Winner: Gbatundu Ndeyia Kutubu

School: Sierra Leone Grammar School

Mental Health according to the World Health Organization is: “A state of well-being in which the individual realizes his or her own abilities, can cope with normal stresses of life, can work productively and fruitfully, and is able to make contributions to his or her community”. Today, there are different kinds of mental health problems but the most common and dangerous occurs as a result of substance abuse which is also known as drug abuse.

Substance and drug abuse on the other hand is described as a specific use of a substance (drug) in which the user consumes the substance in a given amount or other harmful methods which is hazardous to themselves or others. The excessive or addictive use of these drugs for non medical purposes usually defines a state; emotional and sometimes physical, characterized by a compulsion to take them on constant bases in order to experience their mental effect. The effect of drug abuse on an individual forms the bases for its cumulative effect on the society and this is the major danger of drug abuse.

A wide range of drugs are susceptible to abuse by youths, these drugs ranges from most common and less expensive such as cigarette to expensive and more deadly ones like cocaine and heroin. The abuse of these substance leads to criminal penalty in addition to possible physical social and psychological harm. There are many cases in which criminal or anti-social behavior occurs when the person is under the influence of a drug. Long term personality changes in individuals may occur as well. Substance or drug abuse is prevalent with an estimated one hundred and twenty Million users of hard drugs such as Cocaine, heroin and other synthetic drugs. Young Sierra Leoneans especially pupils and students develop certain habit, for the sake of acceptance in a group. Some of these dangerous habits such as smoking, alcohol drinking and drug taking are resorted to for the sake of helping them to cope with the problems, fears and pressured of everyday life. Some use this as a means of escape from the realities of life; realities which they do not want to face tackle.

There are various kinds of drugs which are usually abused by young people (mainly Students) in Sierra Leone. They include Cigarettes, Alcohol, Marijuana and Cocaine.

Cigarettes for instance are drugs easily available to youths. They are quite addictive and can cause lasting effects on young people. They are consumed by smoking and could therefore be related to Marijuana which is also very widely consumed. Smoking of these drugs provides a source of pleasure and at the same time posed as menace to health. Most adolescents and students in Sierra Leone smoke because it makes them feel like adults by imitating adult activities or even keeping them “awake”. The various activities connected to smoking provide a way to get over nervous tensions. A heavy smoker craves for tobacco and an addictive habit is often stronger than will and knowledge combined. No evil habit has to enslave the students of this nation as that of using tobacco and marijuana. I sometimes wonder about the universal acceptance and indulgence of tobacco when its effects are only harmful.

Alcohol is another substance which when abused destroys the mental health of students and poses a great challenge towards enhancing a productive future for all. Contrary to the general belief that alcohol is stimulant, it is a drug which is habit-forming. It produces a harmful effect on the behavior of students. Due to social or peer pressure and public tolerance, alcoholism is widespread. The wide range of hazards on the brain hinders the effectiveness of

learning for students and pupils seeking education. Alcohol impedes self control, impairs judgment and affects conscious actions. Drunkenness does not only lead to loss of intelligence but can also lead to death, thereby terminating the very existence and possible future of youths, who happens to be one of the most vulnerable groups to alcoholism.

When young people indulged themselves in the intake of alcohol, they act as criminals doing wicked deeds. Many youths are led into sin while under the influence of alcohol. Those who wish to have full control over their behavior should surely abstain from the use of all intoxicating beverages. Even Solomon, the wise king of old condemned alcoholism. There is also a high rate of suicide in alcoholic and other drug abusers. This is very common among adolescents, with one in four suicide in adolescent being related to alcohol abuse. For instance, approximately thirty percent (30%) of suicide cases in the United States of America are related to alcohol abuse.

Our social skills are significantly impaired by alcoholism due to the neurotoxin effects of alcohol on the brain. It has been suggested that social skills training adjunctive to impatient treatment of alcohol dependence is probably efficacious. The initiation of drug and alcohol use from 2010 “Monitoring the future survey”, a nationwide study on rates of substance use in the United States, shows that forty-eight percent (48%) of 12th graders report having used an illicit drug at some point in their lives. In the thirtieth day prior to the survey, 41% of 12th graders had consumed alcohol and 19.2% of 12th graders had smoked tobacco cigarette.

The World Health Organization estimated that around 140 Million people were alcohol dependants and another 400 Million suffered alcohol related problems. Do all think this statistics describe a better future for students today? Students and those in adolescent as a whole occupy a delicate and sensitive position within the political structure for several reasons. Research have proven that drug barons prefer recruiting their traffickers from the age of fifteen (15) to thirty-five (35)years, most of whom are either unskilled, unschooled or students and even the unemployed. So in reiterating the question, what is the fate of the young generation and what is the assurance of a brighter future for them when such menaces plague our society.

