PIH Sierra Leone

Mental Health Program

Program Overview

As PIH Sierra Leone shifted out of their 2014-2016 Ebola emergency response period, there were renewed opportunities and unprecedented momentum to focus on PIH’s core strength – long-term health systems strengthening.  Starting in 2017, with support from the Many Voices Collaborative (MVC), the team established its mental health program to address critical human resource and mental health infrastructure gaps in the country. Their strategic plan advocates for increased resources and forming successful partnerships with the government to improve mental health care availability, access, and quality in the country. Since 2017, they have expanded community and clinic-based care in Kono District, transformed the oldest psychiatric hospital in Sub-Saharan Africa, introduced the nation’s first mental health helpline, and piloted the nation’s first psychiatry residency program at the Sierra Leone Psychiatric Teaching Hospital (SLPTH).

Innovation

Mental Health Care Across the Value Chain

The Sierra Leone mental health program integrates mental health services into general health care across community, primary, secondary, and tertiary levels. In Kono District in the Eastern Province, a team of trained clinicians and counselors provide a comprehensive model of care, within Koidu Government Hospital and Wellbody Clinic, and in the community, tailored to meet patients where they are. Through a robust team of Community Health Workers (CHWs), homeless individuals living with mental illness are connected to psychosocial counseling, rehabilitation activities, and income generating projects. In 2022, the team launched the  nation’s first toll-free mental health helpline ,  enabling patients across the country to access care. From July 2023-June 2024, the helpline reached an average of 200 individuals per month, linking them to localized services, including mental health care, medical care, and social services, as needed.

In response to President Julius Maada Bio's declaration of a state of emergency on substance use, PIH SIerra Leone, in collaboration with the Sierra Leone Ministry of Health and Sanitation (MOHS), opened the  Drug Abuse & Rehabilitation Center at Sierra Leone’s Psychiatric Teaching Hospital . The hospital, which houses 30 beds (20 for men and 10 for women), is staffed by a multidisciplinary team, including one clinical psychologist, three psychiatrists, and seven resident psychiatrists, along with a dedicated cadre of mental health nurses and care providers. To decentralize mental health care, the team also supported mental health visits to peripheral districts such as Bo and Kailahun, provided mental health and psychosocial support at Lakka Government Hospital, and continue to implement community-based psychotherapy interventions such as the  Common Elements Treatment Approach (CETA). 

Training and Education

With a population of over 8 million and only three psychiatrists, Sierra Leone continues to face a high burden of disease, with most mental health services centralized in the capital, Freetown. In 2021, the government requested PIH’s support in the developing of a psychiatry residency training program as a flagship initiative to support both specialist and non-specialist mental health training in the country. Officially accredited in July 2022, the residency program utilizes a training curriculum based on the West African College of Physician’s (WACP) training curriculum and welcomed its first class of seven Sierra Leonean residents. This year, two residents traveled to Ghana College of Physicians and Surgeons in Accra, Ghana to fulfill critical rotations in child & adolescent mental health and neurology as they continue to grow essential knowledge and skills.

Replication

The PIH Sierra Leone team continues to advocate for mental health and serve as a technical advisor to the Sierra Leone MOHS. In 2023, PIH SL served on the steering committee to update Sierra Leone’s 2024 – 2030 Mental Health Strategic Plan. Recently, the team worked closely with the Directorate of NCDs & Mental Health to bring together national mental health stakeholders and develop a package of integrated Mental Health and Psychosocial Support (MHPSS) services within existing HIV and TB services.  

Impact

From July 2023-June 2024, the PIH Sierra Leone Mental Health Team:

  • Admitted an average of 127 patients at Sierra Leone’s Psychiatric Teaching Hospital each month.
  • Provided ongoing training, mentorship, and professional development opportunities for seven residents in Sierra Leone’s pioneering Psychiatry Residency.
  • Provided support to more than 1,810 individuals who called into the national mental health helpline.
  • Conducted an average of 703 outpatient visits per month

Graphics created using programmatic data collected between July 2023 and June 2024

Future Priorities

  • Leverage the psychiatry residency program to strengthen nursing and psychotherapy education across the country.
  • Strengthen and expand community-based mental health programs, including strengthening the capacity of CHWs, for people suffering from mental illness.
  • Integrate mental health into HIV/TB and NCD care.
  • Expand the community substance use intervention in Kono.
  • Expand the package of psychotherapy programming.
  • Serve as a technical advisor for the rollout of Sierra Leone’s 2024 – 2030 Strategic Plan & Policy.

Provider Spotlight

Read through the story below to learn more about the incredible day-to-day work of Dr. Kinie Goba, a resident psychiatrist at SLPTH.

Resources

Reports & Reports

News Articles

Multimedia

Graphics created using programmatic data collected between July 2023 and June 2024