The World Health Organization (WHO) highlights that “mental, neurological and substance use disorders account for more than 10% of the global disease burden.” Furthermore, the “lost productivity resulting from depression and anxiety, two of the most common mental disorders, cost the global economy $1 trillion per year.” Concerningly, in developing nations, more than three-quarters of people suffering from mental conditions do not receive adequate care or treatment. In response, the Ghanaian government has taken steps to improve mental health and mental health care in Ghana. However, in 2022, WHO reported that just “2% of Ghana’s 2.3 million people living with mental health conditions [received] psychiatric treatment and support from health facilities.”

Mental Health Care in Ghana

According to the WHO Mental Health Atlas 2020, Ghana allocates approximately 3% of the government’s total health expenditure on mental health care, with 67.8% of this amount going toward funding the services provided in mental health hospitals across the country.

Ghanaians with mental conditions contribute about 20% toward the cost of the mental health services they use, and similarly, about 20% toward the cost of associated medicines.

Although Ghana had been in the developmental stages of the mental health care sector, from 2014 until 2020, the number of mental health care workers per 100,000 population rose by about 2%. According to the 2020 Atlas, Ghana has 39 psychiatrists, 26 psychologists and 2,463 mental health nurses.

Furthermore, Ghana has three official mental hospitals while 250 hospitals across the country have outpatient mental health facilities. Ghana also has 1,016 community-based mental health outpatient facilities, which makes mental health care more accessible.

The major mental health problems in Ghana are schizophrenia, mood disorders and substance abuse. People with mental disorders in Ghana are often ostracized and treated inhumanely, for example, through restrictive measures such as shackling.

Addressing the Inhumane Treatment of Mentally Illness

Human Rights Watch reported at the end of 2022 several eyewitness accounts of shackled people suffering from mental health conditions. In January 2023, at the Human Rights Council’s Universal Periodic Review of Ghana, U.N. Member States called on the government of Ghana to urgently “address the shackling and inhumane treatment of people with mental health conditions in Ghana.”

Several media outlets have reported on the shackling of mentally ill people in Ghana. Human Rights Watch reported, “Families often take people with mental health conditions to faith-based or traditional healers because of widely held beliefs that psychosocial disabilities are caused by curses or evil spirits.” People who are shackled face further issues such as post-traumatic stress disorder and muscular atrophy. Furthermore, in these faith-based centers and camps, shackled mentally ill people are confined to small and unhygienic spaces, deprived of basic human needs.

Understanding the Problem

Mental health nurse and founder of the Ghanaian NGO called the Mental Health Advocacy Foundation, Stephen Asante, has a different view. He explains that the use of shackles is not a matter of “abandonment or abuse,” but rather, of poverty and under-resourced health care systems. Families and other caregivers resort to chaining due to a lack of access to medication and adequate mental health care treatment. Asante notes that by addressing underfunding and the lack of mental health care resources in Ghana, the issue of shackling will dissolve.

Due to the cultural stigma surrounding mental health in Ghana, people suffering from mental health conditions object to and fear seeking help. Therefore, many Ghanaians remain suffering in silence. Changes in attitudes toward mental health will require community-wide interventions and campaigns.

Ghana’s mental health budget stands at about 1.4% of its total health care expenditure, according to WHO. This is low in comparison to the 11% that the U.K. committed to mental health care in 2015.

Moving Forward

The Mental Health Society of Ghana (MEHSOG) is a grassroots membership association that aims to improve access to quality and affordable mental health care across Ghana. This association is managing to aid 18,000 people suffering from mental illnesses and their caregivers, across Ghana. MEHSOG also aims to advance mental health in Ghana by influencing decision-makers to implement policies that uphold the rights of people with illnesses and the people who care for them.

In February 2021, MEHSOG partnered with the Ghana Federation of Traditional Medicine Practitioners Associations (GHAFTRAM) to hold three training sessions to train 10 owners and managers of traditional prayer camps and healing centers in Ghana on the rights to bear in mind when treating people with mental health conditions. Michael Osei-Koranteng, the main investigator at the Commission for Human Rights and Administrative Justice (CHRAJ) facilitated these training sessions using his expertise in human rights. Osei-Koranteng highlighted that these facilities must never utilize torture, abuse or any other violations of human rights when dealing with people who have mental conditions.

With greater funding and commitments to upholding the human rights of mentally ill individuals, mental health in Ghana has the potential to significantly improve.

– Louise Kiernan
Photo: Flickr