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Author: search.filters.author.Horn, RebeccaSubject: search.filters.subject.Sierra Leone

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Now showing 1 - 7 of 7
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    Social determinants of psychological distress in Sierra Leone
    (Springer, 2022-04-19) Jailobaeva, Kanykey; Horn, Rebecca; Arakelyan, Stella; Diaconu, Karin; Kamara, Ajaratu; Ager, Alastair
    Purpose Growing evidence demonstrates that daily stressors such as family violence, unemployment, and living conditions play an important part in causing psychological distress. This paper investigates the impact of distressing events and day-to-day living conditions on psychological distress in the fragile context of Sierra Leone.
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    The development of a contextually appropriate measure of psychological distress in Sierra Leone
    (BMC, 2021-07-21) Horn, Rebecca; Jailobaeva, Kanykey; Arakelyan, Stella; Ager, Alastair
    Abstract: Background: Studies of psychological distress in Sierra Leone have typically used measures which were developed for use in other contexts, and which often have not been adapted or validated for use in Sierra Leone. This has resulted in a lack of reliable information about the patterns of psychological distress within the population, which is a barrier to the development of effective and appropriate mental health services. The aim of the study was to develop a locally-appropriate measure of psychological distress for Sierra Leone. Methods: The new measure consists of two instruments: the Sierra Leone Psychological Distress Scale (SLPDS) and a gendered measure of ability to carry out daily tasks—a Function scale—as an indication of the severity of distress. A three-phase mixed methods exploratory sequential study was conducted. Phase 1 was item generation and testing, leading to the development of a set of potential items for both instruments. Phase 2 was a small pilot study (N = 202) leading to the selection of the final set of items for both measures. Phase 3 was a validation phase where the SLPDS and the Function scale were administered with a larger sample of 904 respondents. Item analysis was used to assess the internal consistency of the scales, and Exploratory Factor Analysis to explore the properties of the SLPDS. Results: Exploratory factor analysis using the principal axis factoring with an oblique rotation identified a three-factor structure for the 18-item SLPDS. Internal consistency for the SLPDS (Cronbach’s alpha = 0.89) and three subscales was good (Cronbach’s alpha > 0.73). The internal reliability of the male and female versions of the Function scale was also found to be acceptable (Cronbach’s alpha = 0.90 for the female scale and 0.79 for the male scale). Conclusions: Together the SLPD and Function scales provide a locally-validated tool which will enable government bodies and local and international non-governmental organisations in Sierra Leone to assess mental health and psychosocial needs. This will support both effective service provision and the evaluation of initiatives designed to improve mental health and psychosocial wellbeing.
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    Factors contributing to emotional distress in Sierra Leone: A socio-ecological analysis
    (BMC, 2021-06-11) Horn, Rebecca; Arakelyan, Stella; Wurie, Haja; Ager, Alastair
    Background There is increasing global evidence that mental health is strongly determined by social, economic and environmental factors, and that strategic action in these areas has considerable potential for improving mental health and preventing and alleviating mental disorders. Prevention and promotion activities in mental health must address the needs prioritised by local actors. The aim of this study was to identify stressors with the potential to influence emotional wellbeing and distress within the general population of Sierra Leone, in order to contribute to an inter-sectoral public mental health approach to improving mental health within the country.
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    Expressions of psychological distress in Sierra Leone: Implications for community-based prevention and response
    (Cambridge University Press, 2020-07-29) Horn, Rebecca; Sesay, Simeon S.; Jalloh, Mamadu; Bayoh, Amjata; Lavally, Joan B.; Ager, Alastair
    Background Over recent decades there has been considerable mental health research in Sierra Leone but little on local conceptualisations of mental health conditions. Understanding these is crucial both for identifying the experienced needs of the population and utilising relevant community-based resources to address them. This study took a grounded approach to identify the ways in which adults in Sierra Leone express psychological distress.
