Client characteristics at Kissy Mental Hospital, Freetown, Sierra Leone

In- and out-patient data from the only Western mental health institution in Sierra Leone, Kissy Mental Hospital in Freetown , were analyzed using basic epidemiological techniques. Although it could not be proved conclusively with the available data, the educational and occupational levels of the patients appear to be far above that of the general population. Very possibly females are also underserved by the hospital. Contrasts between the two patient populations show that in-patients were more seriously ill, older, more likely to be male, more likely to be single, less educated, less likely to have social support, more likely to express Western ideas about the causes of mental illness and have more previous Western treatment, than out-patients. The literature on mental illness suggested the examination of possible associations among diagnosis, illness beliefs and types of previous treatment as response variables and several patient characteristics as explanatory variables. Out-patients who were older and those with lower status occupations had more severe illnesses. Married in-patients and out-patients with higher educational and occupational status had more Western as opposed to native beliefs about the cause of mental illness than their counterparts. More previous Western rather than native treatment was reported by in-patients who were older, from certain tribes, or had Western beliefs and by younger out-patients. Points of agreement and disagreement of study results with findings from Africa and the United States are discussed.