How is mental health connected to history? And what can one hospital teach us about it? In Unchain, a new podcast miniseries from Partners In Health, doctors, patients and historians in Sierra Leone tell the story of Sierra Leone Psychiatric Teaching Hospital—the oldest psychiatric hospital in sub-Saharan Africa—which marked its 200th anniversary this year.
This miniseries dives deep into Sierra Leone’s history—including slavery, colonialism and civil war—to explore how the past holds implications for mental health.
Sierra Leone Psychiatric Teaching Hospital—once an impoverished facility that, due to lack of resources, used chains to keep patients from harming themselves and others—tells a story of both trauma and transformation: how the past never fully leaves, but can inform our present and future.
Below, a selection of archival photos offer a special glimpse into the hospital’s past and present.
Until PIH partnered with the Ministry of Health to improve the facility, the hospital—then known as “Kissy Mental Hospital”—had no running water, electricity or medications. Because of this lack of resources, clinicians once turned to chains as a way to manage patient and staff safety. The facility was known by the derogatory name “Kissy Crazy Yard.”
Jon Lascher / PIH
Partners In Health began its work building and renovating the hospital in December 2017. PIH focused on resupplying the hospital with psychiatric medications and making major infrastructure improvements, including resourcing the facility with running water and electricity.
John Ra / PIH
PIH co-founder and chief strategist Paul Farmer visited the hospital while renovations were underway.
Jon Lascher / PIH
PIH’s infrastructure team led renovations of the hospital’s various buildings and wards, in order to provide comfortable, dignified accommodations to patients and staff.
John Ra / PIH
Today, with PIH support, the hospital—now called Sierra Leone Psychiatric Teaching Hospital—is a clean, welcoming facility with electricity, running water, and medications. Chains are no longer used and have been replaced with soft restraints—which are rarely necessary.
John Ra / PIH
In June 2020, Sierra Leonan President Julius Maada Bio visited the hospital for a ceremony to honor the renovations.
Jon Lascher / PIH
President Bio, Minister of Health Dr. Alpha Wurie (right), and Umaru Sheriff, PIH program officer at SLPTH, unveil a new plaque commemorating the hospital renovations.
Jon Lascher / PIH
Dr. Edward Nahim, who for decades was Sierra Leone’s only psychiatrist, attended an event at the hospital in November 2020, during which the hospital welcomed a new consultant psychiatrist—a promising sign for Sierra Leone’s mental health care field.
Maya Brownstein / PIH
33-year-old Haja Salimatu Bah was diagnosed with psychosis and received inpatient care at the hospital. Since receiving proper medication and care, she has transitioned to outpatient care and recently had a daughter. She is pictured here with 10-month-old Ceray Kamara.
John Ra / PIH
