Article: Fauziatu Adam
IT is widely believed that mental illnesses are caused by supernatural or evil forces that could be best cured by traditional medicine or spiritual prayers. It is common for a patient to be removed from a hospital by a relative and taken to a traditional or spiritual healer.
This psychiatric practice has existed for more than a century in Ghana. In some situations it is not known if the patient’s recovery could be attributed to medication or the intervention of the traditional healer or both.
In the ninetieth century, patients suffering form mental illness in the then Gold Coast were kept in prisons. Before this period, mental patients were left to fend for themselves or sent to traditional healers to be cured.
The colonial government in 1888 under Sir Edward Griffiths passed a legislative instrument (The Lunatic Asylum Ordinance), to establish an asylum in a vacated High Court building in Accra.
It was not until 1904 that the Accra Psychiatric Hospital was built and officially commissioned in 1906, which was to accommodate 200 patients. During that period psychiatric treatment was primarily in the form of custodial care.
The Accra Psychiatric Hospital has undergone major expansion in the past 105 years and currently houses about 1200 inmates; Half of them are cured but still living in the hospital because their relatives have abandoned them, and some others have no home to go to.
There were extensive changes to the hospital buildings, and staff training and recruitment were expanded. Other reforms introduced were the removal of chains from the legs of patients, refraining from punishing patients and discouraging isolation.
Currently, the hospital lacks resources in terms of staff, finances, drugs, among others, making it difficult for the few medical team there to attend to patients promptly.
Accessibility to psychiatric care
With a population of 24 million, and three psychiatric hospitals with 1200 beds, the ratio of one bed to 20,000 persons is glaringly insufficient. There is the uneven accessibilty of mental hospitals in the country since all three mental hospitals are located in the southern part of the country. It is no wonder then that some patients or their relatives would rather seek help from traditional sources, not only because of their cultural or religious beliefs in the cause of psychiatric illness, but because of easy or inexpensive access to traditional healers who live in their community.
When I visited the Accra Psychiatric hospital, Dr Osei took me to three wards. Two special wards -one for male patients and the other one for the female patients and the normal ward for only male patients. Before we went to the wards, the doctor asked me if I could stand what I was about to see.
Sincerely, that question alone got me frightened. We went to the special ward for the male which was also called the forensic ward, there were four staff attending to the needs of 232 male patients. There were two male nurses and two health assistants. The other male ward called the acute ward had 126 patients with only 49 beds and four nurses attending to them at the time of the visit. The largest female ward also had 112 patients taken care of by five nurses.
The food alone could send signals that the patients were treated like criminals. Most of them were fighting over the food I would not give to my pet. Moreover, the place was congested and I was told that most of them slept outside and when it rains the situation really gets worse.
According to Dr Osei, the World Health Organisation (WHO), requires that mental healthcare should start from self care through informal community care, primary healthcare, community health service, regional and finally to long stay facilities. He, however, noted that the reversed situation prevailed in Ghana.
"This situation if not corrected would spell doom for the country," he cautioned.
The pending Mental Health Bill, which he said had been hailed by the WHO as one of the best legislation worldwide, seeks to ensure that adequate provision of resources has nine parts, consisting of a mental health board, a Service, a Review Tribunal (to review mental cases), Visiting Committee, Voluntary Treatment and involuntary treatment.
The other parts of the Bill are the Rights of a Person (to take a look at human right abuses and discrimination associated with mental health), Protection of the Vulnerable Group and miscellaneous provisions. The Bill would also de-emphasise institutional care and help place mental care on the National Health Insurance Scheme (NHIS).
He charged the media to put the government through the Ministry of Health on it toes to ensure the passage of the Bill, adding that the poor state of mental rights, protection of mental patients were justification for its passage.
Solutions:
With the pending bill which is likely to be passed soon, government should make sure that the contents of the bill are implemented. It is not only the passage of the bill that can enforce the implementation.
There is the need for the provision of adequate infrastructure and logistics for the training of community psychiatric nurses to encourage community healthcare with the view of bringing patients closer to their families for them to feel a part of society.
It is only through such realistic steps that the nation can avoid the danger we would all be exposed to if cured mental patients make the psychiatric hospitals their eternal home.
The government should help in the decentralisation of treatment of mental patients, and also establish mental health departments in all the general and community hospitals across the country to help provide easy access for mental health treatment in the country.
Furthermore, families tend to neglect their relatives who happen to find themselves in such situations because of the stigmatisation of mental patients.
Indeed, stigmatisation, as well as the lack of understanding of mental illness in the country, is one major problem that worsens the mental illnesses. There is, therefore, the need for more education on mental health to enhance the public’s understanding of the issue to erase the perception of the public on mental illness.
Stigmatisation is natural in every human being but it can be controlled.
According to Dr Osei, "if we are able to embark on a massive public education against stigmatisation, then it would be reduced”.
Community care is critical in mental treatment, since, according to health experts, it makes patients feel a part of the community, instead of being chained in hospitals. But this demands the training of more staff to perform the enormous task.
The media goes a long way in influencing the lives of people. The media is there to basically educate, inform and entertain the public. It should also liaise with mental institutions in the country to inform people and the various institutions about mental illnesses and what it comes with.
