Child mental health and neurodevelopmental disorders in Sierra Leone: a mixed methods study.

Lead Research Organisation: King's College London
Department Name: Psychology


Conflict and disasters impact disproportionately on low income countries. Sierra Leone has been burdened by a twelve year civil war and recent Ebola-virus outbreak. Such 'population shocks' with their attendant mortality, morbidity and societal disruption exacerbate chronic effects of poverty, limited resources, and poor governance. Half of Sierra Leone's population are children; whilst mental health research has focused on increased internalised and externalised psychological distress in child soldiers, little attention has been given to mental health and neurodevelopmental problems in the child population overall.

Children and Adolescent Mental Health (CAMH) services are near non-existent in Sierra Leone; with no children's mental health data, specific national policies, or plans. There is only one CAMH professional, and one psychiatric hospital that does not provide services to children. Most children lack access to care. The estimated treatment gap for children in Sierra Leone is 99.8%. Support for affected children and their families is likely to be further impeded by high levels of stigma, lack of awareness and negative attitudes to mental health disorders common in Sierra Leone and other sub-Saharan African countries.

There is a growing urgency to develop community based models of mental health care that are tailored to the needs of these vulnerable children and their families in line with the governments vision to decentralise mental health services by 2020. This timely in-depth study will provide country and culture specific data to inform policy and a community based social intervention.

Adopting a developmental perspective, which is consistent with research indicating that rapidly developing biological systems of children are shaped by life experiences (eg. poverty, population shocks and other forms of social adversity) which subsequently interact to influence mental health trajectories (14). This project aims to gain a better understanding of contextual and individual risk factors (eg. adversity) and protective factors (eg. social support) that influence mental health and neurodevelopmental disorders of children in Sierra Leone.

The proposed project aims to produce both qualitative and quantitative evidence on country and culture specific mental health and neurodevelopmental disorders. This will increase the depth of understanding and management of these disorders in Sierra Leone. The following research questions will be addressed:

Q1. What is the prevalence of mental health and neurodevelopmental disorders amongst children living in Sierra Leone?
Q2. What are the major risk and protective factors for these disorders?
Q3. How do children's caregivers and local stakeholders (e.g. policymakers, health professionals, educators, religious leaders and traditional healers) perceive these disorders? For caregivers, what are the help seeking behaviours and barriers to support seeking?
Q4. What is the current service provision and what are the most prominent unmet needs?


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Studentship Projects

Project Reference Relationship Related To Start End Student Name
ES/P000703/1 30/09/2017 29/09/2027
1916104 Studentship ES/P000703/1 30/09/2017 30/07/2021 Temitope Ademosu