In Ghana, Persons with Mental Disabilities (PMDs) constitute a vulnerable group. They are often subjected to discrimination, social isolation and exclusion, human rights violations and cultural stigma, which leads to lack of social support and access to health care. For a population of more than 28 million people, there are currently only 16 psychiatrists and 1,558 psychiatric nurses operating in the country (numbers from 2015). The psychiatrist treatment at hospitals is politically under-prioritized and inaccessible to the majority of the more than 2.8 million people who live with mental disability, whereas 650,000 suffer from a severe mental illness. This unbearable situation, tend to compel the majority of PMDs or their relations to resort to the easily accessible, culturally accepted and affordable treatment of traditional or faith-based healing options at the Traditional Mental Health Centers (TMHCs). Others seek treatment from TMHCs in order to avoid being stigmatized by community members or close family relations as well as from service providers in public mental health institutions.
While TMHCs have been accepted by most Ghanaians as an alternative avenue of treatment of mental illness, TMHC’s practices and treatment services are in some situations unregulated. Attempts have been made by some bodies such as the Council for Traditional Medicine Practitioners and the Ghana Federation of Traditional Medicines Practitioners Associations (GHAFTRAM) under the Traditional Medicines and Practice Act, (Act 575) 2000 to certify, regulate and monitor the administration of traditional medicines for health treatment-including mental illness. The Mental Health Authority has also been committed to raising awareness amongst operators on minimum forms of treatment including unshackling of PMDs. Nonetheless, these efforts do not adequately reach operators who use ‘spiritual’ and traditional medicines for treating mental illness-which sometimes are clandestine in nature and fail to adhere to minimum standards of treatment of care.
In view of this, the STAR-Coalition that is, the Human Rights Advocacy Centre (HRAC) together with Mind Freedom Ghana, is implementing a project dubbed “Promoting quality access to mental health care and rights of persons with mental disabilities in traditional mental health centers in Ghana”.
This project seeks to advocate for the improvement of mental health care services and treatment in TMHCs and ensure equitable access to medical care and human rights protection of PMDs. It also aims at addressing systemic issues and constraints that exclude PMD from having equitable access to mental health treatment in Ghana. It further aims to improve the understanding of human rights abuses and conditions of PMDs at TMHCs through information and data collection. This will put the spotlight on institutional and policy lapses in the national response on mental health care.
The Project which began in September, 2017 with an inception meeting with stakeholders from the Health, Human Rights, and Law Enforcement fraternity is expected to last for 30 months
Activities scheduled to address issues of Mental Health as part of the project are as follows;
- Focusing on advocacy and research as a way to ensure the promotion and protection of the human rights of PMDs and secure their access to service delivery. This is done through the generation of evidence for advocacy to improve and regulate treatment for PMDs at TMHCs.
- An operational protocol will be developed jointly by civil society organizations working with PMDs and national stakeholders and used as a framework for institutional response on the treatment of PMDs in TMHC.
- The Star-Coalition will hold meetings with stakeholders, decision-makers and CSOs to initiate dialogues with key stakeholders around the adoption of the protocol.
- Activities also include training workshops for operators of TMHC and community health psychiatric nurses and community outreaches and awareness raising through public media. Together these activities will educate, strengthen and promote the treatment and civic consciousness on mental health as a medical condition and promote a collective action to de-stigmatize responses to PMDs.
The project seeks to employ the different media platforms to create awareness on improved mental health conditions and be watchdogs to ensuring the law on mental health is enforced. The project will also highlight issues of mental health, and as well hold people accountable for their actions. Finally, it will provide the necessary knowledge about institutions that have the mandate to enforce the mental health of PMDs, thereby challenging institutions to be responsive to their mandate.