When hunger weighs on people’s mental health

Teenagers are particularly vulnerable 

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. 

Mental health, a priority for Action contre la Faim 

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. To date, 91% of the boys and girls who have taken part in the program have reported an improvement in their well-being and social support.

Right in the heart of Susan’s bay, a poor district of Freetown, you must make your way through the crowd of market stalls to get to the health center. In this small health facility, five young teenage girls gather in a cramped room, out of sight. Singing, laughing, talking, they take turns confiding in Mariatu, a psychosocial worker from CAPS (Community Association for Psychosocial Services), a local partner of Action contre la Faim.

One of them, Aminata, goes to the Adolescent Friendly Space every Friday, but says that she can come every day if she feels the need. Living in this neighborhood, the 21-year-old felt a lot of stress and anxiety before coming to the center.

“I regularly come to the friendly space to interact with my friends who are experiencing similar problems so that we can share issues together that can help us feel relieved. Mariatu, the CAPS psychosocial counselor is very supportive, I love her so much, I can share my stress with her, and others.”

“When I come here, I come here for peace. And after that I come back home and feel relieved from my stress. So now I know the things that I will do to not feel stressed, the meetings and sharing together has helped me to understand my challenges and how to better manage them.

I also can share the knowledge gained with friends who are not fortunate to come to this place so that they will visit the AFS in case they are having issues that can have negative impact on their daily life”.

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.

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 Presidential 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.  Now that Mental Health needs are overwhelming, The Lunacy Act will soon become the Mental Health Review Bill, and joint efforts are taking place by more than 85 stakeholders in the country to improve the wellbeing of the population in Sierra Leone.