The Emergence of Counseling in Sierra Leone

Akinsulure‐Smith, Adeyinka M.; Conteh, John A.

doi:10.1002/jcad.12206

Cited by 6 publications

(7 citation statements)

References 53 publications

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“…Future analyses on mental health spillover effects in LMICs would benefit from including additional household members in qualitative data collection and also from better exploring the potential influence of cultural factors on the phenomenon of mental health spillover effects. For example, stigma regarding mental illness in Sierra Leone (Akinsulure-Smith and Conteh, 2018 ) could impact the extent to which caregivers may openly discuss their feelings of anxiety, stress or depression related to caregiving burdens.…”

Section: Discussionmentioning

confidence: 99%

“…Significant limitations in the nation’s health infrastructure have made it difficult to effectively address the unmet mental health needs of the population (Alemu et al, 2012 ; Yoder et al, 2016 ; Hopwood et al, 2021 ). In Sierra Leone, these limitations are further compounded by negative beliefs associated with poor mental health and the stigma regarding mental illness (Akinsulure-Smith and Conteh, 2018 ). Gaining a better understanding of “whether” and “how” evidence-based mental health interventions might offer wider societal benefits and reach a larger segment of the population could help address resource constraints in LMICs and spur stakeholder investments in scaling out mental health interventions.…”

Section: Exploring Potential Mental Health Spillover Effects Among Ca...mentioning

confidence: 99%

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Exploring potential mental health spillover effects among caregivers and partners of youth in Sierra Leone: A qualitative study

Desrosiers¹,

Schafer²,

Bond³

et al. 2023

Camb. prisms Glob. ment. health

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Given the large mental health treatment gap in low- and middle-income countries (LMICs), particularly in post-conflict settings like Sierra Leone, and the limited healthcare infrastructure, understanding the wider benefits of evidence-based mental health interventions within households is critical. This study explored potential mental health spillover effects – the phenomenon of beneficial effects among nonparticipants – among cohabitating caregivers and partners of youth who participated in an evidence-based mental health intervention in Sierra Leone. We recruited a sub-sample of cohabitating caregivers and partners (N = 20) of youth intervention participants; caregivers had enrolled in a larger study investigating indirect benefits of the evidence-based intervention in Sierra Leone (MH117359). Qualitative interviews were conducted at two time points to explore the following: (a) potential mental health spillover effects and (b) through which mechanisms spillover may have occurred. Two trained coders reviewed transcripts and analyzed qualitative data, assisted by MaxQDA. Qualitative findings suggested that spillover effects likely occurred and supported three potential mechanisms: decreased caregiving burden, behavior changes among Youth Readiness Intervention participants and improved interpersonal relationships. Mental health spillover effects may occur following youth intervention participation in a post-conflict LMIC. Investing in evidence-based services may offer indirect benefits that extend beyond those directly receiving services.

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Section: Discussionmentioning

confidence: 99%

Section: Exploring Potential Mental Health Spillover Effects Among Ca...mentioning

confidence: 99%

Exploring potential mental health spillover effects among caregivers and partners of youth in Sierra Leone: A qualitative study

Desrosiers¹,

Schafer²,

Bond³

et al. 2023

Camb. prisms Glob. ment. health

View full text Add to dashboard Cite

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“…One of the most limiting factors in mental health-care development in Sierra Leone is funding (45, 52). Despite the increased interest in MHPSS after the EVD outbreak, there is no separate budget line for mental health in the budget of the Ministry of Health and Sanitation (7).…”

Section: Contextmentioning

confidence: 99%

“…Ray et al, who studied the support system of the ISF in the context of evidence-based prevention projects, describe how literature increasingly shows that training by itself is not sufficient to ensure quality implementation and that it should be accompanied by ongoing tailored support of those who participated in the training (88). While many organizations provide short-term MHPSS training in Sierra Leone, there is frequently no sufficient follow-up in the form of ongoing coaching or supervision (52), nor are there clear guidelines for supervision in terms of qualifications of the supervisor, frequency and method of supervision, etc. (89).…”

Section: Supporting the Work—support Systemmentioning

confidence: 99%

Reflections on “Building Back Better” Child and Adolescent Mental Health Care in a Low-Resource Postemergency Setting: The Case of Sierra Leone

