Though mental illnesses do have a low morbidity, mentally ill people experience many years living with pain, stigma, lifestyle changes, complicated therapeutic regimes, the long-term threat of decline, and shortened life expectancy. With a lack of general funding for healthcare, more money is given to high fatality, international attention-grabbing physical diseases like malaria, AIDS, TB, cancer, etc. Now, after the advocacy from doctors and NGOs bombarded the media, the Ministry of Health is finally being forced to change their stance on mental health care. The Parliament is currently conducting consultations and is reviewing the bill to guarantee that fragmentation of the mental system is what is best for Ghana. Mind Freedom and Dr. Osei hope that the bill will be passed by June 2011, and if it is not, then Dr. Osei flippantly said he will personally march all of his patients at the Accra Psychiatric Hospital down to the Parliament building to fight for their rights. Dr. Osei hopes that the long struggling advocacy for mental health improvement will not lose steam and keep pushing until the bill is passed and even after to ensure the implementation of the law. Immediately after the bill is passed, he advises that a mental health board needs to be established with the purpose of overseeing the implementation of the bills requirements and the training of judiciaries, policemen, mental health personnel, nurses, and traditional faith healers in the law’s policies. He wants Ghana to have state-of-the-art mental health care which delivers care to the doorsteps of every Ghanaian, provides a wide range of medicine, is part of the national health insurance scheme, employs mental health personnel of various categories,marijuana drying rack and is adequately funded and operated by motivated leaders and supported by research and evidence based data.
This could be achieved by having one of the best mental health laws in the world and by removing the emphasis from hospital based care to community care. Similar to Dr. Osei, MindFreedom thinks that Ghana’s mental health system should change from institutional care to community care. The hospitals should be decongested, CPNs should be given transportation to move between communities, newer medication should be used, and mental health workers should be given more incentives and should be covered by insurance. Most importantly, psychiatrists need to more frequently go into the community, human resource needs to increase, and medication needs to be more available. Also, the perception of mental illness needs to be worked on. Stigma makes the situation drastically worse and makes people less likely to seek treatment even when it is important to seek early treatment so the problem does not aggravate. Despite the Accra Psychiatric Hospital’s disturbing conditions and appalling lack of resources, Dr. Osei’s undaunted and resolute passion for mental health is leading the country towards progress. In the beginning of 2011, Dr. Osei launched a repatriation of 600 recovered patients, whose families could be tracked down, to be discharged and returned home. Dr. Osei oversees each case to make sure that each discharged patient is well enough to go home and that they have a family or home to return to. So far the repatriation has been successful in decongesting the hospital, as 200 patients have been discharged by March 2011 and the total of 600 is expected to be achieved by June 2011. If the hospital does reduce its capacity to 600 inpatients by the summer, then it is well on the way to reaching the ultimate downsizing goal of 300 inpatients, what Dr. Osei wants most to happen for his hospital. Upon hearing news of the repatriation, more families are inquiring about the possibility of picking up their once abandoned relatives. Social welfare workers and CPNs are in charge of bringing the patients back home safely. MindFreedom Ghana fully supports Dr. Osei’s repatriation of patients.
They trust that sending patients back into society will help lower the stigma of mental illness by making their families reaccept them and by showing the public that survivors can become productive members of the community. Right now MindFreedom is searching for someone to fund a project that would help teach, empower, and rehabilitate the patients who are being sent home. The repatriation is noted as a sign of improvement in the mental health care system and MindFreedom thinks that the decongestion act should be replicated by the Pantang and Ankaful hospitals. MindFreedom believes that Dr. Osei and Dr. Dzadey have a lot of energy and passion for the mentally ill and are doing the best they can with the resources available. Despite challenges, many achievements have been accomplished by Dr. Dzadey and the Pantang Hospital. In 2007, a revenue-producing Rehabilitation Vegetable Garden opened and is now tended to by patients and national service personnel who have a background in agricultural science. In 2009, a Drug Treatment and Rehabilitation Unit was created and in 2010 it was recognized by the World Federation of Therapeutic Communities. It is totally inappropriate to group addicts with other mentally ill patients, seeing that drug abusers who do not consider themselves mentally ill will steer clear from entering psychiatric hospitals. Because of the initial lack of focused addiction counselling, users would often return to the hospital shortly after they were discharged. Henceforth, this Drug Rehabilitation unit was the first step taken to take care of addictions separate from the mainstream patients in the wards. Addicts pay to reside at the hospital and partake in this structured 6 am–10 pm program at the Drug Rehabilitation Centre, where they receive therapy from a well trained staff for a minimum of six months.