Generally, peer pressure, child abuse, emotional stress, weak parental control, imitation, truancy among young students, the easy accessibility and availability of drugs and the ineffectiveness of the laws on drug trafficking are the factors influencing the abuse of drugs among youths especially students.

It is becoming unhidden and undisputable that illicit drug usage is rapidly becoming a part of students’ lives and for a large number of students it starts in secondary schools. All these we must not forget, affect our mental wellbeing which shapes our personalities and future. Young people and adolescence also end up as drug addicts in their search for fun, joy and a diversion from the real challenges of life.

A piece of advice to all Students:

There should first of all be the strong determination and firm resolve to overcome this evil habit. Drug abuse should be discouraged by the older generation. This plague could be tackled by a proper family upbringing, parental care, guidance and love, parent-teacher co-ordination, awareness raising against the use of drugs through the use of mass media and sustained efforts of religious organizations.

Students should not allow themselves to be overwhelmed by the excessive demands made on them by older folks and society which is also another factor for resorting to the use of drugs.

They should be watchful against the rampant encroachment of western civilization with its attractions and the breakdown of the hold of traditional ways of life and societies which has made drug abuse a custom for most students.

The choice of friends is of utmost importance as “birds of a feather flock together”. By all means, if success is to crown the efforts in keeping students and pupils away from tobacco, the parents, should set the right example.

In conclusion, the dangers of drug abuse should be reiterated to youths and students involved in it.

If substance abuse and mental health is curtailed, then, education could be achieved to the highest peak probably re-establishing Sierra Leone as the “Athens of West Africa”. This will ensure the brightest and most productive future for students and the young generation.

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Mental Health and Older adults was designated as the primary focus of the recently commemorated 21st World Mental Health Day on 10 October 2013 by the World Federation for Mental Health. In Sierra Leone the day was utilised to raise public awareness on mental health issues including mental disorders and the need to invest in the prevention, promotion and treatment services for mental health in general and specifically for older adults as a vulnerable social group.

Globally, the population of older adults aged 60 and above is more than 800 million and this figure has been projected to increase to over two billion in 2050. In Sub-Saharan Africa, the proportion of this age group has increased from 4.7% in 2005 and has been projected to increase to 5.5% in 2030 (Research document on ageing in Africa – Velkoff et al ).In Sierra Leone, the proportion of this age group  was 3.6% of our National Population in 2012 and it has been projected to increase to 7.5 %  in 2050 (Global Age Watch Report card  for Sierra Leone , 2013). It is significant to note that the actual number of people in this age-group in our population is increasing ( 2% Growth rate ) even though the  above proportion is small ( 2004 National Population and Housing Census report).

Older adults as a vulnerable social group are faced with special health challenges including losing their ability to live independently because of limited mobility, frailty or other physical or mental health problems and some may even require long-term care. They suffer more commonly from depression, suicide, dementia, alcohol and substance abuse, misuse of medications and anxiety disorders. At least 20% of these conditions are unrelated to normal ageing process as has been misconstrued by lay people.

Barriers  in our  setting such as  stigma, ageism with myths and misconceptions, limited training of primary care physicians in the care and management of geriatric patients, gaps in service delivery, service disintegration in diverse ways have  ideally contributed to the limited / non- availability of  mental health services  for  our older adults

Mental Health has been recognized has a serious health issue in Sierra Leone based on prevalence rates ( 13% of adult population)  data from the World Mental Health Survey (2004) in which it was indicated that  at least 420,000 people in this country have had a mental disorder in the past 12 months. The country summary report  estimates that  only 0.5% of these people have access to treatment and Severe depression ( 4%),psychosis (2 %), Severe Substance abuse (4 %), Epilepsy (1 %) and Mental Retardation( 1%) were the commonest reported mental disorders.  Severe depression in the older adult is difficult to diagnose  and its commonest complication of suicide is responsible for a significant number of deaths every year.

The Revised National Mental Health Strategic Action Plan 2014-2018 now provides a positive perspective  on action for older adults and other vulnerable groups in our society including age specific services, mobile programs, effective treatment for depression , training sessions of staff an d advocacy packages for policy makers/ politicians on the unique needs of older adults in our society.

Therefore, the National Mental Health Program of the Ministry of Health and Sanitation in collaboration with WHO , Mental Health Coalition and other development partners solicit your  fullest support in the implementation of our revised Action Plan for Mental Health 2014-2018.

Submitted: Dr Andrew Muana, MD                                   Medical Superintendent, SL Psychiatric Hospital                   Head of NCD/Mental Health Focal Person,(Ministry of Health and Sanitation).