Integrating Mental Health into Community-Based Health Services: Motivational Strategies for Eradicating Kush Use Amongst Sierra Leonean Youth.

Background: Kush use, a synthetic cannabis variant, has emerged as a public health crisis in Sierra Leone, particularly among youth. Its widespread availability, affordability, and harmful composition have led to rising rates of mental health disorders, addiction, and socio-economic instability. Despite the urgency, limited psychiatric infrastructure, stigma, and lack of trained professionals hinder effective interventions. Integrating mental health services into community-based health systems, supported by motivational strategies, offers a promising pathway for addressing this crisis. Methodology: A mixed-methods design was employed, combining quantitative surveys (n = 300; 200 youth and 100 community health stakeholders) with qualitative interviews and focus group discussions. Quantitative data were analyzed using descriptive statistics, chi-square tests, and logistic regression, while qualitative data underwent thematic analysis. Ethical approval and informed consent were obtained, and confidentiality was ensured. Results: Findings revealed that 68% of youth had ever used Kush, with 42% reporting current use. Unemployment was the strongest predictor of use (OR = 2.65, p = 0.001), while males were nearly twice as likely as females to consume Kush (OR = 1.87, p = 0.021). Younger participants (20–24 years) reported higher prevalence. Community stakeholders strongly endorsed integrating mental health into primary healthcare, with 77% highlighting the effectiveness of motivational counseling and peer-support groups. Major barriers included stigma, limited funding, and shortage of trained personnel. Conclusion: Kush use in Sierra Leone is driven by socio-economic disadvantage, unemployment, and gender dynamics, posing severe risks to youth health and well-being. Integrating mental health services into community-based systems, coupled with motivational strategies and stigma-reduction initiatives, can provide a sustainable and culturally relevant framework for reducing substance abuse. This approach holds promise for strengthening youth resilience, promoting recovery, and advancing public health in low-resource settings.