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Tackling mental health in Sierra Leone

BMJ 2005; 331 doi: (Published 29 September 2005) Cite this as: BMJ 2005;331:720
  1. Joe Asare,
  2. Lynne Jones

    A pilot scheme has recently introduced basic mental health care to a remote area of west Africa that has never before received orthodox mental interventions. The organisers of the scheme, Lynne Jones and Joe Asare, describe its structure and assess its results

    Despite the emphasis on mental health in the World Health Report of 2001, and the subsequent revolution in mental health care in many countries, the citizens of some countries in Africa have little or no access to mental health care.

    The west African state of Sierra Leone went through a civil war lasting 15years that ended in 2002. With only one psychiatrist, two trained psychiatric nurses, and a population of four million, the country was in a weak position to deal with the mental health needs of its population during the years of reconstruction.

    A survey by the World Health Organization in Sierra Leone in 2002 found that 2% of the population was psychotic; 4% had severe depression; 4% had substance misuse; 1% had mental retardation; and 1% had epilepsy. WHO advocated the creation of community based mental health services.

    As a result, the International Medical Corps, a global humanitarian charity, applied and got funding from the Bureau of Population Refugees, and Migration, of the US State Department, to pilot a community based mental health project in the remote rural area of Kailahun, on the border with Liberia and Guinea.

    Kailahun is a district of about 300 000 people in eastern Sierra Leone. The area …

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