An estimated 1.25 million Sierra Leoneans were living with a mental health condition in 2023, and 98% of those with severe mental illness received no treatment at all.
That shocking revelation was made in Parliament on Thursday, 12 November 2026, by the Minister of Health, Dr Austin Demby, as he urged lawmakers to urgently pass the Mental Health Bill, 2026.
Citing the Global Burden of Disease study, Dr Demby told MPs that about 15 out of every 100 people in Sierra Leone struggle with a mental health condition. “This is not a small problem. This is a national crisis hiding in our homes, our schools, our streets and our communities,” Demby said.
The Minister painted a stark picture of a health system that is almost completely unequipped to respond.
According to Ministry figures for 2026, Sierra Leone has only four psychiatrists for a population of over 8 million people.
There are only seven doctors training in psychiatry and 35 mental health nurses across the entire country.
Even more alarming, the Mental Health Department receives less than 0.0001 per cent of the national health budget.
“We cannot continue to treat mental health as an afterthought,” Demby said. “Mental health is health.”
He disclosed that the Ministry is now training more specialized nurses and plans to employ additional psychiatric specialists, with more than 150 people currently undergoing training in mental health.
The Mental Health Bill, 2026 seeks to repeal and replace Sierra Leone’s 124-year-old Lunacy Ordinance of 1902 a colonial-era law that still governs mental health in the country.
Dr Demby described the old law as outdated, cruel and no longer reflecting modern standards of mental health treatment, human rights and patient protection.
Under the Lunacy Act, people with mental illness were treated as “lunatics” to be locked away, chained and hidden not as patients to be cared for.
“The Lunacy Act belongs in a museum, not in our statute books,” Demby told Parliament. “We need a law that places compassion, human dignity and access to quality care at the centre.”
The new Bill is designed to establish a more progressive, rights-based system.
1. Establish a National Mental Health Directorate to coordinate mental health services across Sierra Leone, under the oversight of an independent Board.
2. Appoint District Mental Health Coordinators to ensure services reach every district, not just Freetown.
3. Protect Patients’ Rights with stronger safeguards against abuse, unlawful restraint and arbitrary detention.
4. Set Standards for Care Facilities so that no facility can chain, beat or humiliate patients.
5. Provide Frameworks for Voluntary and Involuntary Admissions with clear rules on confidentiality, consent and review.
6. Address Children, Community Care and Justiceincluding how mental health intersects with the criminal justice system, and care for minors.
Kush, War And Trauma – Why The Crisis Is Growing
Dr Demby’s appeal comes amid growing concerns about mental health and substance use disorders, particularly among young people.
Sierra Leone is still living with the deep psychological wounds of the 11-year civil war, the Ebola outbreak, COVID-19, flooding, and now the devastating *Kush* drug epidemic that has destroyed thousands of young lives.
Opposition Minority Whip, Hon. Abdul Karim Kamara, supported the call for greater attention and resources for mental health, saying the issue affects every family.
Other MPs noted that in many communities, people with mental illness are still chained, beaten, taken to traditional healers, or left to roam the streets of Freetown, Bo, Kenema, Makeni and Waterloo.
“We cannot build a healthy Sierra Leone if we ignore the minds of our people,” Demby concluded. “Passing this Bill is not just about law. It is about dignity.”