Sierra Leone Telegraph: 11 February 2020:
An increasing number of young people in Sierra Leone are at greater risk of developing mental illness due to drug abuse, joblessness, alcoholism and general apathy.
In a country with just one mental health hospital and one psychiatrist, the challenge for the government cannot be more serious and urgent.
Although the Bio-led government of Sierra Leone has significantly increased spending on healthcare, the increasing pressure on the country’s health service by a growing population of 7 million, 40% of whom are 40 years old and above with multiple health conditions, mental health provision is not a priority.
But with hundreds of thousands of young people estimated to be suffering from some form of mental disorder in the country, there is urgent need to increase spending on improving access to psychiatric therapy, counselling and medicines.
Sierra Leone’s Psychiatric Hospital is in desperate need of increased funding support, especially from Sierra Leoneans in the diaspora and other well-wishers in the international community.
The Sierra Leone Telegraph is appealing for funding donors to help sponsor the work of the hospital, so that it can continue to meet current demand as well expand its capacity to meet the growing and acute need.
Last Sunday, the Sierra Leone Telegraph published a story about the work of Dr Abdul Jalloh (Photo) – a qualified and experienced Psychiatrist, who took over from Dr Nahim as the country’s only psychiatrist in charge of the Sierra Leone Psychiatric Hospital in Freetown.
Today, we publish an interview that the editor of the Sierra Leone Telegraph – Mr Abdul Rashid Thomas (ART) had with Dr Jalloh, discussing the immediate and long-term needs of the hospital:
ART: What are the challenges facing us as a nation in addressing mental illness in the country?
Dr Abdul Jalloh: To start with, the Government of Sierra Leone through the Ministry of Health and Sanitation has taken mental health very seriously. The facelift that is presently taking place in the hospital is as a result of good leadership and support from the Ministry of Health and Sanitation.
The Ministry of Health and Sanitation is currently working round the clock to improve mental health services in the country. They have advertised for a Consultant Psychiatrist and there’s a Mental health diploma course ongoing at the College of Medicine and Allied Health Sciences, University of Sierra Leone. However, the Government can’t do it alone and we need the following:
Human Resource across the board
We need psychiatrists (Child and adolescents Psychiatrist, forensic psychiatrist, Adult and old age psychiatrist, etc), clinical psychologists, mental health social workers, addiction specialists, occupational therapist, Psychiatric nurses.
Stigmatisation and discrimination
People with mental health challenges are been stigmatized and sometimes discriminated against in society. We need more awareness raising to educate people about mental health.
The Ministry of Health and Sanitation is doing well to increase funding in support of mental healthcare delivery in the country. The private sector and NGOs such as WHO, UNODC, need to come on board to compliment government’s effort. Let them follow the footsteps of Partners in Health.
ART: What kind of support and assistance do you need at the hospital to deal with the huge number of cases you are faced with?
Dr. Abdul Jalloh: Abandonment of patients. 70% of patients in the hospital have been abandoned and neglected by relatives, with the burden on the Ministry of Health and Sanitation. People should know that these patients are human beings just like them, and there is a thin line between insanity and sanity. These people can be productive in society just like us.
Training- Currently we have three Psychiatric nurses in the hospital, with majority General nurses. We need University collaborations with the University of Sierra Leone, Njala University to establish mental health departments to train mental health professionals to degree levels. We need short and long term training courses for our staff, and exposure to modern mental health care internationally to widen their knowledge and skills in managing mental health challenges.
We need to provide broadband internet services in the hospital to aid teaching and service delivery.
We need ambulances and utility vehicles for staff and patients.
We need utility vehicles, such as a bus for staff to aid transportation to and from work. Some staff live very far from the hospital.
We ned on the job training of our staff.
ART: What needs to be done to ensure we have many more young people like yourself becoming a psychiatrist?
Dr. Abdul Jalloh: We need to make psychiatry an accessible profession by creating a well-equipped and conducive learning environment (which we are trying to do); repealing and replacing the 1902 Lunacy Act which lacks human rights of patients and staff, with a new Mental health Act, creating more opportunities for young people entering the profession.
ART: What is the capacity of the facility? What is the maximum number of patients that can be accommodated at the facility? How many are currently at the facility? And what are your plans for expansion of capacity?
Dr Abdul Jalloh: The facility is a 400 bed capacity hospital with 10 wards. For now we can have 300 patients to avoid overcrowding in the hospital. Currently we have 92 inpatients with over 500 outpatients. Before 2018, we were getting more inpatients than outpatient.
Because of the current treatment and services in the hospital, patients do not stay longer than six weeks in the hospital. The recovery rate is higher. Now you see patients coming to the hospital voluntarily for follow ups unaccompanied.
The modern trend in psychiatry is community psychiatry, wherein patients are managed in the community and the integration of mental health services into primary health care. This is to prevent stigmatisation and discrimination of mental illnesses and to provide equity in physical and mental health.
Only severe cases that can’t be managed in the community can be referred to a psychiatric hospital. However, we plan to established a canteen, drug treatment and rehabilitation centre and other services such as forensic old age and child and adolescent psychiatry, special ward for physical cases and psychiatric intensive care unit.
The Ministry also plans to train more mental health professionals that can be posted nationwide. Meanwhile, we have mental health nurses in all district and regional hospitals in the country, with 8 currently undergoing mental health diploma training at the College of Medicine and Allied Health Sciences, University of Sierra Leone.
ART: Dr Jalloh thank you for the chat and we look forward to catching up with you again soon to review progress.