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The Barriers and Facilitators to Decentralised Nurse-Led Mental Health Service Delivery in Sierra Leone

In 2009, 98.0% of people with mental illness in Sierra Leone were not receiving treatment, partly due to the absence of public psychiatric facilities outside the capital. In response to this situation, the Ministry of Health and Sanitation rolled out nurse-led mental health units (MHUs) to every dis...

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Autores principales: Hopwood, Helen, Harris, Dawn, Sevalie, Stephen, Iyawa, Gloria, Langan Martin, Julie
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer US 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10289970/
https://www.ncbi.nlm.nih.gov/pubmed/36692702
http://dx.doi.org/10.1007/s10597-023-01087-0
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author Hopwood, Helen
Harris, Dawn
Sevalie, Stephen
Iyawa, Gloria
Langan Martin, Julie
author_facet Hopwood, Helen
Harris, Dawn
Sevalie, Stephen
Iyawa, Gloria
Langan Martin, Julie
author_sort Hopwood, Helen
collection PubMed
description In 2009, 98.0% of people with mental illness in Sierra Leone were not receiving treatment, partly due to the absence of public psychiatric facilities outside the capital. In response to this situation, the Ministry of Health and Sanitation rolled out nurse-led mental health units (MHUs) to every district. This study evaluates the barriers and facilitators to mental health service delivery in decentralised MHUs in Sierra Leone using key informant interviews and focus group discussions with 13 purposefully sampled clinical staff and senior management personnel. The interviews were audio-recorded, translated from Krio if necessary, transcribed, and analysed using manifest content analysis. The findings suggest that factors affecting nurse-led mental health service delivery include small workforce and high workload, culture and beliefs, risks, lack of safety measures and required resources, outdated policies, poor salaries, lack of funds for medication, distance, power, influence, and stigma. Factors that could facilitate nurse-led mental health services include: increasing motivation, increasing the workforce, knowledge sharing, mentorship, availability of medication, passion and modern psychiatry. The findings contribute towards understanding the challenges and opportunities faced by the recently established nurse-led decentralised mental health services across Sierra Leone, in order to address the large mental health treatment gap. We hope the findings will inform further policy and planning to improve the quality of decentralised mental healthcare.
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spelling pubmed-102899702023-06-25 The Barriers and Facilitators to Decentralised Nurse-Led Mental Health Service Delivery in Sierra Leone Hopwood, Helen Harris, Dawn Sevalie, Stephen Iyawa, Gloria Langan Martin, Julie Community Ment Health J Original Paper In 2009, 98.0% of people with mental illness in Sierra Leone were not receiving treatment, partly due to the absence of public psychiatric facilities outside the capital. In response to this situation, the Ministry of Health and Sanitation rolled out nurse-led mental health units (MHUs) to every district. This study evaluates the barriers and facilitators to mental health service delivery in decentralised MHUs in Sierra Leone using key informant interviews and focus group discussions with 13 purposefully sampled clinical staff and senior management personnel. The interviews were audio-recorded, translated from Krio if necessary, transcribed, and analysed using manifest content analysis. The findings suggest that factors affecting nurse-led mental health service delivery include small workforce and high workload, culture and beliefs, risks, lack of safety measures and required resources, outdated policies, poor salaries, lack of funds for medication, distance, power, influence, and stigma. Factors that could facilitate nurse-led mental health services include: increasing motivation, increasing the workforce, knowledge sharing, mentorship, availability of medication, passion and modern psychiatry. The findings contribute towards understanding the challenges and opportunities faced by the recently established nurse-led decentralised mental health services across Sierra Leone, in order to address the large mental health treatment gap. We hope the findings will inform further policy and planning to improve the quality of decentralised mental healthcare. Springer US 2023-01-24 2023 /pmc/articles/PMC10289970/ /pubmed/36692702 http://dx.doi.org/10.1007/s10597-023-01087-0 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Original Paper
Hopwood, Helen
Harris, Dawn
Sevalie, Stephen
Iyawa, Gloria
Langan Martin, Julie
The Barriers and Facilitators to Decentralised Nurse-Led Mental Health Service Delivery in Sierra Leone
title The Barriers and Facilitators to Decentralised Nurse-Led Mental Health Service Delivery in Sierra Leone
title_full The Barriers and Facilitators to Decentralised Nurse-Led Mental Health Service Delivery in Sierra Leone
title_fullStr The Barriers and Facilitators to Decentralised Nurse-Led Mental Health Service Delivery in Sierra Leone
title_full_unstemmed The Barriers and Facilitators to Decentralised Nurse-Led Mental Health Service Delivery in Sierra Leone
title_short The Barriers and Facilitators to Decentralised Nurse-Led Mental Health Service Delivery in Sierra Leone
title_sort barriers and facilitators to decentralised nurse-led mental health service delivery in sierra leone
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10289970/
https://www.ncbi.nlm.nih.gov/pubmed/36692702
http://dx.doi.org/10.1007/s10597-023-01087-0
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