The Dark Mind in Ghana; Unspoken and Unheard.

A Public Health Concern.

Ghana, the model of hope for Africa, has over the years demonstrated great
achievements in Governance, Leadership, Education, Health and, Security However
with Ghana’s prosperity in mind there is a need to further build infrastructure for
basic services, including health which are far from meeting the needs of the
population. This is particularly the case in mental health, where many years of
neglect have left services even further behind.

This is now beginning to change, with Ghana adopting a progressive Mental Health
Act (2012), a reflection of the substantial efforts made by a growing civil society
sector interested in mental health. A healthy mind of citizens transforms better into a
productive nation enhancing prosperity and growth which has the potential to enable
Ghana to shine as a beacon of hope for Africa.

Research from the World Health Organisation (WHO), suggests, out of an

estimated 30.42 million people living in Ghana, about 650,000 are suffering from a
severe mental health difficulty and a further 266,000 are suffering from a
moderate to mild mental health illness. However, there is no help and support for
these individuals with a treatment gap of 98% with a large proportion of the total
population expected to have a mental disorder. Mental health services in Ghana
are available at most levels of care.

However, most of the care is provided through specialized psychiatric hospitals

(close to the capital and servicing only a small proportion of the population), with
relatively little government provision and funding for general hospital and primary
health care-based services. The few community-based services being provided
are private, but with a large rural population many individuals do not receive
appropriate support.

The media have played their role in telling the ‘Unspoken and Unheard’ of various
forms of mental illness ranging from self-harm to suicide, depression of many
prominent people mostly in the formal sector of employment in Ghana. But what is
really known of the poor ‘Unspoken and Unheard’ farmer from Nandom in the
Upper West Region? Have the media broadcast changed people’s perception
about mental health or is still unknown, unspoken and classified as witch craft or
superstition?

Research indicates there are about 123 mental health outpatient facilities, 3
psychiatric hospitals, 7 community based psychiatric inpatient units, 4 community
residential facilities and 1-day treatment centre to cater for an
estimated population of 30.42 million of Ghanaians, which is well below what
would be expected for Ghana’s economic status, M. Roberts, et al (2014). It is
clear the above facilities are inadequate in providing appropriate treatment to all
those people affected and sadly tells the story of the ‘Dark Mind’ of the ‘unspoken
and unheard’ in Ghana.
Ghana has experienced a positive trend in its economic development over the past
two decades and seen a gradual strengthening of its democracy in recent years.
Ghanaian society scarcely speaks about mental illness, and people’s attitudes
haven’t change in speaking about mental illness, and when mental health is
discussed it is done in a way that perpetuates stigma and a fear of those that suffer
from it, with most forced to rather bear in silence than be labelled as “crazy”. This
overall picture hides persistent inequity.

Health policies should integrate and involve the community in an active participation
in the understanding and advocacy role of mental health as a measure of increasing
need. An awareness to openly discuss mental health and seek early treatment
requires a step change in the delivery and access to care for all Ghanaian’s. When
more people understand the importance of protecting the mental wellbeing of the
population, they will demand the policy changes to ensure it.

Transparency about mental illness will become a norm and will gradually render fear
and labelling obsolete. The research directives which aims to alleviate the
challenges faced by those suffering from mental health may provide pragmatic
solutions aimed at tackling this large mental health treatment gap.

Let’s talk about mental health in our homes, religious centres, workplaces and
communities and find solutions the now obsolete to and damaging concept of ‘Dark
Minds’.
Author: Pascal Landindome Navelle

Public Health Consultant

Mind ‘N’ Health – Nexus, University of Leeds

United Kingdom

Email: pascal.navelle@mindnhealth.co.uk