healing strategies are complex and uncontrolled, leaving the considerable potential for violence, such as prolonged chaining, pounding, containment, food, and water deprivation(Jones et al., 2009).


Let’s rewind to history.

In 1991, different political ideas paved the way for a long decade of civil war that has left us psychologically displaced (Brima, 2017). The war’s impact has stemmed from debilitating mental wounds. Adverse repercussions of the bloodshed that ended in 2002 led to severe consequences. There are deaths, accidents, abuse, and trauma that are too severe even to imagine (Harris et al., 2019).
Despite the civil war experience, we were also challenged with Ebola in 2014 and a devastating mudslide in 2017(Esliker, 2017). Both of these events snatched our loved ones and countrymen away from us through death. A lot of people (I mean us) have lost whole families and hope for the future. Fear, anxiety, guilt, vulnerability, and loneliness are more and more common feelings among survivors.

After the flash floods and mudslide disasters of August 14, 2017, which affected an estimated 3,000 people and left almost 500 dead and an approximate 600 unaccounted for, the need to provide an urgent response to victims of the catastrophe with medical and mental health assistance has been highlighted as a top priority(Brima, 2017). Recently the coronavirus came and halted everything; as a result of this, WHO has estimated that 10% of the total population has mental health problems. The intensity of depression, psychosis, or post-traumatic stress disorder (PTSD) is significantly higher due to an unknown number of unreported cases(WHO, 2017).

Let’s discuss
As we usually say, do you think all of this was caused by the devil’s work? No, I don’t think so. It’s natural to feel sad and numbed when you lose someone very close to you. Death is an inevitable reality that we all are aware of. However, the fact remains that it always presents itself most shockingly. Imagine losing all of your family members right in front of your face, and there is absolutely nothing you can do about it. Just imagine that pain…! This is just an example of the psychological damage war, and other disheartening events can cause. Such activities may have physical, mental, psychological, and social effects for affected persons, and therefore, recovery can be challenging. Previous research has shown that, relative to physical damage, a massive disaster’s psychological impact has a more extensive and more prolonged effect on people(Allsopp et al., 2019). This is to say that people will take a longer time to heal emotionally than physical injuries.

Now what? How can I make a difference?

All understanding begins with awareness, every year; mental disorders affect 19% of the adult population, 46% of adolescents, and 13% of infants(Centers for Disease Control and Prevention, 2018). People dealing with their mental health may live next door or even be within your immediate family. Still, only half of those affected are treated, mostly because of the stigma associated with it. Unaddressed, mental illness can lead to higher healthcare costs, lower school results, fewer opportunities for jobs, and an increased risk of suicide(WHO, 2020). Stigma affects not just the number of individuals seeking care but also the number of services available to treat them properly. To anyone who is dealing with a mental health problem, stigma and misinformation may sound like daunting barriers. Here are a few beautiful things that you can do to help:

Educate yourself about mental health.
Disburse your knowledge and teach other people about the importance of having a sound mental health system.
And lastly, take care of yourself.

References
Brima, A. (2017, December 8). Invisible scars? Mental health provision in Sierra Leone. Peace Insight. https://www.peaceinsight.org/en/articles/invisible-scars-mental-health-provision-sierra-leone/?location=sierra-leone&theme=culture-media-advocacy
Centers for Disease Control and Prevention. (2018, January 26). Learn About Mental Health – Mental Health – CDC. Centers for Disease Control and Prevention. https://www.cdc.gov/mentalhealth/learn/index.htm
Esliker, R. (2017). Mental Health in Sierra Leone: Beliefs, Myths, and Truth. http://universityofmakeni.com/wordpress/wp-content/uploads/Mental-Illness-Sierra-Leone.pdf
Fitts, J. J., Gegbe, F., Aber, M. S., Kaitibi, D., & Yokie, M. A. (2020). Strengthening mental health services in Sierra Leone: perspectives from within the health system. Health Policy and Planning, 35(6), 657–664. https://doi.org/10.1093/heapol/czaa029
Harris, D., Endale, T., Lind, U. H., Sevalie, S., Bah, A. J., Jalloh, A., & Baingana, F. (2019). Mental health in Sierra Leone. BJPsych International, 17(1), 14–16. https://doi.org/10.1192/bji.2019.17
Holthaus, jean. (2019, May 2). The Importance of Mental Health Awareness | Pine Rest Blog. Pine Rest Christian Mental Health Services Grand Rapids, MI. https://www.pinerest.org/mental-health-awareness-blog/
Losing Someone, You Love – Dealing With Change, Death – Tributes To Those We Love – Page 10. (n.d.). Motivateus.com. Retrieved December 11, 2020, from https://motivateus.com/stories/grieve-10.htm
National Alliance on Mental Illness. (, 2019). Mental Health Month | NAMI: National Alliance on Mental Illness. Nami.org. https://www.nami.org/Get-Involved/Awareness-Events/Mental-Health-Month
paint. 10, E., 2018, & Pm, 12:45. (2018, October 10). Why World Mental Health Day matters for scientists. Science | AAAS. https://bit.ly/31h0TtH
says, M. H. A. (2020, December 4). The Importance of Mental Health Awareness. TABIIB Blog. https://blog.tabiib.com/general-health/the-importance-of-mental-health-awareness/
Sikafi, D. Z. (2018, September 11). How can we break the taboo of mental health in the workplace? Training Journal. https://www.trainingjournal.com/articles/opinion/how-can-we-break-taboo-mental-health-workplace
Tello, P. (2020, July 7). The pandemic is a new cause of depression in children, Part 3 | South Florida Media Network. FIU’s South Florida Media Network. http://sfmn.fiu.edu/the-pandemic-is-a-new-cause-of-depression-in-children-part-3/
Werne, M., & Acland, O. (2019, July 9). ‘Toxic stress’: Addressing mental health needs in Sierra Leone. Www.Aljazeera.com. https://www.aljazeera.com/gallery/2019/7/21/toxic-stress-addressing-mental-health-needs-in-sierra-leone/
World Health Organization. (, 2012). WHO | WHO Country Profiles: Mental Health in Development (WHO proMIND). WHO. https://www.who.int/mental_health/policy/country/countrysummary/en/
World Health Organization: WHO. (2018, March 30). Mental health: strengthening our response. Who. Int; World Health Organization: WHO. https://www.who.int/en/news-room/fact-sheets/detail/mental-health-strengthening-our-response
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