The transformation has been backed by the U.S.-based health nonprofit Partners in Health, which has invested millions in rehabilitating the hospital including providing training, equipment, and services. A new building opened in mid-June as a rehabilitation center for drug users.
But there is little professional medical help for those living in the rest of the country beyond Freetown. The Ministry of Health established units for mental health in all 14 districts of the country almost a decade ago, but few function as intended due to a lack of trained staff and other resources.
Many people still go to traditional healers or religious figures for help, as many mental health conditions are associated with spiritual or demonic forces.
Sierra Leone’s population is still scarred from a more than decade-long civil war that began in the 1990s. Widespread unemployment, poverty, and other hardship also take a toll on mental health, contributing to the soaring rates of addiction to a locally produced drug known as kush.
There are also wider systemic challenges to mental health services.
Joshua Abioseh Duncan, the head of the Mental Health Coalition of Sierra Leone, a group that advocates for mental health, said the long overdue review of the country’s 1902 Lunacy Act that stigmatizes mental health issues — and strips people of basic rights — is contributing to the low level of funding and resources.
“The current law treats people with mental health issues as deviants in society who should be kept out of sight,” he said.
Few medical students in Sierra Leone consider psychiatry because of the lack of training opportunities and the limited earnings associated with the career, he added.
The government is taking some steps in coordination with international organizations. The health ministry is implementing a World Health Organization training program that aims to help healthcare workers identify and manage common mental health problems like depression, substance abuse and post-traumatic stress. The first 50 workers took the four-day course in June.
Sierra Leone’s director of mental health at the ministry declined to comment to the AP.
“Transforming mental health is a long game, it takes time,” said Giuseppe Raviola, a director at Partners In Health, which also set up a mental help line in Sierra Leone last year for counseling and advice. “Part of what takes time is not only building local capacity, but also making sure services are aligned with cultural beliefs and practices, and that things are driven locally.”
Jalloh first came to the psychiatric hospital for training during his fourth year of medical school and was shocked by its conditions.
He told his friends he would become a psychiatrist, which they thought was a joke. The profession is known to make little money and often fails to treat its patients. But after three years, he returned to the hospital and vowed to turn it from a place of suffering to sanctuary.
Despite the transformation of the hospital, Jalloh said soaring rates of addiction had taken a toll on his own mental health. The hospital continues to face challenges including a lack of security personnel to stop patients from scaling the walls to buy drugs.
As you can see me, I am not feeling well. There are a lot of challenges. We don’t have the capacity to handle the (kush) crisis, considering human resources, infrastructure, medication,” he said. “It’s a big challenge and a huge burden on us.”
