By Jariatu S. Bangura
Sierra Leone, a West African nation known for its resilience in the face of war, poverty, and disease, is now grappling with an invisible and deeply misunderstood crisis: depression. Though the country has made remarkable strides in recovering from its brutal civil war and the Ebola outbreak, deceased parents leaving their children at vulnerable states, the scars left behind go beyond physical and economic devastation.
Mental health, particularly depression, is a growing concern, though it remains largely unacknowledged and untreated. In a society where survival often takes precedence over emotional well-being, depression has quietly woven itself into the fabric of everyday life for many Sierra Leoneans.
The Quiet Rise of Depression
Depression in Sierra Leone is a hidden epidemic, largely overshadowed by the nation’s struggle with poverty, infectious diseases, and rebuilding after years of conflict. While there is limited data on mental health in the country, healthcare professionals and NGOs report a significant rise in cases of depression, especially among vulnerable groups such as war survivors, women, and young people leading them to drugs taking, acholic addicts as a means of redress.
The country’s civil war, which lasted from 1991 to 2002, left deep psychological wounds. An entire generation witnessed unimaginable horrors, including violence, displacement, and loss of family members. The lingering effects of trauma, grief, and post-war stress have not dissipated with time. For many, the mental scars have manifested as depression, affecting their ability to lead productive lives, yet the stigma surrounding mental health prevents many from seeking help.
In 2014, Sierra Leone faced another catastrophe: the Ebola outbreak. Thousands of lives were lost, and entire communities were devastated. The fear, isolation, and loss associated with Ebola contributed to a surge in mental health issues, particularly depression and anxiety. Today, many Sierra Leoneans continue to cope with the residual impact of both the war and the epidemic, often without the necessary mental health resources.
The Stigma of Depression-
In Sierra Leone, mental health issues like depression are rarely discussed openly. Mental illness is often misunderstood and associated with spiritual or supernatural causes. Many communities believe that depression is a result of witchcraft, curses, or evil spirits, which leads to shame and ostracism for those suffering from it.
Dr. Abdulai Jalloh, a psychiatrist based in Freetown, explains, “There is a strong cultural belief here that mental illness, including depression, is not a medical issue but a spiritual one. People often turn to traditional healers instead of seeking professional medical help, which delays or prevents effective treatment.”
As a result, many individuals suffering from depression remain untreated, locked in silence due to fear of being judged or labeled as ‘crazy.’ The cultural stigma, combined with a lack of awareness about depression as a legitimate medical condition, makes it difficult for people to recognize when they need help. This stigma not only affects individuals but also families and communities, leaving depression to fester and deepen over time.
The Lack of Mental Health Infrastructure- One of the major challenges in addressing depression in Sierra Leone is the severe lack of mental health infrastructure. There are only a handful of mental health professionals in the entire country, with fewer than 10 trained psychiatrists for a population of over 8 million people. Most mental health services are concentrated in the capital city, Freetown, leaving rural areas severely underserved.
The Sierra Leone Psychiatric Hospital, located in Kissy, Freetown, is the country’s only dedicated psychiatric facility. However, it faces many challenges, including a lack of funding, inadequate staffing, and outdated facilities. The hospital was originally built during the colonial era and has seen little improvement since. Most individuals dealing with depression or other mental health issues do not have access to the hospital or are reluctant to seek help due to the stigma attached to mental illness.
Dr. Jalloh notes, “We are in desperate need of more mental health professionals and better facilities. Most people with depression never receive a diagnosis or treatment, and the situation is particularly dire in rural communities where access to healthcare is already limited.”
Depression disproportionately affects vulnerable groups in Sierra Leone, including women, young people, and survivors of the civil war. For women, in particular, the issue is compounded by socio-economic challenges, gender-based violence, and limited opportunities for education or employment. Many women who experienced sexual violence during the war continue to live with the trauma, which often leads to depression.
Fatmata, a 35-year-old mother of three from Freetown, explains her struggle: “During the war, I lost my family, my home, and everything I knew. I was just a child then, but the pain has never left me. I feel so tired all the time, and it’s hard to care for my children. I know something is wrong, but people just tell me to pray or that I’m lazy.”
For young people, the pressures of poverty, unemployment, and a lack of future prospects contribute to rising depression rates. Youth unemployment in Sierra Leone stands at nearly 70%, leaving many feeling hopeless about their future. The frustration and despair of unemployment, combined with the memories of growing up in the aftermath of the war and Ebola, have taken a significant toll on the mental health of Sierra Leone’s youth.
In addressing the crisis, efforts to address the growing mental health crisis in Sierra Leone have begun, but there is still a long way to go. Several NGOs, including Medecins Sans Frontieres (MSF) and The Sierra Leone Mental Health Coalition, have been working to raise awareness about mental health and provide services to those in need. These organizations aim to break the stigma surrounding depression and mental illness while advocating for better mental health care infrastructure.
One promising development is the ‘Mental Health Act of 2018’, which aims to improve mental health services in Sierra Leone by integrating mental health into primary healthcare. This law emphasizes the importance of training healthcare workers in recognizing and treating mental health disorders, including depression. While this is a step in the right direction, the law has yet to be fully implemented, and significant challenges remain, particularly in rural areas.
Community-based mental health programs, such as the “Chain-Free Initiative”, are also working to shift cultural perceptions about mental illness. The initiative seeks to end the inhumane practice of chaining people with mental illnesses and instead promote compassionate care and rehabilitation. By focusing on educating families and communities, these programs hope to foster a more supportive environment for individuals living with depression and other mental health issues.
While Sierra Leone has made significant strides in its recovery from war and disease, depression remains a silent crisis that affects the nation’s social fabric. The road to addressing this mental health challenge will require a multifaceted approach, involving cultural education, investment in mental health infrastructure, and efforts to break down the stigma that surrounds depression.
For many Sierra Leoneans, depression is an unspoken burden carried in isolation. But as awareness grows and more resources become available, there is hope that the country can begin to heal not only from its physical wounds but also from the deep emotional scars left behind by decades of trauma. Addressing the depression crisis in Sierra Leone is not only a matter of healthcare but also a crucial step toward rebuilding a resilient and mentally healthy society.
