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Factors for Success – Mental Health Coalition in Sierra Leone

36 year old Osman Kamara (name changed) is a mental health patient who underwent training on leadership and advocacy conducted by the Mental Health Coalition. If released from the mental hospital, Osman would like to continue being involved with the Coalition.

CBM undertook a study to investigate factors associated with successful mental health advocacy in a low-income country (Sierra Leone).

Sierra Leone faces many challenges in providing accessible mental health care and combating stigma. In an effort to improve the mental health situation in Sierra Leone, stakeholders have come together to form the country's first mental health advocacy group: the Mental Health Coalition (MHC) - Sierra Leone.

CBM through its Community Mental Health Advisory Group and with the support of members of the MHC and in collaboration with the Enabling Access to Mental Health in Sierra Leone (EAMH) programme undertook a study to investigate factors associated with successful mental health advocacy in a low-income country (Sierra Leone) using community-based participatory research (CBPR) methodology.

The study revealed ongoing efforts towards advocacy outputs relating to scaling up of mental health and policy development, with slow, but positive change in the policy sphere. Making good practices of advocacy groups available helped pushing the mental health agenda and holding governments to account.

While adoption of the National Mental Health Policy in Sierra Leone was a success, implementation remains a serious challenge, including the priority of legislative reform. Limited resources and the competition for resources were additional obstacles. Strategic engagement and effective working relationships with government, specifically the Ministry of Health and Sanitation, and stakeholders were significant successes.

Overall, the results confirmed the need for coordinated advocacy movements for mental health to spur demand for change in the context of low political will of public policy makers. This study uncovers advocacy as an essential, integrated, component of programmes, including those focused on service development or systems strengthening. The utilisation of a participatory approach contributed to a higher quality research process and a reinforcement of the aims of the Coalition through the research itself and its dissemination.

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