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).

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