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Between tradition, faith and biomedicine

Caregivers' perceptions of child and adolescent mental health services in Sierra Leone

Bibliographic Data

ID2999249
AuthorsMoritz Matakas (0000-0003-1619-990X, King's College London, corresponding author), Andreas Papamichail (0000-0001-8938-6410, Queen Mary University of London), Dawn Harris (0000-0001-7010-9077, King's College London), Joshua Duncan (0000-0002-0333-4781, Mental Health Coalition, Sierra Leone, Freetown, Sierra Leone), Abdulai Jawo Bah (0000-0002-3334-7882, Boston College), Temitope Ademosu (Adult Social Care, Birmingham City Council, Birmingham, UK)
Year2025
Volume62
Issue4
Pages539-552
Publication date2025-08-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueTranscultural Psychiatry (JOURNAL)
Journal identifiersISSN: 1363-4615 • E-ISSN: 1461-7471
PublisherSAGE Publications Inc (PUBLISHER)
DOI10.1177/13634615251359373
PMID40905764
OpenAlexW4413987172
LanguageEN
Citations received2
References cited47

In 2016, the Ola During Children's Hospital (ODCH) in Freetown, Sierra Leone, introduced the country's first and only Children and Adolescent Mental Health (CAMH) service with treatments based on a biomedical understanding of mental illness. The service at ODCH contrasts with the prevailing traditionally defined mental health landscape in and around Freetown, Sierra Leone, which largely relies on supernatural and spiritual explanatory models. The study investigates how service-users perceive the biomedical treatment practices and makes a first attempt at examining how the different services relate to each other. Semi-structured interviews were conducted with eight female caregivers of children and adolescents with mental illness (aged 6-19), as well as with two traditional healers, two religious healers, and five mental health nurses. The interviews were thematically analysed following Braun and Clarke's six-phase approach, with Arthur Kleinman's concept of "explanatory models" (EMs) serving as the primary analytical lens to examine how understandings of illness shape perceptions and help-seeking behaviour. The study concludes first that biomedical explanations about children's mental health conditions were well received by care seekers and help to improve their understanding of the condition and ways to deal with it; second, the concept of EMs can be helpful to understand different help-seeking behaviours of caregivers of children with mental illness in Sierra Leone, however, this concept has to be taken as flexible and people adapt to what they are exposed to; and third, a scale-up of CAMH services should include awareness-raising among health practitioners and show itself open to cooperate with non-biomedical practitioners under certain conditions

Biomedicine · Mental health · Mental illness · Perception · Psychiatry · Sierra leone · Socioeconomics · Sociology · Homelessness and Social Issues · Medicine · Nursing · Poverty, Education, and Child Welfare · Psychology · Religion, Spirituality, and Psychology

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Unique citing works2
Citations per year2
Citation span2025 - 2025 (1)
Citation velocityrecent
Highly citedNo
Citation typesNeutral: 2
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