Sierra Leone is undergoing a quiet but critical transformation in its mental health sector, as the country confronts deep-rooted trauma from war and epidemics while battling a fast-growing substance abuse crisis driven largely by the drug known as Kush.
For decades, mental health care in Sierra Leone operated under outdated laws and heavy stigma, with services concentrated in a few urban centres and many citizens turning to traditional or spiritual healers. Today, however, the country is attempting to replace neglect with reform, compassion, and community-based solutions.
One of the most significant developments is the ongoing review of the national Mental Health and Psychosocial Support (MHPSS) strategy, aimed at aligning mental health care with current realities. The revised strategy seeks to address trauma linked to the civil war, the Ebola outbreak, recurring public health emergencies, and rising youth vulnerability to drugs. Health officials say the review marks a shift from reactive care to long-term planning.
At the heart of the current crisis is Kush, a highly addictive substance that has devastated young populations and overwhelmed fragile health services. Reports indicate an explosive rise in drug use over the past five years, with treatment centres struggling to cope. Mental health professionals warn that untreated addiction is fueling depression, psychosis, crime, and preventable deaths.
In response, the Ministry of Health has launched the Mental Health Champions Network, a community-driven initiative designed to bridge the gap between professionals and underserved communities. These trained volunteers provide basic mental health education, identify people in distress, and guide them toward available care. For a country with a severe shortage of psychiatrists and psychologists, this grassroots approach is seen as a lifeline.
Children’s mental health is also gaining renewed attention. In Freetown, humanitarian organisations are introducing play therapy to help children process trauma stemming from conflict, loss, and disease outbreaks. The initiative supports both children and caregivers, helping families rebuild emotional resilience in environments where professional therapy remains scarce.
Institutional reform is slowly taking shape as well. The Mental Health Secretariat, established in recent years, is working to dismantle colonial-era frameworks such as the 1902 Lunacy Act and replace them with modern, rights-based mental health legislation. Advocates say this step is crucial to ending abuse, discrimination, and unlawful detention of people living with mental illness.
Despite these advances, challenges remain daunting. Mental health funding accounts for less than one per cent of the national health budget, stigma continues to silence many sufferers, and the demand for services far outpaces supply. Yet, experts agree that Sierra Leone’s current efforts represent one of the most hopeful moments in its mental health history.
As the nation grapples with the scars of its past and the pressures of a drug-fuelled present, Sierra Leone stands at a crossroads — where sustained political will, community engagement, and international support could finally turn mental health from a neglected issue into a national priority.
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