Where there is no psychiatrist: A mental health programme in Sierra Leone
Background. For most low- and middle-income countries, mental health remains a neglected area, despite the recognised burden associated with neuropsychiatric conditions and the inextricable link to other public health priorities. Objectives. To describe the results of a free outpatient mental healt...
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doaj-cab3d451032a486697eb213ac10a62382020-11-25T01:08:58ZengAOSISSouth African Journal of Psychiatry 1608-96852078-67862014-08-01203e1e610.4102/sajpsychiatry.v20i3.49824Where there is no psychiatrist: A mental health programme in Sierra LeonePino Alonso0Brian Price1Abdul R Conteh2Carmen Valle3Patrick E Turay4Lourdes Paton5Joseph A Turay6Department of Psychiatry, Bellvitge Biomedical Research Institute-IDIBELL, Hospital de Bellvitge, University of Barcelona; Centro de Investigación en Red de Salud Mental, Carlos III Health Institute, Madrid, SpainAdler School of Professional Psychology, Chicago, Illinois, USAHoly Spirit Hospital, Makeni, Sierra LeoneUniversity of Makeni, Sierra LeoneHoly Spirit Hospital, Makeni, Sierra LeoneUniversity of Makeni, Sierra LeoneUniversity of Makeni, Sierra LeoneBackground. For most low- and middle-income countries, mental health remains a neglected area, despite the recognised burden associated with neuropsychiatric conditions and the inextricable link to other public health priorities. Objectives. To describe the results of a free outpatient mental health programme delivered by non-specialist health workers in Makeni, Sierra Leone between July 2008 and May 2012. Methods. A nurse and two counsellors completed an 8-week training course focused on the identification and management of seven priority conditions: psychosis, bipolar disorder, depression, mental disorders due to medical conditions, developmental and behavioural disorders, alcohol and drug use disorders, and dementia. The World Health Organization recommendations on basic mental healthcare packages were followed to establish treatment for each condition. Results. A total of 549 patients was assessed and diagnosed as suffering from psychotic disorders (n=295, 53.7%), manic episodes (n=69, 12.5%), depressive episodes (n=53, 9.6%), drug use disorders (n=182, 33.1%), dementia (n=30, 5.4%), mental disorders due to medical conditions (n=39, 7.1%), and developmental disorders (n=46, 8.3%). Of these, 417 patients received pharmacological therapy and 70.7% were rated as much or very much improved. Of those who could not be offered medication, 93.4% dropped out of the programme after the first visit. Conclusions. The identification and treatment of mental disorders must be considered an urgent public health priority in low- and middle-income countries. Trained primary health workers can deliver safe and effective treatment for mental disorders as a feasible alternative to ease the scarcity of mental health specialists in developing countries.http://www.sajp.org.za/index.php/sajp/article/view/498Low- and middle-income countriesMental healthPrimary health care system |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Pino Alonso Brian Price Abdul R Conteh Carmen Valle Patrick E Turay Lourdes Paton Joseph A Turay |
spellingShingle |
Pino Alonso Brian Price Abdul R Conteh Carmen Valle Patrick E Turay Lourdes Paton Joseph A Turay Where there is no psychiatrist: A mental health programme in Sierra Leone South African Journal of Psychiatry Low- and middle-income countries Mental health Primary health care system |
author_facet |
Pino Alonso Brian Price Abdul R Conteh Carmen Valle Patrick E Turay Lourdes Paton Joseph A Turay |
author_sort |
Pino Alonso |
title |
Where there is no psychiatrist: A mental health programme in Sierra Leone |
title_short |
Where there is no psychiatrist: A mental health programme in Sierra Leone |
title_full |
Where there is no psychiatrist: A mental health programme in Sierra Leone |
title_fullStr |
Where there is no psychiatrist: A mental health programme in Sierra Leone |
title_full_unstemmed |
Where there is no psychiatrist: A mental health programme in Sierra Leone |
title_sort |
where there is no psychiatrist: a mental health programme in sierra leone |
publisher |
AOSIS |
series |
South African Journal of Psychiatry |
issn |
1608-9685 2078-6786 |
publishDate |
2014-08-01 |
description |
Background. For most low- and middle-income countries, mental health remains a neglected area, despite the recognised burden associated with neuropsychiatric conditions and the inextricable link to other public health priorities.
Objectives. To describe the results of a free outpatient mental health programme delivered by non-specialist health workers in Makeni, Sierra Leone between July 2008 and May 2012.
Methods. A nurse and two counsellors completed an 8-week training course focused on the identification and management of seven priority conditions: psychosis, bipolar disorder, depression, mental disorders due to medical conditions, developmental and behavioural disorders, alcohol and drug use disorders, and dementia. The World Health Organization recommendations on basic mental healthcare packages were followed to establish treatment for each condition.
Results. A total of 549 patients was assessed and diagnosed as suffering from psychotic disorders (n=295, 53.7%), manic episodes (n=69, 12.5%), depressive episodes (n=53, 9.6%), drug use disorders (n=182, 33.1%), dementia (n=30, 5.4%), mental disorders due to medical conditions (n=39, 7.1%), and developmental disorders (n=46, 8.3%). Of these, 417 patients received pharmacological therapy and 70.7% were rated as much or very much improved. Of those who could not be offered medication, 93.4% dropped out of the programme after the first visit.
Conclusions. The identification and treatment of mental disorders must be considered an urgent public health priority in low- and middle-income countries. Trained primary health workers can deliver safe and effective treatment for mental disorders as a feasible alternative to ease the scarcity of mental health specialists in developing countries. |
topic |
Low- and middle-income countries Mental health Primary health care system |
url |
http://www.sajp.org.za/index.php/sajp/article/view/498 |
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