About insomnia
Chronic insomnia means difficulty falling or staying asleep several nights a week for months. Cognitive-behavioural therapy for insomnia (CBT-I) is the recommended first treatment and works on habits, schedules and the thoughts that keep sleeplessness going.
Psychiatrists are medical doctors specialised in mental health. They diagnose, prescribe and monitor medication and may also provide psychotherapy. They are usually the first choice when medication may be needed or symptoms are severe.
Getting mental health care in Sierra Leone
Public health system · Ministry of Health, Sierra Leone Psychiatric Teaching Hospital (Kissy)
Public mental health care is very limited: the Sierra Leone Psychiatric Teaching Hospital in Kissy, Freetown, is the only dedicated psychiatric hospital, and WHO has reported only a handful of psychiatrists and clinical psychologists for the whole country, supported by mental health nurses. Mental health law is still based on the 1902 Lunacy Act, with a replacement bill in preparation.
Urgent help in Sierra Leone
If your life or someone else's is in danger, call the emergency number now. These services can help at any time:
- 117 · Emergency services (police, ambulance, fire)
Information reviewed in November 2026 · Sources: afro.who.int, pih.org
Signs to look out for
Everyone sleeps badly sometimes, especially during stress. Insomnia may need attention when you regularly struggle to fall asleep, wake up often or very early and cannot get back to sleep, or wake unrefreshed, for several weeks, and it affects your mood, concentration, energy or safety during the day. Worrying about sleep itself often becomes part of the problem.
What helps: treatments and professionals
Cognitive-behavioural therapy for insomnia (CBT-I) is recommended as a first-line treatment for chronic insomnia. It includes sleep scheduling, stimulus control, work on unhelpful beliefs about sleep and relaxation techniques. Psychologists and clinical psychologists trained in CBT-I usually provide it, individually, in groups or through guided digital programmes. A doctor should rule out physical causes and other sleep disorders.
When to seek urgent help
Seek prompt medical attention if you stop breathing or gasp during sleep, fall asleep while driving or in dangerous situations, or go several nights with almost no sleep alongside unusual energy, racing thoughts or confusion. If lack of sleep comes with hopelessness or thoughts of harming yourself, contact your local emergency services or go to the nearest emergency department.
What you can do in the meantime
Keep a regular wake-up time every day, including weekends, and only go to bed when you feel sleepy. If you cannot sleep after a while, get up and do something calm in dim light until you feel drowsy. Limit caffeine after midday, alcohol and heavy meals at night. Reduce screens before bed and get daylight and movement during the day.
What does a psychiatrist do?
A psychiatrist is a medical doctor who assesses mental health problems from a medical point of view. Day to day they carry out diagnostic interviews, rule out physical causes, decide whether medication could help, prescribe it and monitor its effects and side effects. Many also offer psychotherapy or work alongside psychologists. They see adults, older people and, if specialised, children and adolescents.
When to see a psychiatrist
Consider a psychiatrist when symptoms are intense or long-lasting, when therapy alone has not been enough, when you are already taking psychiatric medication, or when there are experiences such as severe mood swings, hearing or seeing things others do not, or very disturbed sleep. If what you mainly need is talking therapy for everyday difficulties, a psychologist or psychotherapist may fit better.
How to choose
When choosing, check the licence and training, the approach they use and whether they have experience with what you need. Consider practical aspects too: language, price, location or online sessions and availability. The relationship with the professional matters a great deal; if after a few sessions it does not feel right, it is fine to change.
Frequently asked questions
Does the public health system in Sierra Leone cover psychological care?
Public mental health care is very limited: the Sierra Leone Psychiatric Teaching Hospital in Kissy, Freetown, is the only dedicated psychiatric hospital, and WHO has reported only a handful of psychiatrists and clinical psychologists for the whole country, supported by mental health nurses. Mental health law is still based on the 1902 Lunacy Act, with a replacement bill in preparation.