Who Cares for Former Child Soldiers? Mental Health Systems of Care in Sierra Leone
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While numerous studies on former child soldiers (FCS) have shown mental health needs, adequate services are a challenge. This study aimed to identify priorities, barriers and facilitators of mental health care for Sierra Leonean FCS. Thematic analysis was done on 24 qualitative interviews with participants from diverse sectors. Priorities of mental distress, substance abuse, and gender-based violence were common among FCS clients. Barriers were governmental support and communication with other providers. Perceived facilitators of care were primary- and secondary-level interventions. A public mental health model would feasibly build upon local, culturally embraced interventions, targeting local priorities and reducing barriers to care.
KeywordsMental health Child soldiers War Systems of care Psychosocial
- Amnesty International. (1998). Sierra Leone: 1998—A year of atrocities against civilians. London: Amnesty International.Google Scholar
- Baasher, T. (1982). The healing power of faith. World Health, 9(10), 5–7.Google Scholar
- Bannerman, R. B., Buton, J., & Wen-Chieh, C. (1983). Traditional medicine and health care coverage. Geneva: World Health Organization.Google Scholar
- Betancourt, T., Agnew-Blais, J., Gilman, S., Williams, D., & Ellis, H. (2010a). Past horrors, present struggles: The role of stigma in the association between war experiences and psychosocial adjustment among former child soldiers in Sierra Leone. Social Science and Medicine, 70(1), 17–26.PubMedCrossRefGoogle Scholar
- Betancourt, T. S., Brennan, R. T., Rubin-Smith, J., Fitzmaurice, G., & Gilman, S. (2010b). Sierra Leone’s former child soldiers: A longitudinal study of risk, protective factors, and mental health. Journal of the American Academy of Child and Adolescent Psychiatry, 49(6), 606–615.PubMedGoogle Scholar
- Central Intelligence Agency World Fact Book. (2010). Sierra Leone Demographics Profile 2011. Available at http://www.indexmundi.com/sierra_leone/demographics_profile.html. Last Accessed on May 1, 2011.
- Coalition to Stop the Use of Child Soldiers (CSC). (2001). Child soldiers global report 2001. London.Google Scholar
- De Jong, J. (2011). (Disaster) Public mental health. In D. J. Stein, M. J. Friedman, & C. Blanco (Eds.), Trauma and mental health: Resilience and posttraumatic disorders. Oxford: Wiley-Blackwell.Google Scholar
- van De, V., & Niekerk, J. P. (2012). Traditional healers formalised? South African Medical Journal, 102(3), 105–106.Google Scholar
- Human Rights Watch. (2005). Youth, poverty, and blood: The lethal legacy of West Africa’s regional warriors. Available at: http://reliefweb.int/node/23325. Last Accessed November 1, 2011.
- Inter-Agency Standing Committee (IASC). (2007). Guidelines on mental health and psychosocial support in emergency settings. Geneva: Inter-Agency Standing Committee. Available at: http://www.who.int/mental_health/emergencies/guidelines_iasc_mental_health_psychosocial_june_2007.pdf. Last Accessed January 2, 2011.
- McKay, S., & Mazurana, D. (2004). Where are the girls? Girls in fighting forces in Northern Uganda, Sierra Leone, and Mozambique: Their Lives During and After War. Montreal: International Centre for Human Rights and Democratic Development.Google Scholar
- Mussema, Y. (2006). A historical overview of traditional medicine practices and policy in Ethiopia. Ethiopian Journal of Health Development, 20(2), 127–134.Google Scholar
- National Reference Centre for African Traditional Medicine (NRCATM). Available at: http://www.sahealthinfo.org/traditionalmeds/traditionalpart1.pdf. Last Accessed on June 22, 2012.
- Patton, M. Q. (2002). Qualitative research and evaluation methods. Thousand Oaks, CA: Sage.Google Scholar
- Petersen, I., Ssebunnya, J., Bhana, A., Baillie, K., & Mental Health and Poverty Program Research Programme Consortium. (2011). Lessons from case studies of integrating mental health systems into primary health care in South Africa and Uganda. International Journal of Mental Health Systems, 5, 8–20.PubMedCrossRefGoogle Scholar
- Sierra Leone Mental Health Policy. (2009). Available at: http://www.whosierraleone.org/1_docs/mohspartnersdocs/mental_health_policy.pdf. Last Accessed on June 22, 2012.
- Tabuti, J. R. S., Dhillion, S. S., & Lye, K. A. (2006). Traditional medicine in Bulamogi County, Uganda: ITS practitioners, users and visability. Journal of Ethnopharmacology, 85(20), 127–134.Google Scholar
- UNICEF. (2007). Paris principles: Principles and guidelines on children associated with armed forces or armed conflict. New York: UNICEF.Google Scholar
- United Nations Children’s Fund (UNICEF). (2001). The State of the World’s Children 2001. New York: United Nations.Google Scholar
- Van der Kolk, B. (2005). Developmental trauma disorder. Psychiatric Annals, 35(5), 401–408.Google Scholar
- Wessells, M. (2006). Child soldiers: From violence to protection. Cambridge: Harvard University Press.Google Scholar
- WHO. (2008). Mental Health Gap Action Programme (mhGAP): Scaling up care for mental, neurological and substance abuse disorders. Geneva: WHO.Google Scholar
- WHO. (2010). mhGAP Intervention Guide for mental, neurological and substance abuse disorders in non-specialized health settings. Geneva: WHO.Google Scholar
- Williamson, J. (2005). Reintegration of child soldiers in Sierra Leone. USAID. Available at: http://pdf.usaid.gov/pdf_docs/PDACH599.pdf. Last Accessed on June 22, 2012.
- World Health Organization (WHO). (2005). Sierra Leone. Mental Health Atlas 2005. Geneva: WHO.Google Scholar