Sierra Leone has recently ended the practice of chaining mental health patients as part of a new transformation initiative.

Abdul Jalloh, the only practicing psychiatrist in Sierra Leone initially, undertook the task of revamping the nation’s only psychiatric hospital on the outskirts of the capital and has since spearheaded a significant transformation in mental health services in the country. Over the last six years, Jalloh has eliminated the practice of chaining patients to their beds and has focused on attracting new talent, aided by a U.S.-based nonprofit organization that has injected substantial funds along with support from the Sierra Leonean government.

Under Jalloh’s leadership, the hospital now boasts three fully qualified psychiatrists, seven doctors enrolled in a groundbreaking residency training program, and an expanded staff of 135, including specialized mental health nurses, addiction professionals, clinical psychologists, and occupational therapists. The hospital has garnered a new reputation and is now known as the Sierra Leone Psychiatric Teaching Hospital, a far cry from its previous label as the “Crase Yard.”

Despite these advancements, Sierra Leone still faces challenges in providing mental health services beyond the capital. While units for mental health were established in all 14 districts nearly a decade ago, most do not operate effectively due to a lack of trained personnel and resources. Additionally, traditional healers and religious figures remain common sources of support for mental health issues in the country.

The country, scarred by a lengthy civil war and plagued by unemployment and poverty, is grappling with high rates of addiction, particularly to a locally produced drug called kush. There are systemic hurdles to mental health services, including outdated laws that stigmatize mental health conditions and discourage individuals from seeking help.

Efforts are being made by the government in collaboration with international organizations to improve mental health services. A World Health Organization training program is being implemented by the health ministry to assist healthcare workers in identifying and managing common mental health problems. Partners In Health, the U.S.-based nonprofit, has also established a mental health helpline for counseling and advice.

Jalloh’s commitment to transforming the psychiatric hospital has been significant, though challenges persist, including limited resources to address the addiction crisis. Despite the progress, Jalloh acknowledged facing personal mental health challenges due to the demanding nature of his work. Transforming mental health services in Sierra Leone is a gradual process that requires addressing various factors, including cultural beliefs and practices.