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PERSPECTIVE article

Front. Psychiatry
Sec. Social Psychiatry and Psychiatric Rehabilitation
Volume 16 - 2025 | doi: 10.3389/fpsyt.2025.1419448

Policy and practice implications of contextual understanding and tools to address mental health and psychosocial support needs in Sierra Leone

Provisionally accepted
Alastair Ager Alastair Ager 1*Rebecca Horn Rebecca Horn 1Abdulai Jawo Bah Abdulai Jawo Bah 1Haja Wurie Haja Wurie 2Mohamed Samai Mohamed Samai 3
  • 1 Queen Margaret University, Musselburgh, Scotland, United Kingdom
  • 2 College of Medicine and Allied Health Sciences, University of SIerra Leone, Freetown, Sierra Leone
  • 3 Ministry of Health and Sanitation (Sierra Leone), Freetown, Sierra Leone

The final, formatted version of the article will be published soon.

    The last two decades have seen increased awareness of the impact of mental health issues on the population of Sierra Leone. Local capacity to respond to these needs is severely limited. In 2017, key stakeholders worked together to define a research agenda that would support the development of community-based mental health provision. This paper summarises work in relation to this agenda, and its emerging impact. Studies have - through participatory and ethnographically-informed methods -identified local idioms and social determinants of distress and mapped health seeking pathways and barriers to care. This information was utilised in the development and validation of two culturally appropriate measures: the Sierra Leone Psychological Distress Scale (to assess needs at the community level) and the Sierra Leone Perinatal Psychological Distress Scale (to identify distress amongst pregnant and lactating mothers). For this latter population, a culturally adapted form of a problem solving intervention delivered through existing mother-to-mother supports has been shown to be feasible, acceptable and potentially effective. This work has major policy and practice implications, and early evidence of uptake is noted. This includes mental health capacity development through online training guides and plans for incorporation of material regarding idioms and social determinants of distress in pre-and post-professional training curricula. In terms of community-based initiatives, there has been evidence of uptake from the Mental Health Coalition Sierra Leone. In policy terms, findings reinforce key principles regarding community-based provision, integration of mental health care into primary health care, and actions to reduce stigma associated with mental health.

    Keywords: Mental Health, policy, culture, psychometric measurement/psychological assessment, impact

    Received: 18 Apr 2024; Accepted: 07 Jan 2025.

    Copyright: © 2025 Ager, Horn, Bah, Wurie and Samai. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Alastair Ager, Queen Margaret University, Musselburgh, EH21 6UU, Scotland, United Kingdom

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.