Mental health service delivery in Sierra Leone: Reducing stigma and exploring opportunities for expansion in primary care
type: CreativeWork
description: Globally, untreated mental illness is a public health crisis that confers preventable suffering. In low- and middle-income countries (LMICs) in particular, the vast majority of individuals with serious mental illness receive no formal treatment. In response to the challenge of a vast treatment gap and limited resources allocated to mental health, best practices have highlighted strategies that utilize existing infrastructure and human resources. Integration of mental health into primary care settings and task-sharing to enable non-specialist health workers to provide mental health services have emerged as key strategies towards reducing the treatment gap. Despite a growing body of evidence illustrating that non-specialists can effectively provide a variety of mental health services in primary care, there has been limited success in expanding these models beyond clinical trials. The present studies explore this challenge in the context of Sierra Leone, a small country on the west coast of Africa. In Sierra Leone, a network of peripheral health units (PHUs) are the core component of first line primary care. The healthcare staff working in these small, decentralized clinics are typically the first, and often only, contact that most community members have with the healthcare system. The present studies focus on these health care workers as key providers of accessible physical health care and as providers who could potentially take on mental health service tasks in an expanded system of mental health care. We focus first on barriers to the integration of mental health care into primary care and utilization of existing services: namely, stigma towards mental illness and a lack of knowledge about mental health. We then shift our focus to a more exploratory look at health care worker’s perspectives on the potential for expanding mental health services within primary health care. Study 1 builds on prior work that identified widespread stigma towards mental illness, commonly …
abstract: Globally, untreated mental illness is a public health crisis that confers preventable suffering. In low- and middle-income countries (LMICs) in particular, the vast majority of individuals with serious mental illness receive no formal treatment. In response to the challenge of a vast treatment gap and limited resources allocated to mental health, best practices have highlighted strategies that utilize existing infrastructure and human resources. Integration of mental health into primary care settings and task-sharing to enable non-specialist health workers to provide mental health services have emerged as key strategies towards reducing the treatment gap. Despite a growing body of evidence illustrating that non-specialists can effectively provide a variety of mental health services in primary care, there has been limited success in expanding these models beyond clinical trials. The present studies explore this challenge in the context of Sierra Leone, a small country on the west coast of Africa. In Sierra Leone, a network of peripheral health units (PHUs) are the core component of first line primary care. The healthcare staff working in these small, decentralized clinics are typically the first, and often only, contact that most community members have with the healthcare system. The present studies focus on these health care workers as key providers of accessible physical health care and as providers who could potentially take on mental health service tasks in an expanded system of mental health care. We focus first on barriers to the integration of mental health care into primary care and utilization of existing services: namely, stigma towards mental illness and a lack of knowledge about mental health. We then shift our focus to a more exploratory look at health care worker’s perspectives on the potential for expanding mental health services within primary health care. Study 1 builds on prior work that identified widespread stigma towards mental illness, commonly …
author: Fitts, Jessica Jacqueline
language: en
keywords: global mental health, mental health stigma, primary care, Sierra Leone
date published: 2022-01-12T22:34:56Z
date modified: 2026-07-22T22:24:53Z
provider: University of Illinois - Urbana-Champaign
publisher: Networked Digital Library of Theses and Dissertations
type: WebPage
source organization: University of Illinois at Urbana-Champaign

PropertyValue
property ID: Handle
value: http://hdl.handle.net/2142/113144