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    The myth of the 1-day training: The effectiveness of psychosocial support capacity-building during the Ebola outbreak in West Africa
    (Cambridge University Press, 2019-05-07) Horn, Rebecca; O'May, Fiona; Esliker, Rebecca; Gwaikolo, Wilfred; Woensdregt, Lise; Ruttenberg, Leontien; Ager, Alastair
    Background - In emergencies and resource-poor settings, non-specialists are increasingly being trained to provide psychosocial support to people in distress, with Psychological First Aid (PFA) one of the most widely-used approaches. This paper considers the effectiveness of short training programmes to equip volunteers to provide psychosocial support in emergencies, focusing particularly on whether the PFA training provided during the Ebola outbreak enabled non-specialists to incorporate the key principles into their practice. Methods - Semi-structured interviews were conducted in Sierra Leone and Liberia with 24 PFA trainers; 36 individuals who participated in PFA training; and 12 key informants involved in planning and implementing the PFA roll-out. Results - Findings indicate that many PFA ToTs were short and rarely included content designed to develop training skills. As a result, the PFA training delivered was of variable quality. PFA providers had a good understanding of active listening, but responses to a person in distress were less consistent with the guidance in the PFA training or with the principles of effective interventions outlined by Hobfoll et al. Conclusions - There are advantages to training non-specialists to provide psychosocial support during emergencies, and PFA has all the elements of an effective approach. However, the very short training programmes which have been used to train non-specialists in PFA might be appropriate for participants who already bring a set of relevant skills to the training, but for others it is insufficient. Government/NGO standardisation of PFA training and integration in national emergency response structures and systems could strengthen in-country capacity.
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    'I don't need an eye for an eye': Women's responses to intimate partner violence in Sierra Leone and Liberia
    (Taylor & Francis, 2016-02) Horn, Rebecca; Puffer, Eve S.; Roesch, Elisabeth; Lehmann, Heidi
    This paper explores the possibilities for agency in intimate partner violence (IPV) situations from the perspective of women in Sierra Leone and Liberia using focus group discussions (N groups = 14, N participants = 110) and individual interviews (N = 20). Findings identify multiple interrelated factors influencing the decisionmaking of women experiencing IPV. At the individual level, emotional factors and women's knowledge of their rights and options influence their decision-making. At the relational level, the role of neighbours, family and friends is crucial, both for emotional support and practical assistance. At the community level, more formal structures play a role, such as chiefs and women's groups, though their effectiveness varies. At the structural level are barriers to effective responses, including a poorly functioning criminal justice system and a social system in which children often stay with fathers following separation or divorce. Strong cultural beliefs operate to keep women in abusive relationships. We identify implications for prevention and response services and make practice recommendations. Since the desire of most women experiencing IPV was to live in peace with their husbands, interventions should respect women's priorities by focusing more on prevention and interventions to end the violence, rather than solely assisting women to leave violent relationships.
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    The victim-witness experience in the Special Court for Sierra Leone.
    (A B Academic Publishers, 2009) Horn, Rebecca; Charters, Simon; Vahidy, Saleem
    This paper reports the findings of an interview study of 144 victim-witnesses who testified in the Special Court for Sierra Leone (SCSL). Witnesses expressed satisfaction with the preparation they received for testifying from their lawyers, particularly appreciating emotional support, as well as practical preparations. Victim-witnesses generally evaluated their interactions with all court staff positively, and reported feeling well-treated by the Court. The experience of cross-examination was difficult for a large proportion of witnesses in the current study, but an even larger group of witnesses reported the experience to be positive. For some witnesses, the experience of successfully coping with the challenge of cross-examination may be empowering. The feelings reportedly experienced by witnesses during their testimony are similarly mixed: a large proportion reported painful feelings, but others reported feeling confident, relieved and happy when they testified. The importance of continued post-testimony contact with witnesses is supported by the current study; witnesses expressed a strong desire for ongoing contact with the SCSL. According to witnesses' own evaluations, their security was not negatively affected by their involvement with the court. This indicates that the SCSL has been largely successful in its attempt to protect the identities of those who testify in its trials.