THE 2016 WORLD MENTAL HEALTH DAY CEREMONY ORGANISED BY ADVOCACY FOR MENTAL HEALTH AND HUMAN RIGHTS SIERRA LEONE: KEYNOTE SPEECH BY DR. ADONIS ABBOUD

The Chairman,
Honourable Ministers,
Distinguished Ladies and Gentlemen,
More than a decade after the end of our civil war, I have been left wondering if collectively as a society, we really understood the totality of the impact and ramifications on survivors of that unfortunate experience, especially young men and women.
In coming across several cases, some of which I shall recall shortly, what I have discovered is that our society has failed to bear in mind, the damage to the emotions, behaviour, attitudes and spirituality of victims of the socio-political and economic trauma of our fellow citizens, in the course of their daily existence.
Over the past several weeks, there have been numerous stories, articles, revelations of rapes and other sexual abuses so much so that it is beginning to feel uncomfortable and perversely as if it has become fashionable.
Miss X had a difficult early life, marked by intra-familial domestic abuse. She learnt strategies of conflict resolution that included fighting, and learnt that violence was acceptable. Family life was chaotic and outside of usual societal norms. Miss X in the process may have learnt anti-authority attitudes.
Given her parent’s own difficulties regulating their emotions it seems likely that Miss X struggled to understand her own emotional and psychological life, and had difficulty regulating her own emotions. Her parents abused alcohol. She dropped out of school at an early age.
In early adolescence she moved out of the family home to live with a man and his mother whilst working for them. She was sexually abused by this man.
Through her early life experiences, Miss X may also have learnt that she could be very vulnerable, and that those in positions of power and authority over her were likely to abuse her in various ways. This is likely to have affected trust in her relationships with those in authority.
For the past three years, a mason who once worked for me.. I would rather call him an artist who does beautiful things while building a wall or paving  an incredibly creative mind  started having illusions.  Since then, all that has been happening is that his sister takes him to Kissy Hospital once every month.
Fair enough. The trouble is that he is simply given an injection and sent home. What good is that?
This is the same mental health institution where a man in his 50’s was interviewed for a documentary. From his responses it was very apparent that the unfortunate man did not really need to be kept in confinement. He was simply a man whose collapsed business left him traumatised and with no social cushion.
Listening to him you see clearly that guy does not belong to the category of those who have lost their sanity. More social awareness would have shown that he would have benefitted more from counselling than the indignity of being locked up …he said it himself ” I don’t know why I am here . I had good business in Kono.  I lost all and was penniless …they brought me here …I am better off back in Kono.
What strikes me about Kissy Mess Mess mental Hospital is that it is in a real Mess. Having seen the documentary on the inmates in that hospital, it was clear that several of them merely needed proper counselling.. Instead, what you see is that across board, all that happens is that the inmates are injected periodically with some kind of heavy tranquilisers.
Most traumatic events are experiences that create stressful responses and intense emotional behaviour.
The crucial element is the support that we offer people who experience trauma, crisis and distress as in the cases above. We need to ensure that victims get the kind of care that is needed promptly and appropriately.
What people understand by Mental Health and mental wellbeing is influenced by a combination of their:  Age, Class, and Gender, personal experiences and expectations, ethnicity, cultural and religious beliefs.
SO WHAT IS MENTAL HEALTH? Health is described by the World Health Organisation as a state of complete physical mental and social well-being and is not merely the absence of disease or infirmity. Health is a resource for everyday life, not for the object of living. It is a positive concept emphasising social and personal resources as well as physical capabilities.
The definition of Mental Health as a “positive sense of well being” therefore challenges the idea that Mental Health is the opposite of mental illness.
Mental Health influences how we: think and feel about ourselves; think about our future; think about others; interpret events  or are able to learn, communicate, form, sustain and end relationships  as well as cope with change, transition and life events.
It is a shame indeed that in this day and age, Sierra Leone has just one retired but active psychiatrist and two trained psychiatric nurses for the whole country. This is an indication of the levity with which we treat mental health needs.
The problem is that we are stoking a future that is damaged even before it begins.
When our young men and women have little or no access to mental health care, we seal their fate as we may fail to distinguish between personality disorders, psychological stress and mental health needs and so give appropriate interventions.
How many of us are really aware of the fact that personality disorders are a type of mental disorder that can damage lives and relationships if left undiagnosed and untreated.
People who have personality disorders can express a wide range of emotions and behaviours that are considered detrimental to relationships, causing friends and family to withdraw from the individual.
While some personality disorders border on the mental state of the individual, cognitive therapy and other psychoanalytical treatments are better suited than what presently obtains in our society where we simply classify everyone showing symptoms of mental imbalance as a lunatic.
In this regard, I wish to express a personal gratitude to our hosts – for the initiative to change the “passive culture” among the country’s population by strengthening and supporting their social and cultural environment and to play an active role in promoting the rights of people with mental health illness at community level.
I am particularly elated by the psychosocial interventions in 4 schools in Bo to children who have experienced adverse life events to address their trauma, promote resilience and empower them.
I believe that this will help people understand their personality better and to think about how their personality affects their relationships, emotions and risk.
We all have mental health and it is just as important as our physical health. There are times we feel stressed. Pressures can build across different areas of our lives. We may have a tough time at work. We might be experiencing relationship problems in our families. Financial problems can build. Therefore, mental health problems range from the everyday worries through to anxiety and depression and more serious long term conditions.
Because as individuals we cope differently, such situations can develop into a more serious and long term mental health problem as you move through different stages of our existence.
I wish to appeal to the government through the relevant ministries, to recognise the need for increased and intensified awareness programme on mental health issues.
There is a stigma attached to mental health problems or what is seen sometimes as weakness and inability to cope with setbacks. As a result, people feel uncomfortable talking about how they are really feeling.
Educating the general public is important. It makes people aware of these mental health conditions and, in turn, hopefully reduces stigma. It may also help someone recognize the warning signs of a mental illness that they, or a loved one, have been experiencing; thus leading them to seek a professional diagnosis and treatment.
Unless there is a general awareness about the fact that not all mental health problems are insanity, efforts by organisations such as Advocacy for Mental Health and Human Rights, will amount to a drop in the ocean and invariable be at a huge future cost to the nation.
In the light of this year’s theme  Psychological First Aid  I call on everyone of us to contribute to the goal of taking mental health out of the shadows so that people in general feel more confident in tackling the stigma, isolation and discrimination that continues to plague those with mental health conditions, their families and carers.
Collectively as a society, we need to support one another better and become more of our brother’s keeper.
I think these awareness days can serve an additional purpose. They should remind us that mental illnesses are very real and require real treatment.
It’s also a reminder that we have to educate ourselves and our loved ones (supporters, caregivers) about these conditions so we can live the best lives possible.
I thank you all for your attention and my thanks to Advocacy for mental health for this opportunity.
It is my prayer that this will be the turning point in mental health awareness in Sierra Leone.