The euphoria, enthusiasm and joy with which the passage of the Mental Health Act (Act 846) came with, somewhere in March 2012 have evaporated into thin air like morning dew beyond the immediate cognisance of the mind.
The ambience of excitement on the 2nd of March 2012 is a dream never fulfilled and the hope of seeing the full implementation of the Act is still uncertain. Or rather, better to say the fate of the full implementation of the Act rest on the shoulders of parliament as far as the Legislative Instrument (LI), which is the main engine of the Act, is concerned.
Stakeholders in the sector anticipated a speedy revolution in mental healthcare delivery in Ghana since the new law is impregnated with sufficient and pungent antidote to christen the sector into a new chapter. However, the hope of seeing a brighter and improved mental healthcare system has become a long-term dream than anticipated.
It requires the passage of a Legislative Instrument (LI) to fortify it financially. The status quo of funding mental health is a perennial challenge. Government is doing it best but the hard truth is that the funds released by government is woefully inadequate to meet the demands of the sector.
The only three psychiatric hospitals in the country are constantly in the news either soliciting for funds from the public and philanthropists or threatening to stop admitting patients for shortage of food and patients’ drugs.
Accra Psychiatric Hospital, the country’s main headquarters of mental healthcare, popularly called Accra Mental was recently in the news. The hospital did not have common A-4 sheets and other basic logistics to work with. This compelled the facility to suspend its Out-Patient Department (O. P.D).
This dire situation is not limited to Accra Psychiatric Hospital alone. The problem of financial constraints transcends the borders of Accra Psychiatric Hospital. It is a viral that confronts all the three psychiatric hospitals. All three psychiatric hospitals sing the same financial chorus.
The hospitals owe their food suppliers huge sums of monies. Some of the suppliers have stopped supplying and others too have resorted to court action. This quagmire inevitably contributes to poor working conditions of the facilities and unquestionably demoralises the staff spirit, especially the nurses. Staff cannot give out their best when things such as gloves, A-4 sheets, disinfectants, plasters, ex cetera are constantly in short supply.
The new mental health law is one of the best mental health laws in Africa if adequately resourced. It replaces the Mental Health Decree 1972, (NRCD 30) which lacks enough provisions to match modern trend of mental healthcare. The new law seeks to protect the fundamental human right of the mentally challenged, incorporate and regulate the proliferation of prayer camps and traditional healers in the treatment and care of mental patients, deemphasising institutional care of mental patients, and decentralising mental healthcare.
Though the law is in existence, the state of mental healthcare has not seen much improvement as expected. Things seem to retrogress after four years of the existence of the new law.
Mental patients are is still rampant on the streets. Efforts by Mental Health Authority to clear the cities of mental patients have not yielded much positive results. It needs the financial muscle to carry out the exercise periodically and accordingly reintegrate them with their families.
The springing up of prayer camps, traditional healers, and their attitudes towards the mental patients they attend to, leaves much to be desired. Abuse of the rights of mental patients is a daily tale at the camps.
The right of mental patients and people living with mental disorders including those on the streets are enshrined in the new law and need to be protected but as the law sits now, it is akin to a ‘toothless dog’ who only bark loudly but cannot bite.
Does the government care about the mental health? Your guess is as good as mine.
The government of the day and past governments have not placed much priority on mental health in this country. It is not surprising that none of the presidential candidates said anything tangible in their manifestoes about uplifting the image of mental health from its current predicaments. A country that does not put premium on its health sector, more especially on mental health is a country bound to making bad policies by it leaders.
Barely a month ago, the presidential candidate of the ruling National Democratic Party (NDC), President John Dramani Mahama in his quest to lure the good people of Ghana to give him a second term, confidently said he will build two additional psychiatric hospitals in the country when voted into power come December 7. That, one will be built in the northern region and one in the Ashanti region. Again, his government in their second term will develop Pantang Psychiatric Hospital to a first class mental health facility and relocate Accra Psychiatric Hospital.
Really! That sounds good, isn’t it? Provided it is not a political talk show. The politician is capable of saying anything that comes to his mind when their political libido is high. Even if it is about telling the people that Jesus Christ is coming on an appointment date, they will say it without fear. After all, they know how to reverse the gear if their promises become a nine-day wonder.
Is the president aware of the current situation of mental healthcare in the country? Why building additional psychiatric hospitals when the only three hospitals are struggling to survive?
What is the essence of building additional hospitals when common A-4 sheets, gloves, disinfectants and other basic logistics are not available at a hospital?
The status quo of mental healthcare and for that matter psychiatric hospitals need resources to deliver. It needs adequate funding to meet its myriad challenges that have been bedevilling the sector since the year 2000. Expansion is not the solution, adequate funding is.
The new mental health law already has provision to building a 50-bed capacity in each region of Ghana. Is the president aware of this?
The new law will also ensure the establishment of four Drug Rehabilitation Centres and 20-bed ward in each regional hospital across the country.
More psychiatrists, clinical psychologists, Physician Assistants in psychiatry, as well as occupational therapists are going to be trained.
Whiles the idea of expansion is not wholly misplaced, the president should demonstrate his true commitment to the sector now by equipping and resourcing the current hospitals so stakeholders can be convinced rather than trying to bite more than he can chew.
The President should prod parliament to expedite the passage of the legislative instrument (LI) so mental healthcare can have a reliable source of funding instead of the hospitals having to lament always before aid arrives.
The politicians say one student, one tablet. One village, one dam. One district, one factory. They give no heed to mental health and usually end up building castles in the air because they do without a sound mind.
Vote for mental health. Vote for Mental Health Authority to make your mental health its priority.
When the new mental health law is fully equipped and resourced, mental healthcare will be wheeled from Pantang, Accra Mental and Ankaful to your doorstep. This will reduce your stress of having to travel from far places to the only three state psychiatric hospitals in the cities.
Mental health care will be free. Your streets will be cleared of ‘mad people’. Mental health education will be made available in every quarters: on the TV screens, on the radios, on the streets, in churches, mosques, symposiums and all available corners.
Vote for mental health.
You would learn to know, identify and report early signs and symptoms of mental and psychological problems for prompt care.
You will differentiate between a witch and a mentally challenged person on the street. So the naked disorientated old woman on the street who stares blankly and bothers not the lens of your camera and phone snaps would not be mistaken for a witch.
Support mental health today for sound mind. Join the campaign for parliament to pass the LI.
A nation of sound mind is a healthy and prosperous nation.
Mental illness is not a curse, it is a disease and it is no respecter of persons. Today it is somebody, tomorrow it could be you!
Mental Health, Your Total Health.
The writer, Malcolm Akatinga Ali is a nurse at Ankaful Psychiatric Hospital, Cape Coast.
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