According to a recent report by Human Rights Watch, patients with mental illnesses in Ghana have been subject to dire human rights violations in the facilities where they reside. The violations include forced fasting, being chained to trees, living in unsanitary conditions, and physical abuse.
Patients have been chained to trees in their institutions for as long as 8 months, during which they eat, sleep, defecate, and bath, all in the small area in which they are chained. Often these places where they are chained lack roofs and walls or at worst any structure at all, and are without protection from the sun and rain.
What is important to note about the mental health care offered in Ghana is that its medical capacities are not enough to serve its patients. It is estimated that there are about 2.8 million persons who have mental disabilities in Ghana of which 650,000 have severe mental disabilities. Yet, nationwide Ghana only has 600 psychiatric nurses, 12 practicing psychiatrists, and 7 psychiatric hospitals which can serve around 1350 patients in total. In addition to this fact, many patients cannot afford the costs of medical care, and at the hospitals medicine and food needs to be provided by their families or by themselves.
Because of the lack of facilities, persons with mental illnesses are sent to prayer camps. These prayer camps are not state-regulated facilities, but they offer prayer and healing services. The methods of treatment include, fasting, Bible study, and prayer. Some prayer camps also offer traditional medicine as a part of their treatment.
Many of these prayer camps, although they offer some form of treatment, are where these human rights violations occur. The forms of treatment are taken to the extreme at these prayer camps. In many camps, even child patients are forced to fast and be chained. Also many of the facilities cannot provide food for their patients, so it is expected most of the time that their family members will bring food for the patients. However, some family members abandon patients at the prayer camps. Many of them give false addresses so they cannot be traced. In other words, even at these prayer camps adequate care is not provided.
Clearly the conditions in Ghana are caused by the lack of resources and lack of support from the government to address the problem of mental health care. But this is also due to the combination of that problem with the lack of understanding of mental disabilities within Ghana. In Ghana it is often believed that when a person develops a disability, they are possessed by demons of evil spirits. In other words, it is not seen as a medical condition.
This also fuels the lack of doctors and nurses in Ghana specializing in psychiatric medicine because potential nurses and doctors often are drawn away from the field due to the feeling by the public that they are dealing with the outcasts of society. Often nurses and doctors experience abuse from their families and prejudice from their friends because of their jobs. Also because of this prejudice, many nurses beat their patients when they are difficult to work with.
This misunderstanding of persons with mental illnesses leads to abuse by their family members. Family members often think that they are being punished for their past sins. As a result, persons with mental illnesses are often beaten by their family members to “chase out the demons” and in retaliation for bringing disgrace to the family.
With public understanding of mental illnesses, the social stigma that persons with mental illness experience in Ghana could change. Ghana’s public health policies, in comparison to other African countries, are advanced. Yet its policies towards persons with disabilities especially concerning mental illness are in great need of improvements. Since 2000, Ghana has passed several disability related laws, which recognizes right to family life, access to public life, education, health care, and employment.
In March 2012, Ghana passed its new Mental Health Act, which established a mental health service, regulations on discharge from mental institutions, and a tribunal to investigate complaints. Yet the Mental Health Act does not provide all the protections required in the UN Convention on the Rights of Persons with Disabilities which Ghana signed in 2007 and ratified in July 2012. There are other legislative efforts in the parliament that could improve the disability related laws in Ghana, but there remains a concern over whether good intentioned laws will be fully implemented once passed.