Understanding recovery from emotional distress in Sierra Leone through Crisp Set Analysis

Live presentation on 11th Nov from 15.42-15.45 GMT
Ms Giulia Loffreda, Dr Kanykey Jailobaeva, Dr Rebecca Horn, Prof Alastair Ager, Mr Abdulai Jawo Bah


This paper looks at the signs of recovery from emotional distress in Sierra Leone. The country encounters serious social, economic, and governance challenges which have been further exacerbated by such crises as Ebola in 2014. The mental health services remain limited and face such challenges as a lack of staff, a shortage of funding, and a weak enabling environment.


Our study explored lay perceptions of the signs of recovery from emotional distress caused by such events as loss of a family member, severe sickness, and loss of a relationship in Sierra Leone. The data used in the paper comes from a larger study on the idioms of distress in Sierra Leone, specifically from 75 case study interviews with women and men. During interviews we asked the participants to describe the signs of distress they have observed in two people known to them, and how these people changed when they began to recover emotionally from their experiences. In our analysis, we used a Qualitative Comparative Analysis, specifically a Crisp Set Analysis (Ragin 2008). This method bridges qualitative and quantitative analysis to study causality in data of binary variables and multiple and conjunctural conditions of an outcome. In our analysis, we used six most frequent signs of recovery reported in the interviews: i) work/study, ii) healthy relationships, iii) faith, iv) hope, v) new family, and vi) personal care.


The exploration of the truth table generated through QCA software showed a striking pattern that two signs of recovery (work/study and healthy relations) were the most prevalent. 98% of 75 cases, where either Work/Study and Health Relationships occurred, these signs were in pattern with either one or several of other four signs. The analysis of sub-set relations in QCA software showed that Work/Study and Health Relations can be considered as necessary conditions for recovery from distress to occur (consistency 0.89, coverage 1.00).


These findings suggest that, to enable recovery from emotional distress, support needs to be broad and bring together services that will enable individuals to improve their social and relational wellbeing. In other words, as the health systems imply, responses to emotional distress needs to involve a wide range of community-based stakeholders who will help individuals to engage in constructive activity and strengthen relations with their family members, friends, and broader community as these two factors seems to be necessary conditions leading to recovery.

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