IT is widely believed that mental illnesses are caused by supernatural or evil forces that could be best cured by traditional medicine or spiritual prayers. It is common for a patient to be removed from a hospital by a relative and taken to a traditional or spiritual healer.
This psychiatric practice has existed for more than a century in Ghana. In some situations it is not known if the patient’s recovery could be attributed to medication or the intervention of the traditional healer or both.
In the ninetieth century, patients suffering form mental illness in the then Gold Coast were kept in prisons. Before this period, mental patients were left to fend for themselves or sent to traditional healers to be cured.
The colonial government in 1888 under Sir Edward Griffiths passed a legislative instrument (The Lunatic Asylum Ordinance), to establish an asylum in a vacated High Court building in Accra.
It was not until 1904 that the Accra Psychiatric Hospital was built and officially commissioned in 1906, which was to accommodate 200 patients. During that period psychiatric treatment was primarily in the form of custodial care.
The Accra Psychiatric Hospital has undergone major expansion in the past 105 years and currently houses about 1200 inmates; Half of them are cured but still living in the hospital because their relatives have abandoned them, and some others have no home to go to.
There were extensive changes to the hospital buildings, and staff training and recruitment were expanded. Other reforms introduced were the removal of chains from the legs of patients, refraining from punishing patients and discouraging isolation.
Currently, the hospital lacks resources in terms of staff, finances, drugs, among others, making it difficult for the few medical team there to attend to patients promptly.
Accessibility to psychiatric care
With a population of 24 million, and three psychiatric hospitals with 1200 beds, the ratio of one bed to 20,000 persons is glaringly insufficient. There is the uneven accessibilty of mental hospitals in the country since all three mental hospitals are located in the southern part of the country. It is no wonder then that some patients or their relatives would rather seek help from traditional sources, not only because of their cultural or religious beliefs in the cause of psychiatric illness, but because of easy or inexpensive access to traditional healers who live in their community.
When I visited the Accra Psychiatric hospital, Dr Osei took me to three wards. Two special wards -one for male patients and the other one for the female patients and the normal ward for only male patients. Before we went to the wards, the doctor asked me if I could stand what I was about to see.
Sincerely, that question alone got me frightened. We went to the special ward for the male which was also called the forensic ward, there were four staff attending to the needs of 232 male patients. There were two male nurses and two health assistants. The other male ward called the acute ward had 126 patients with only 49 beds and four nurses attending to them at the time of the visit. The largest female ward also had 112 patients taken care of by five nurses.
The food alone could send signals that the patients were treated like criminals. Most of them were fighting over the food I would not give to my pet. Moreover, the place was congested and I was told that most of them slept outside and when it rains the situation really gets worse.
According to Dr Osei, the World Health Organisation (WHO), requires that mental healthcare should start from self care through informal community care, primary healthcare, community health service, regional and finally to long stay facilities. He, however, noted that the reversed situation prevailed in Ghana.
"This situation if not corrected would spell doom for the country," he cautioned.
The pending Mental Health Bill, which he said had been hailed by the WHO as one of the best legislation worldwide, seeks to ensure that adequate provision of resources has nine parts, consisting of a mental health board, a Service, a Review Tribunal (to review mental cases), Visiting Committee, Voluntary Treatment and involuntary treatment.
The other parts of the Bill are the Rights of a Person (to take a look at human right abuses and discrimination associated with mental health), Protection of the Vulnerable Group and miscellaneous provisions. The Bill would also de-emphasise institutional care and help place mental care on the National Health Insurance Scheme (NHIS).
He charged the media to put the government through the Ministry of Health on it toes to ensure the passage of the Bill, adding that the poor state of mental rights, protection of mental patients were justification for its passage.
Solutions:
With the pending bill which is likely to be passed soon, government should make sure that the contents of the bill are implemented. It is not only the passage of the bill that can enforce the implementation.
There is the need for the provision of adequate infrastructure and logistics for the training of community psychiatric nurses to encourage community healthcare with the view of bringing patients closer to their families for them to feel a part of society.
It is only through such realistic steps that the nation can avoid the danger we would all be exposed to if cured mental patients make the psychiatric hospitals their eternal home.
The government should help in the decentralisation of treatment of mental patients, and also establish mental health departments in all the general and community hospitals across the country to help provide easy access for mental health treatment in the country.
Furthermore, families tend to neglect their relatives who happen to find themselves in such situations because of the stigmatisation of mental patients.
Indeed, stigmatisation, as well as the lack of understanding of mental illness in the country, is one major problem that worsens the mental illnesses. There is, therefore, the need for more education on mental health to enhance the public’s understanding of the issue to erase the perception of the public on mental illness.
Stigmatisation is natural in every human being but it can be controlled.
According to Dr Osei, "if we are able to embark on a massive public education against stigmatisation, then it would be reduced”.
Community care is critical in mental treatment, since, according to health experts, it makes patients feel a part of the community, instead of being chained in hospitals. But this demands the training of more staff to perform the enormous task.
The media goes a long way in influencing the lives of people. The media is there to basically educate, inform and entertain the public. It should also liaise with mental institutions in the country to inform people and the various institutions about mental illnesses and what it comes with.
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