How play therapy supports children’s mental health in Sierra Leone

Play can be a doorway to recovery

In some Sierra Leonean communities, particularly in rural areas where families work as farmers, play is often undervalued and discouraged. Prioritizing food and daily livelihoods, many view play as a non-essential activity that does not contribute to family or community.

“My family used to stop me from playing with my son,” says Adama Williams. “They see playing as something foolish.”

Adama and her 1-year-old son, Morrison Williams, arrived at the MSF Mother and Child Hospital in Kenema in August, after Morrison suffered a high fever. He was later diagnosed with malaria, which made him too weak to walk. Play sessions inside the hospital played a key role in her son’s recovery, as it was through these activities that he began using a baby walker and gradually regained his ability to walk.

“After joining the group play session three times, he started to walk again,” says Adama.

At the MSF Mother and Child Hospital in Kenema, MSF teams provide essential care to pregnant women, lactating mothers, and children under 5, with play therapy as a part of our comprehensive health care approach. Through the mental health and psychosocial support unit, known as the "nepo center" [nepo means comfort in the local Mende language], play supports children’s emotional expression, builds social skills, and addresses developmental delays.

Play also deepens the bond between children and caregivers by enabling positive interactions. Through activities like group play or ball games, children freely express emotions and develop social skills, while caregivers learn to respond to their needs. Bonding with a caregiver creates a secure attachment, providing children with a foundation of safety and emotional support. This fosters confidence, enabling children to explore their environment, manage stress, and cope with frustration effectively.

“At the hospital, play therapy starts with ward screenings and physical exams by the MSF team,” says Kemoh. “We assess children for developmental delays, like crawling, walking, or cognitive development and bonding with the caregivers, based on their age. We then tailor play sessions to meet their specific needs.”

When Isata Sheriff brought her daughter, 2-year-old Maella Conteh, to the hospital, she was severely ill and uninterested in playing or interacting. After joining play sessions, Maella began playing with balls and a toy car. 

“She was uninterested before, but now she’s happy, and that makes me happy too,” Isata says.

Family support ensures continued skill-building at home

Five times a week, the mental health team conducts group play sessions within the hospital, focusing on psychosocial need assessment and skill-building. These sessions create a supportive environment to educate caregivers and parents about the value of play, teaching them how to engage with their children and create simple toys to continue playing at home.

“Children here love rattles,” says Kemoh. “Most parents or caregivers cannot afford toys, so we teach them to create rattles using rice and empty plastic bottles, enabling them to continue playing at home.”

Since 2022 to July 2025, MSF teams have facilitated 1,937 group play sessions, engaging 23,665 participants and screening 4,985 patients in the intensive therapeutic feeding center. These initiatives provide vital opportunities to support the mental well-being of children in circumstances like Morrison and Maella’s.