Mental health care during the Ebola virus disease outbreak in Sierra Leone

Abstract

ProblemReported levels of mental health and psychosocial problems rose during the 2014–2015 Ebola virus disease outbreak in Sierra Leone.ApproachAs part of the emergency response, existing plans to create mental health units within the existing hospital framework were brought forward. A nurse-led mental health and psychosocial support service, with an inpatient liaison service and an outpatient clinic, was set up at the largest government hospital in the country. One mental health nurse trained general nurses in psychological first aid, case identification and referral pathways. Health-care staff attended mental well-being workshops on coping with stigma and stress.Local settingMental health service provision in Sierra Leone is poor, with one specialist psychiatric hospital to serve the population of 7 million.Relevant changesFrom March 2015 to February 2016, 143 patients were seen at the clinic; 20 had survived or had relatives affected by Ebola virus disease. Half the patients (71) had mild distress or depression, anxiety disorders and grief or social problems, while 30 patients presented with psychosis requiring medication. Fourteen non-specialist nurses received mental health awareness training. Over 100 physicians, nurses and auxiliary staff participated in well-being workshops. Lessons learntA nurse-led approach within a non-specialist setting was a successful model for delivering mental health and psychosocial support services during the Ebola outbreak in Sierra Leone. Strong leadership and partnerships were essential for establishing a successful service. Lack of affordable psychotropic medications, limited human resources and weak social welfare structures remain challenges.

Psychological symptoms of ordinary Chinese citizens based on SCL-90 during the level I emergency response to COVID-19

“…According to estimates from the Centers for Disease Control and Prevention, between April 2009 and April 2010 alone, it infected more than 60 million people in the United States and caused 12,469 deaths (Centers for Disease Control and Prevention, 2010). Generally speaking, the outbreak of an epidemic will cause a crisis of psychological health (Ji et al, 2017;Kamara et al, 2017;Maunder et al, 2003), and therefore, we must pay attention to people's psychological health in the fight against the epidemic. Since the outbreak of COVID-19, some research groups have applied a selfmade scale to assess the psychological impact of the epidemic on Chinese people (Qiu et al, 2020;Wang et al, 2020).…”

“…Among the occupations, medical staff had the most severe psychological symptoms. During the outbreak of infectious diseases, medical staff are frontline workers, who tend to show more intense anxiety, fear, and stigma than ordinary citizens (Curto et al, 2018;Kamara et al, 2017). Previous research has shown that the psychological symptoms of females are generally higher than that of males (Lim et al, 2018).…”

Survey of Anxiety and Depression in Patients with Suspected and Confirmed Cases of COVID-19 During Hospitalization and Isolation

“…This is consistent with the results of Cheng Li's research [10], which showed that patients with COVID-19 had significant anxiety; during the SARS epidemic in 2003, there were also studies that showed that patients with suspected cases of SARS who were totally isolated experienced anxiety, fear, loneliness and other psychological problems [11]. During the Ebola outbreak in Sierra Leone from 2014 to 2015, the number of people with mental illnesses in the region increased significantly: 71 patients (50%) experienced mild pain, depression, anxiety, grief or social problems, while thirty patients developed psychosis requiring medication [12]. Therefore, during epidemics of infectious diseases, monitoring patients' psychological behavior and providing interventions at an early stage is very important for their rehabilitation.…”

The prevalence and influencing factors for anxiety in medical workers fighting COVID-19 in China: A cross-sectional survey

“…Medical staff are frontline workers to treat infected patients, however, with a higher risk of exposure. Current source data have presented the proportion of infected medical staff at 3.8%, mainly due to early non-protected contact with infected patients 5,6 . Several previous studies reported that medical staff might suffer adverse psychological disorders, such as anxiety, fear and stigmatization, which occurred during the SARS and Ebola outbreaks, and could exert an adverse effect on care quality [7][8][9][10] .…”