Brink

2019

Front. Psychiatry

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Over the past three decades, Sierra Leone has experienced two major humanitarian crises: an armed conflict (1991–2002) and an Ebola virus disease outbreak (2014–2015). In addition to these country-wide crises, the capital Freetown experienced a mudslide affecting thousands of people in 2017. In response to these emergencies, donors and aid organizations showed an increased interest in supporting and implementing mental health and psychosocial support interventions. Despite these efforts, the mental health infrastructure of the country remains frail. Specifically, systemic improvements in the implementation of evidence-based mental health care for children and adolescents appear to be lacking. In this article, the Interactive Systems Framework for Dissemination and Implementation is used as a tool to analyze issues related to the development of a sustainable, contextually relevant child and adolescent mental health-care delivery system. The author draws on her long-term experience as a child mental health specialist in Sierra Leone. Observations and hypotheses are tested and supplemented by formal and informal reports and national and international literature. The three systems described by the Interactive Systems Framework are explored in the context of Sierra Leone: (1) Synthesis and Translation, (2) Support, and (3) Delivery. Interaction between the three Systems is discussed as critical to the successful dissemination and implementation of interventions. Ample attention is given to contextual factors that are believed to be paramount to the development of child and adolescent mental health care in Sierra Leone. The article concludes with a reflection on the usefulness of the Interactive Systems Framework in the dissemination and implementation of child and adolescent mental health-care interventions in low-resource, postemergency settings. It is suggested that, in addition to funding and policies, the child and adolescent mental health system in Sierra Leone could benefit from the development of contextually relevant interventions, improvement of capacity-building efforts, and acknowledgment of the role of community-based practitioners in the delivery of services. Local mental health experts, especially those trained in child and adolescent mental health, should be empowered to work together with culturally competent expatriate professionals to improve child and adolescent mental health care in Sierra Leone.

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“…After two decades of civil war, natural disasters, and public health crises that included a loss of 7% of its health care workforce, Sierra Leone is now rebuilding its health and social services systems [1,2]. Although still in an early stage of recovery, multiple partnerships between government institutions, civil society organisations, and international nongovernmental organisations have been engaged in regional and national projects to deliver health and psychosocial support services, as well as rebuilding the country's capacity in these areas [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

Development and Validation of the Krio Version of the WHOQOL-BREF for Use in Sierra Leone

Price

Conteh

Esliker

2019

SN Compr. Clin. Med.

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Formal measures of subjective well-being are needed to assure that health and psychosocial support services in Sierra Leone are objectively evaluated and evidence-based. The purpose of this study was to evaluate a Krio version of the brief form of the World Health Organization's Quality of Life (WHOQOL-BREF) questionnaire. A convenience sample of 425 adult Sierra Leoneans was verbally interviewed in the northern province of Bombali, using a previously piloted version of the scale, as well as a short demographic survey. Descriptive, correlational, and inferential statistics were used to assess evidence of reliability and validity in a manner similar to the WHOQOL-BREF international field trial. Cronbach's alpha for the four domains ranged from 0.55 to 0.72 and improved when the three negatively phrased items requiring reversed scoring were removed, as well as when all items were treated as a unidimensional scale (alpha = 0.83). Patients scored significantly lower scores on all four subscales and the question assessing overall quality of health question. Persons with no formal education had lower scores on Physical, Psychological, and Environmental domains, as well as the two overall quality of life and health questions. Age was negatively correlated with Physical, Psychological, and Social domains, as well as the questions for overall quality of life and quality of health. Multiple regression analyses found Physical, Psychological, and Environmental domains to be significantly associated with questions assessing overall quality of life and quality of health. Twenty-three out of 24 items correlated highest to their expected domain, but 10 also correlated above 0.40 on another domain. Confirmatory factor analysis allowing for two pairs of error variances to covary showed good fit with the original scale's four domain model (χ 2 /df = 3.02; CFI = .833; RMSEA = .069, 90% CI = 0.063-0.076). The results indicate that the new scale shares many of the same psychometric properties as the original WHOQOL-BREF and is appropriate for health-related research. Future studies with the WHOQOL and other quality of life instruments should use caution when developing negatively phrased items in scale development, particularly when planned for use across multiple settings, as they may yield unwanted method effects and adversely impact test reliability and internal structure.

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The Emergence of Counseling in Sierra Leone

Cited by 6 publications

References 53 publications

Exploring potential mental health spillover effects among caregivers and partners of youth in Sierra Leone: A qualitative study

Exploring potential mental health spillover effects among caregivers and partners of youth in Sierra Leone: A qualitative study

Reflections on “Building Back Better” Child and Adolescent Mental Health Care in a Low-Resource Postemergency Setting: The Case of Sierra Leone

Development and Validation of the Krio Version of the WHOQOL-BREF for Use in Sierra Leone

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