Occupational therapy assistants involved in VSO now help assess the therapeutic needs of the patients, teach bead making, and collaborate with the wards. A nursing assistant even started an initiative for engaging the patients in physical activities and successfully organized a week long inter-wards sports competition a year ago that was well received by both staff and patients. Also, the general supply of new generation anti-psychotics improved and two boreholes were built by the National Security office to help create an independent water supply in 2010. Awareness, stemming from mental health workers and the birth of mental health NGOs, is undeniably increasing. Before the year 2000 there were no NGOs in Ghana that directly focused on issues in mental health, and now there are at least six very active ones. BasicNeeds, MindFreedom, PsychoMental Health Foundation, the Mental Health Society of Ghana, and the Ghana Mental Health Association are the most prominent. Still,vertical grow rack system the number of NGOs for mental health is miniscule compared to the number of NGOs for malaria and AIDS. The media also began getting engaged with the movement towards improvement of mental health when journalists became more radical rather than being obsequious to the government. With the help of NGOs, the media, and certain mental health professionals, the National Development Planning Commission of Ghana finally adopted mental health as a developmental agenda for 2010–2013. MindFreedom, one of the Mental Health NGOs, began in the home of Director Janet Amegatcher in 2004 with Nii Lartey Adico as Co-Director and Dan Taylor as Executive Secretary with the mission to advocate for the rights and dignity of persons with mental disabilities in Ghana. All of the three were so dismayed by the callous popular opinion and the condition of the psychiatric hospitals that they searched for a way to educate and sensitize the Ghanaian public. Originally the NGO was funded by the World Health Organization but is now funded by America’s international Disability Rights Fund. In July of 2008, the company moved into a permanent building in Osu, Accra and is open for counselling during normal working hours. The director is trained in counselling and MindFreedom has both a clinical psychologist and a psychiatrist as board members who are utilized for referrals. The NGO also puts on advocation and awareness events in Accra about twice a year. For three years, MindFreedom has organized annual street marches through popular roads in downtown Accra, the most recent being in 2010 with 700 participants, in order to fight mental health stigma and to bring attention to the Mental Health Bill and the UN Convention on the Rights of Persons with Disabilities. They try to change perception through education by discussing mental health issues on the air, radio, and newspapers and by posting small posters and stickers around the city. The NGO also puts on training workshops for journalists, judges, lawyers, the police, prison service, and other workers who have direct or indirect contact with the mentally ill, to teach them about how to appropriately deal with the mentally ill and to educate them on current policies.
Currently MindFreedom Ghana has 154 members, either mentally ill or survivors of mental illness, most of whom have now luckily stabilized enough toreturn to work. Because of funding and the price of transportation, the members can only meet every three months to discuss their issues and their progress. MindFreedom is now submitting a proposal for a three year reintegration and rehabilitation program to help those discharged from the psychiatric hospitals. The mission of BasicNeeds, a worldwide mental health NGO, is “to initiate programmes in developing countries which actively involve mentally ill people and their carers/families that enable them to satisfy their basic needs and exercise their basic rights. Under the management of Badimak Peter Yaro, BasicNeeds Ghana was established in 2002 with the purpose “to enable people with mental illness and epilepsy to live and work successfully within their community. Over the past nine years, BasicNeeds Ghana has affected the lives of 18,838 sufferers of mental illness or epilepsy, and 17,603 of them are still receiving regular treatment and counselling thanks to the NGO. BasicNeeds has helped create 182 community self-help groups for the mentally ill and their primary carers. The NGO has trained or is currently training 4,681 beneficiaries in some form of vocational training while also hosting several public awareness events a year. In the winter of 2010, a march took place in the Upper East Region of Ghana for the celebration of the World Mental Health Day, a community durbar was held in Accra in order to increase awareness of Self-Help Groups for people with mental illness and epilepsy, and a photo project took place in 12 different districts to visually capture the conditions the mentally ill people live in. Most importantly, BasicNeeds puts on quarterly community outreach clinics in the north of Ghana, specifically in poor communities in the three northern regions where there is no permanent psychiatrist. The most recent clinic, in the last quarter of 2010, reached 155 mentally ill people from five districts in the Upper West Region. BasicNeeds strongly believes in community care and has helped many mentally ill people gain access to professional treatment. Through funding from the European Union’s project “Ensuring Secure Livelihoods for Poor Mentally ill People and their Primary Carers in Ghana, BasicNeeds organized a secure livelihoods module and assists CPNs and self-help groups in the assessment of skills priority and livelihood options of stabilized members who are then subsidized by the specific group they belong to [6]. Common livelihood options and skills priorities users pursue include farming, animal rearing, grain storage and sale, petty trading, food processing, tailoring, hairdressing, weaving, and bicycle repairs. This sustainable project encourages social, human, and economic development, while positively changing the attitude regarding the mentally ill and their carers by showing the society that they can be productive. Over the past two years, BasicNeeds has conducted one to two day workshops on procedural and financial training for self-help groups, epilepsy training for medical practitioners, mental health training for master craftsmen arranged to teach skills to the mentally ill, mental health training for Agric Extension Workers who have contact with mentally ill workers on farms, and policy and human rights training for security officers in the Ghana Armed Forces, Ghana Police Service, Ghana Immigration Service, Ghana Prisons Service, Customs Excise and Preventive Services, Ghana National Fire Service, City Guards Unit of the Tamale Metropolitan Assembly Task Force, and Bilchinsi Task force.