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Headline
Sierra Leone is marked by an increase in the cost of living, impacting on the food security and living conditions of the population. Hunger is one of the main causes of the psychological distress experienced by Sierra Leoneans, yet health care is limited. Action contre la Faim addresses the structural causes of hunger, with a particular focus on mental health, especially among adolescents.
A staggering 81% of the population¹–more than 6 million people–lack reliable access to nutritious and affordable food. Local food production has decreased dramatically due to high input prices and extreme weather, leading to a 46%² increase in food costs over the past year.
The situation is taking a toll on mental health. An assessment conducted in May 2022 by Action contre la Faim revealed that lack of resources to meet basic needs, including food, was the main cause of mental health distress among those surveyed, followed by gender-based violence and neglectful behavior towards children. Participants reported that not having enough to eat caused regular discomfort and mood swings, such as sadness and anger.
Mental health and psychosocial issues are particularly acute among adolescents and young people, who have to cope with adversity generating stress, anxiety and depression. Seventy percent³ of young people in Sierra Leone are underemployed or unemployed, and a significant number are homeless, making them more vulnerable. Some resort to negative coping strategies: the majority of drug and alcohol abusers (60%) are young people aged between 15 and 35; and 80% of adolescent girls adopt risky sexual behaviors, resorting to transactional sex.
Adolescent girls are also vulnerable to gender-based violence, including early marriage and pregnancy. Indeed, Sierra Leone has one of the highest rates of teenage pregnancy in the world: 28%⁴ of girls aged 15-19 have children. Teenage mothers can face stigmatization, rejection and chronic poverty. Less than 2%⁵ of married girls aged 15-19 attend school, compromising their future prospects. All these factors can lead to psychological distress, including depression and anxiety, which can have lasting consequences on their health and that of their babies, including breastfeeding difficulties, leading to risks of malnutrition.
Action contre la Faim has implemented multi-sectoral programs to help young people in several urban and rural areas of Sierra Leone, including a mental health and psychosocial support component to address these complex and interrelated issues. These programs include “adolescent-friendly spaces” in health centers, which offer a safe and confidential space to discuss their issues, including mental health problems, through individual and/or group support sessions, wellness activities and sexual and reproductive health education sessions, led by trained psychosocial workers and health staff.
In addition, mental health and psychosocial support activities have been initiated in schools within school health clubs. Using a peer-to-peer approach, students are trained to organize discussion groups and support each other, helping to empower them and boost their self-esteem. To date, 95% of the boys and girls who have taken part in the program have reported an improvement in their well-being and social support.
These initiatives provide access to mental health and psychosocial support services to meet the needs of adolescents and young people. They strengthen the health system in Sierra Leone by integrating accessible mental health support at primary health care and community levels.
Sierra Leone’s president, Julius Maada Bio, recently announced the creation of a National Mental Health Task Force which aims to integrate mental health into a national strategic plan, alongside issues such as education and social protection. This is a major step forward in a country where the Lunacy Act of 1902 is still in force and considers people suffering from mental disorders as criminals or victims of witchcraft or demonic possession.
Now, things are changing. The Lunacy Act will soon become the Mental Health Review Bill, and more people are becoming aware of the mental health crisis that Sierra Leone is facing.
Sierra Leone
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