Expressions of psychological distress in Sierra Leone: implications for community-based prevention and response
AbstractBackgroundOver recent decades there has been considerable mental health research in Sierra Leone but little on local conceptualisations of mental health conditions. Understanding these is crucial both for identifying the experienced needs of the population and utilising relevant community-ba...
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2020-01-01
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| Series: | Cambridge Prisms: Global Mental Health |
| Subjects: | |
| Online Access: | https://www.cambridge.org/core/product/identifier/S2054425120000126/type/journal_article |
| _version_ | 1811156098471690240 |
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| author | Rebecca Horn Simeon S. Sesay Mamadu Jalloh Amjata Bayoh Joan B. Lavally Alastair Ager |
| author_facet | Rebecca Horn Simeon S. Sesay Mamadu Jalloh Amjata Bayoh Joan B. Lavally Alastair Ager |
| author_sort | Rebecca Horn |
| collection | DOAJ |
| description | AbstractBackgroundOver recent decades there has been considerable mental health research in Sierra Leone but little on local conceptualisations of mental health conditions. Understanding these is crucial both for identifying the experienced needs of the population and utilising relevant community-based resources to address them. This study took a grounded approach to identify the ways in which adults in Sierra Leone express psychological distress.MethodsRapid ethnographic methods deployed included 75 case study interviews with community members, 12 key informant (KI) pile sorts and 55 KI interviews. Thematic analysis of data was supported by frequency analysis and multi-dimensional scaling.ResultsThirty signs of distress were identified. The only consistent ‘syndrome’ identified with respect to these was a general concept of crase, which referred to psychosis-related presentation but also a wide range of other signs of distress. We did not find consensus on locally defined concepts for mild-moderate forms of mental disorder: people use multiple overlapping signs and terms indicating psychological distress.ConclusionsAnalysis supports calls to view mental health problems as a ‘continuum of distress’ rather than as discrete categories. This framing is coherent with opportunities for prevention and response in Sierra Leone which do not focus primarily on formal healthcare service providers but rather involve a range of community-based actors. It also enables attention to be paid to the identification of milder signs of distress with a view to early response and prevention of more severe mental health problems. |
| first_indexed | 2024-04-10T04:45:53Z |
| format | Article |
| id | doaj.art-2eecfff7b301441ea0e848d6f0602629 |
| institution | Directory Open Access Journal |
| issn | 2054-4251 |
| language | English |
| last_indexed | 2024-04-10T04:45:53Z |
| publishDate | 2020-01-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | Cambridge Prisms: Global Mental Health |
| spelling | doaj.art-2eecfff7b301441ea0e848d6f06026292023-03-09T12:35:39ZengCambridge University PressCambridge Prisms: Global Mental Health2054-42512020-01-01710.1017/gmh.2020.12Expressions of psychological distress in Sierra Leone: implications for community-based prevention and responseRebecca Horn0https://orcid.org/0000-0002-9869-544XSimeon S. Sesay1Mamadu Jalloh2Amjata Bayoh3Joan B. Lavally4Alastair Ager5NIHR Global Health Research Unit on Health in Situations of Fragility, Institute for Global Health & Development, Queen Margaret University, Musselburgh, Edinburgh, ScotlandIndependent researcher, Freetown, Sierra LeoneIndependent researcher, Freetown, Sierra LeoneIndependent researcher, Freetown, Sierra LeoneIndependent researcher, Freetown, Sierra LeoneNIHR Global Health Research Unit on Health in Situations of Fragility, Institute for Global Health & Development, Queen Margaret University, Musselburgh, Edinburgh, ScotlandAbstractBackgroundOver recent decades there has been considerable mental health research in Sierra Leone but little on local conceptualisations of mental health conditions. Understanding these is crucial both for identifying the experienced needs of the population and utilising relevant community-based resources to address them. This study took a grounded approach to identify the ways in which adults in Sierra Leone express psychological distress.MethodsRapid ethnographic methods deployed included 75 case study interviews with community members, 12 key informant (KI) pile sorts and 55 KI interviews. Thematic analysis of data was supported by frequency analysis and multi-dimensional scaling.ResultsThirty signs of distress were identified. The only consistent ‘syndrome’ identified with respect to these was a general concept of crase, which referred to psychosis-related presentation but also a wide range of other signs of distress. We did not find consensus on locally defined concepts for mild-moderate forms of mental disorder: people use multiple overlapping signs and terms indicating psychological distress.ConclusionsAnalysis supports calls to view mental health problems as a ‘continuum of distress’ rather than as discrete categories. This framing is coherent with opportunities for prevention and response in Sierra Leone which do not focus primarily on formal healthcare service providers but rather involve a range of community-based actors. It also enables attention to be paid to the identification of milder signs of distress with a view to early response and prevention of more severe mental health problems.https://www.cambridge.org/core/product/identifier/S2054425120000126/type/journal_articleCultural idiomsmental healthpreventionpsychological distressSierra Leonewell-being |
| spellingShingle | Rebecca Horn Simeon S. Sesay Mamadu Jalloh Amjata Bayoh Joan B. Lavally Alastair Ager Expressions of psychological distress in Sierra Leone: implications for community-based prevention and response Cambridge Prisms: Global Mental Health Cultural idioms mental health prevention psychological distress Sierra Leone well-being |
| title | Expressions of psychological distress in Sierra Leone: implications for community-based prevention and response |
| title_full | Expressions of psychological distress in Sierra Leone: implications for community-based prevention and response |
| title_fullStr | Expressions of psychological distress in Sierra Leone: implications for community-based prevention and response |
| title_full_unstemmed | Expressions of psychological distress in Sierra Leone: implications for community-based prevention and response |
| title_short | Expressions of psychological distress in Sierra Leone: implications for community-based prevention and response |
| title_sort | expressions of psychological distress in sierra leone implications for community based prevention and response |
| topic | Cultural idioms mental health prevention psychological distress Sierra Leone well-being |
| url | https://www.cambridge.org/core/product/identifier/S2054425120000126/type/journal_article |
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