World Health Day: Improving mental health in Sierra Leone
by Colin Brown
April 7th marks World Health Day, established in 1948 at the First World Health Assembly to draw attention to issues of global health importance each year. This year’s theme highlights the issue of mental health, in particular ‘Depression: Let’s Talk’. I’ve just returned from Sierra Leone, where I work with King’s Sierra Leone Partnership (KSLP)*. KSLP has helped pioneer mental health services in a country with severe need, having only one mental health hospital and one retired psychiatrist (out of an estimated 150 doctors in the entire country). With over six million inhabitants, less than 2% have access to any mental health services.
Through our volunteer mental health nurses and psychiatrists, we established a clinic for psychological support for healthcare staff in Connaught hospital. Following the devastation of the West African Ebola outbreak, which saw over 14,000 Ebola Virus Disease (EVD) cases and nearly 4,000 deaths in Sierra Leone alone, nearly everyone in the country has been affected. Many staff lost friends, family, and colleagues, as well as counting survivors among them, and all witnessed unimaginable suffering as the disease ravaged the population. Depression in EVD survivors is increasingly recognised as a common sequela of EVD, and those who survived face a multiple burden of significant family loss and longstanding effects of the disease. Our clinic helps promote mental health and provides psychosocial support services for those affected. KSLP also support mental health services in a variety of other settings including 34 Military Hospital, the main medical centre for the Republic of Sierra Leone Armed Forces (RSLAF), who led the effort to combat EVD spread and now run dedicated clinics for survivors. We also supervise the training of mental health nurses, working to expand the small but dedicated mental health workforce.
Though there are significant challenges facing every health system, including at home with the National Health Service, it is important to remind ourselves this time of year of the health access gap that our colleagues across the globe face. Sierra Leone requires an estimated 2,500 extra doctors and 9,500 nurses and midwives to meet the WHO recommended minimum of 2.3 healthcare workers per 1,000 population. By working in partnership with our Salone colleagues, we are attempting to redress that burden, one consultation on depression at a time.
*KSLP is a bilateral link between King’s Health Partners in the UK and three key Sierra Leonean institutions – the Ministry of Health & Sanitation, Connaught Hospital (the country’s primary teaching and referral hospital), and the College of Medical and Allied Health Sciences (COMAHS), Sierra Leone’s only medical and pharmacy school
Colin Brown is a locum consultant at Public Health England in infectious diseases and microbiology, and works with King’s Sierra Leone Partnership (KSLP) as infectious diseases adviser.