There is increasing global evidence that mental health is strongly determined by social, economic and environmental factors, and that strategic action in these areas has considerable potential for improving mental health and preventing and alleviating mental disorders. Prevention and promotion activities in mental health must address the needs prioritised by local actors. The aim of this study was to identify stressors with the potential to influence emotional wellbeing and distress within the general population of Sierra Leone, in order to contribute to an inter-sectoral public mental health approach to improving mental health within the country. Respondents were a convenience sample of 153 respondents (60 women, 93 men) from five districts of Sierra Leone. Using freelisting methodology, respondents were asked to respond to the open question ‘What kind of problems do women/men have in your community?’. Data analysis involved consolidation of elicited problems into a single list. These were then organised thematically using an adaptation of the socio-ecological model, facilitating exploration of the interactions between problems at individual, family, community and societal levels Overall, respondents located problems predominantly at community and societal levels. Although few respondents identified individual-level issues, they frequently described how problems at other levels contributed to physical health difficulties and emotional distress. Women identified significantly more problems at the family level than men, particularly related to relationships with an intimate partner. Men identified significantly more problems at the societal level than women, primarily related to lack of infrastructure. Men and women were equally focused on problems related to poverty and lack of income generating opportunities. Poverty and inability to earn an income underpinned many of the problems described at individual, family and community level. Actions to address livelihoods, together with improving infrastructure and addressing gender norms which are harmful to both men and women, are likely key to improving the wellbeing of the Sierra Leone population.

中文翻译：

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导致塞拉利昂情绪困扰的因素：社会生态分析

越来越多的全球证据表明，社会、经济和环境因素在很大程度上决定了精神卫生，这些领域的战略行动在改善精神卫生和预防和减轻精神障碍方面具有相当大的潜力。精神卫生方面的预防和促进活动必须满足当地行动者优先考虑的需求。本研究的目的是确定可能影响塞拉利昂普通人群情绪健康和痛苦的压力源，以促进跨部门公共心理健康方法，以改善该国的心理健康。受访者是来自塞拉利昂五个地区的 153 名受访者（60 名女性，93 名男性）的便利样本。使用免费列表方法，受访者被要求回答开放式问题“您所在社区的女性/男性有哪些问题？”。数据分析涉及将引发的问题合并到一个列表中。然后使用社会生态模型的改编按主题组织这些问题，促进探索个人、家庭、社区和社会层面问题之间的相互作用。总体而言，受访者主要将问题定位在社区和社会层面。尽管很少有受访者指出个人层面的问题，但他们经常描述其他层面的问题如何导致身体健康困难和情绪困扰。女性在家庭层面发现的问题明显多于男性，尤其是与亲密伴侣的关系。男性在社会层面发现的问题明显多于女性，主要与缺乏基础设施有关。男性和女性同样关注与贫困和缺乏创收机会有关的问题。贫困和无法赚取收入是个人、家庭和社区层面所描述的许多问题的基础。解决生计问题的行动，连同改善基础设施和解决对男性和女性都有害的性别规范问题，可能是改善塞拉利昂人民福祉的关键。家庭和社区层面。解决生计问题的行动，连同改善基础设施和解决对男性和女性都有害的性别规范问题，可能是改善塞拉利昂人民福祉的关键。家庭和社区层面。解决生计问题的行动，连同改善基础设施和解决对男性和女性都有害的性别规范问题，可能是改善塞拉利昂人民福祉的关键。