Social determinants of psychological distress in Sierra Leone

Abstract

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.

Methods A cross-sectional survey was conducted with 904 adults (454 men, 450 women) in 5 districts of Sierra Leone. The survey questionnaire comprised the Sierra Leone Psychological Distress scale and measures of demographic variables and personal characteristics, current life circumstances and potentially distressing events.

Results Multiple regression results identifed three factors to be the greatest contributors to psychological distress: family confict (β=0.185, p<0.001) and inability to aford basic needs (β=0.175, p<0.001). Gender diferences were evident: factors predicting men’s psychological distress included severe sickness or injury (β=0.203, p<0.001) and being unable to aford basic needs (β=0.190, p<0.001); for women, predicting factors were family confict (β=0.212, p<0.001), perceived poor health (β=0.192, p<0.001) and inability to aford basic needs (β=0.190, p<0.001).

Conclusion Initiatives to promote good mental health and psychosocial wellbeing in Sierra Leone should focus on enhancing income-generating and employment opportunities, promoting access to education, and strengthening family relationships.