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Whilst commending the Government and Parliament for the passage of the Mental Health bill and establishing the Mental Health Authority, there is now the urgent need for Government to also devote an adequate portion of the budget for the implementation of the bill to help address the myriad of challenges confronting mental health in Ghana. Corporate institutions and other stakeholders must also compliment government’s efforts at tackling the issue by contributing to the Mental Health Authority Fund.

The World Health Organization Assessment Instrument for Mental Health Systems (WHO- AIMS) which used to collect information on mental health in Ghana revealed that whilst government budgets significant amount of money to physical health, only a small amount is devoted to the mental health sector and that affects the quality of health delivery. WHO-AIMS also revealed that even the little money released for the Mental Hospitals covers overhead costs, including basic medical supplies and service maintenance.

It is the expectation of Ghanaians that after the passage of the mental health bill,  the government would commit  more funds and resources for mental health care, train more mental health personnel including psychotherapists’ and counsellors, and give incentives (salaries, insurance, and benefits) for people to motivate them work in mental healthcare. The government is also expected to provide newer generation medicines, overhaul and decentralize the hospital-based system to make mental health more community based, create an anti-stigma regime, and advocate towards the prevention of human rights abuses of the mentally ill patients.

Mental Health

It is perhaps not so easy to define Mental Health. For one, there is a wide spectrum of mental disorders that have to be considered. Two, the link to societal well-being has to be acknowledged since being out of sync with one's entourage is generally miserable and stressful. Taking those factors into consideration, the World Health Organization (WHO) relates mental health to the "promotion of well-being, the prevention of mental disorders, and the treatment and rehabilitation of people affected by mental disorders." And in 2005, the WHO endorsed mental health as a universal human right. 

A universal human right it may be, yet millions around the world are still deprived of it, especially those who reside in the developing world. Many African countries in particular, are guilty of discriminating, marginalizing and violating the rights of their people who suffer from mental disorders.

The Ghana Situation

In October 2014, Human Rights Watch released a damning report which documented the inhumane treatment of Ghanaians suffering from mental illnesses. In a country where an estimated three million people live with mental disabilities, the report describes the overcrowding and unsanitary conditions of three public psychiatric hospitals. The report also sheds light on so-called spiritual healing centres presided by independent faith healers. Nearly all patients in the eight centres inspected were chained to trees by their ankles and left to sleep, urinate, defecate and bathe on that same spot. Some of the patients had been chained for five months, and some of the patients were less than 10 years old.

Making a presentation at a dissemination forum organized by the Basic Needs Ghana on key provisions in the Mental Health Law (Act 846) in Bolgatanga in March last year, Dr Akwasi Osei, the Acting Chief Executive Officer (CEO) of the Mental Health Authority said the situation was even worse in the Northern, Upper East and Upper West Regions and indicated that these three regions had only one Psychiatry doctor stationed in Tamale.

He said the major health facilities for serious treatment of mental health related cases were centred in Kumasi and Accra making it difficult for psychiatric patients to access their services.

He mentioned that the Brong Ahafo and Volta Regions each had only one Psychiatrist, Central Region three, whilst Eastern and Western Regions had no such experts, stressing “the same thing goes with psychiatry nurses throughout the regions in the country”.

According to the Acting CEO the deficit in the treatment of mental ill persons in the country was 98 per cent and called for a holistic approach by government and other stakeholders to tackle the problem.

He indicated that a recent study showed that Ghana had 41 per cent prevalence of psychological distress in various degrees – meaning as many as 47 in every 100 admitted were under negative stress which affected them mentally – and that 19 per cent of those with negative stress had moderate to severe symptoms implying that their problem was serious enough to be considered a mental illness.

Dr Osei states that Ghana has 12,700 psychiatric nurses instead of 30,000 and four clinical psychologists instead of a 100. “The field of mental health in Ghana is vast and the workers are few,” he said.

Also, at a media engagement forum to mark the 2014 World Mental Health Day organized by Basic Needs Ghana in Bolgatanga, it was made known that Mental Health Patients cannot get access to the Psychotropic medicine often administered to them at health facilities.

The engagement meeting which had its theme” The Role of the Media in Promoting Mental Health and Development in the Upper East Region” also revealed that apart from the shortage of the medication for the patients all the District Health facilities including the Regional Health Directorate had no designated wards for patients suffering from mental illness.

The Regional Coordinator of Mental Health, Mr Philip Aboagye, who disclosed this at the engagement forum stressed that if Government failed to pay serious attention to the problem of mental illness particularly in relation to the shortage it could worsen the situation.

Giving the statistics of the mental situation in the Region , Mr Aboagye,   said between  January  to June 2014   the region recorded 6,760  reported cases of mental illnesses and  gave some  of  the break down  as below psychosis,  1971 cases, epilepsy 2988 cases,   depression , 240, anxiety 263 and substance abuse 281.

He stated that as it stands now the staff- client ratio is 1:165 and disclosed further that the Region had only 27 mental health officers and 14 community Psychiatrists Nurses all distributed to the 13 Districts in the Region.

Stakeholders’ Contributions

Viewing the magnitude and myriad challenges confronting mental health in Ghana, some non –governmental organizations (NGOs) are contributing to the health of people suffering from mental illness. Notable among the NGOs is Basic Needs Ghana. Since its establishment in 2002 with support from the European Union, DFID, Big Lotteries and STAR- Ghana among others, the organisation has reached more than 18,838 people with mental illness or epilepsy from over 18,700 families, together with more than 18,335 care-givers in Northern, Upper East and Upper West, Central, Brong Ahafo, Greater Accra and Ashanti Regions.

Currently, the organization is working actively with more than  17,603 people with mental illness or epilepsy, all of whom are receiving regular treatment, while more than  4,681 of them had been  stabilized , trained or being  trained in vocational skills and empowered to venture into small businesses, horticultural activities and other several different income generating activities to cater for themselves.

Mr Peter Yaro, the Executive Director of Basic Needs Ghana, who is so passionate about mental health, told this writer there was the urgent need for government to give equal attention to the mental health sector just like it does with physical health.

Another advocate who has devoted himself to supporting mental patients in Tamale is Dr Abduallai.   Apart from using his health facility to provide medical support patients, he feeds them on daily bases with lunch including some of their medical needs. Everybody in Tamale can testify to this, as everyday he organizes his staff to go around the Tamale Metropolis with his vehicle loaded with lunch for them.

What should be borne in mind is that there are still huge numbers of mental patients who need support and care. Some just need a little support and care to enable them to be restored to normal life.  There is the urgent need for Government to release adequate funding for   the Mental Health Authority and the Mental Health Unit of Ghana Health Service to help put up the necessary infrastructure in place and the training of more manpower in the mental health sector to help address the problem.

Way Forward

It is on record that from 2011 until date there has been insufficient funding from Government for mental health services in Ghana. There is the need for government to increase its budget in that sector. Per the Mental Health Act, Municipal and District Assemblies are expected to contribute to addressing the challenges of mental health in their respective jurisdictions.

As proposed by the World Health Organization Assessment Instrument for Mental Health Systems tool and other Stakeholders including CSOs, there is the urgent need for Government to listen to the good people of Ghana by voting adequate funding and resources to the mental health sector to help address their plight. The various Metropolitan, Municipal Assemblies in budgeting their medium and long term planning should devote part of their budget to help address mental issues.

Indeed, it is obligatory on the government and all stakeholders, particularly Corporate Institutions to join the crusade in supporting the fight against mental illness. Corporate institutions and other major stakeholders must be seen contributing to the Mental Health Authority fund to provide support to mental patients.