For centuries, they called the foreboding building on a hill above this capital city the Kissy Lunatic Asylum. It was built in the early 1800s by the British colonial administration, and behind the high walls, patients were kept in chains. People here say the stench seeped from the brick walls, and the screams of patients, whose psychosis and trauma were untreated by medication or therapy, echoed out the narrow, barred windows.
Today a small wooden sign hangs over the front desk in the outpatient department: “Sierra Leone Psychiatric Teaching Hospital: Chain-free since 2018.” The sunny corridors of the newly renovated facility flash with the fuchsia uniforms of psychiatric nursing students. The shelves of the pharmacy are lined with the latest antipsychotics and antidepressants. Children bounce on a trampoline at a cheerful clinic just for them. And six residents are on their way to being the first psychiatrists ever trained in this country.
The transformation at Kissy is part of an extraordinary effort to build a mental health care system from scratch in one of the poorest countries in the world. The residents work the wards and see patients in the packed outpatient clinic, under the supervision of three consulting psychiatrists. They are the only three in the country’s entire health system — a staggering ratio, but a threefold increase from decades when there was just one, who paid the patients at Kissy a weekly visit.
— Mental Health Updates (@mental_updates) April 11, 2022