Two Years of SUCCEED Africa Operations in Sierra Leone

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Posted: 27th September 2022

Sierra Leone over the years has experienced further challenges in the mental health sector with the two devastating outbreaks of Ebola and Corona. Sierra Leone is a middle-income country with a mental health treatment gap of 98%, in other words, only 2% of people with mental health problems receive medical treatment for this. According to WHO in Sierra Leone, Mental Health service delivery remains challenging and critical gaps in staffing mean thousands are unable to access the services they need but some steps are now being taken to address this. Despite this substantial treatment gap, Sierra Leone has recognized mental health problems for over a hundred years and is the oldest Mental Health law in Sub-Saharan Africa (1872). In 2016, the country only had one Psychiatric Doctor out of a population of seven million.

One of the major activities done in the first year of the project was the Theory of Change training, a plan or roadmap for achieving the project’s goals on individual, organizational and social levels within Sierra Leone.

Photo showing Theory of Change training in 2021 in SUCCEED Sierra Leone

Some of the most serious and incapacitating mental health conditions that medical treatment and social support are largely unavailable for are psychotic conditions, which are also on the increase.

Two years ago, a team from the University of Makeni became part of the SUCCEED research intervention project to help improve the care of people who experience psychosis. This is a research project with a special emphasis on Psychosis.

SUCCEED is an acronym for Support Comprehensive Care and Empowerment for People with Psychosocial Disabilities in Sub-Saharan Africa. There are 4 country sites - Sierra Leone, Nigeria, Malawi and Zimbabwe, supported by a team in the UK. It is funded by UK Aid. Five Universities are implementing the project, these are the University of Makeni in Sierra Leone, the University of Ibadan in Nigeria, the Kamuzu University of Health Sciences in Malawi and the University of Zimbabwe in Zimbabwe and the London School of Hygiene and Tropical Medicine in the UK.

On the 8th of April 2021, SUCCEED Sierra Leone was officially launched in Sierra Leone with the presence of a new Local Advisory Group (LAG). The Local Advisory Group is comprised of relevant stakeholders on Mental Health across Sierra Leone. Human Right Activist Alhaji Conteh is among the twenty LAG members. He and the others believed that the launching of SUCCEED in Sierra Leone was timely. He said this would minimize Mental Illness not only in Project operational areas but across the country.

SUCCEED Sierra Leone, like the other country has various work streams to help make the project work. These work streams include the Research work stream, Capacity building work stream, and Communication and Uptake work stream. Here we collaborate with all pillars of the project. This is shown clearly in our monthly and weekly meetings where we discuss updates of all work streams. In addition, our work is informed by invaluable team members who have psychosis and are, therefore ‘experts by experience. The Sierra Leone country team have worked closely with the other country teams to produce an evidence review on Community Based Rehabilitation Intervention to see what medical and social support is most effective and we are soon to publish this.

Regarding our communications and knowledge dissemination work, we have successfully participated in the production of an international webinar about our work ‘Co-production and peer research on mental health and human rights in Africa’ on the 9th of December 2021 to celebrate World Human Rights Day.

Overall, we have held 2 radio discussion programs last year in Makeni. The purpose of the radio programs is to raise awareness of the importance of the project in Sierra Leone and for the people to know the presence of the project in its operational areas. This included the World Mental Health Day 2021 commemoration. The composition of the radio program includes representatives of all work streams of the project.

Group Photo showing staff of both countries

On the 14th of March 2022, the project Principal Investigator Dr Rebecca Esliker and the Project Manager Shaza Dous traveled to Nigeria to share experiences with other teams in this research intervention consortium. This was a cross-country activity involving the four countries and the London of Hygiene and Tropical Medicine. All four countries assembled in Nigeria from the 14th to the 19th of March 2022.

In turn, three members from SUCCEED Nigeria through Ibadan University and London School of Hygiene and Tropical Medicine visited SUCCEED Sierra Leone at the University of Makeni. The team arrived in Makeni, Sierra Leone on the 20th of March 2022. The team met with staff of SUCCEED Sierra Leone and Senior administrators of the University of Makeni. The team comprised of Principal Investigator of SUCCEED Nigeria Professor Olayinka Omigbodun, Dr Abdurahman Haleem from Ibadan University and Rachael Greenley from London School of Hygiene and Tropical Medicine.

On the 22nd of March 2022, the team administered a focus group discussion on lived experience and policymakers in Makeni. On the 23rd of March, the team administered the same focus group discussion in the capital Freetown. In Freetown, the team led by Professor Olayinka conducted a workshop on basic Mental Health for SUCCEED Country Staff in Sierra Leone. The team also visited and held meetings with staff of Ola During Hospital in Freetown, the Kissy Mental Home and the Handicap International in Freetown. In a conversation, Chairman of Service Users Family Members Association (SUFMA) Paul Kaikai is lived experience lead in Freetown, like many Lived Experience also holds the view that the engagement from SUCCEED is necessary for minimizing Psychosis and disability in Sierra Leone after COVID 19.

In conclusion, there is hope that the SUCCEED Africa project in Sierra Leone, using the principles of co-production, would break new ground on evidence-based community care for people with psychosis in Sierra Leone. So far all activities on the project have been successful and it is a great learning platform.

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