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Field Notes

Mental Health in Ghana: Making it Matter

By: Kallan Lyons

ACCRA, GHANA – Sitawa Wafula stands in front of a packed room, poised behind the podium, no notes in hand.  The room falls silent as she begins to speak.  She tells us that her journey to Ghana was a difficult one.  Some days, she says, even just getting out of bed is a struggle.

Mental health survivor and speaker Sitawa Wafula (second from right) with JHR students from the African University College of Communications

Mental health survivor and speaker Sitawa Wafula (second from right) with JHR students from the African University College of Communications

Sitawa has traveled from Kenya to be a guest speaker at Ghana’s first ever mental health conference.  She is a mental health survivor and bravely shares her story with the 100 plus people in attendance. At the age of 18, Sitawa was raped, refusing to seek help right away because she felt ashamed and had no one one to turn to. As a result she became suicidal and started having seizures. She then went through a litany of diagnoses, first epilepsy, then schizophrenia, depression and finally bi-polar disorder.

Her speech, titled “The Power of One” renders everyone speechless. We are moved by her strength and courage. In front of us stands a woman who has overcome adversity and stigma, and now speaks openly about her experience. In Kenya, she is a celebrity.

My students want to interview her and Sitawa happily agrees. After all, educating others is what she is passionate about.

One of the first questions she is asked is: “When did you first become mentally ill?”  Sitawa is quick to correct the interviewer.  “First I’d like to let you know, someone doesn’t become mentally ill.  They develop a mental health condition.”

The student is embarrassed, but Sitawa reassures her no damage has been done.  Overcoming the stigma associated with mental illness starts with changing the way we talk about it, she says.

In Ghana, mental health conditions are not just stigmatized, they are ignored all together.  October 10th marked World Mental Health Day, a celebrated initiative supported by the World Health Organization to raise awareness on mental health issues.  The theme of Ghana’s first mental health conference, which coincided with this day, was ‘Understanding, Inclusion and Stigma Reduction’.

This is because in Ghana, mental health is not talked about in classrooms or communities, nor in health care centres or hospitals.  The issue is confined to the country’s few overcrowded and underfunded psychiatric hospitals.  A Human Rights Watch report estimates 2.8 million persons in Ghana have mental disabilities, of which 650,000 are severe cases.

Last week I visited Ankaful Psychiatric Hospital in Cape Coast with a couple of my students; one of only three psychiatric hospitals in Ghana.  Eleven months ago they stopped admitting patients due to a lack of funds, but those in need of care can still come to the hospital to be administered medications before being sent back to their community.

In this week’s Globe and Mail, an article titled “Exposing Canada’s Ugly Mental Health Secret” explored the costs associated with mental health care.

“You can seek the care of a psychiatrist, a service covered by medicare, but the wait for an appointment is months, maybe even a year. Or, you can seek the help of a psychologist or social worker who also does therapy. There is no wait but services are not covered by medicare, so you must pay out of pocket, roughly $125 an hour.”

While Canadians are currently concerned about the cost of care, Ghanaians are concerned with access. The numbers show a dire need for more professionals. The country only has 12 psychiatrists for its 25 million inhabitants and 700 psychiatric nurses whereas the average number of nurses for a country the size of Ghana is 30,000. This means 97 percent of people with a mental illness who require health care do not receive it, according to Chief Psychiatrist of the Ghana Health Service Dr. Akwasi Osei.

For those that do receive care, it is often a lonely and isolating experience. “The families do not visit”, said a psychiatric nurse at Ankaful, who has asked not to be named. The 80 patients admitted to Ankaful however are the lucky ones, others are forced to live among people who reject and abuse them; while some are pushed into prayer camps, where they can be chained, shackled and subjected to exorcisms.

These human rights violations give purpose to Sitawa’s actions. To improve the condition of those suffering from mental health issues she says, people need to be educated about these very issues; there needs to be more training of health care professionals as well as developing community resources and clinics.

In 2012 Ghana passed the Mental Health Act, a new bill that seeks to incorporate spiritual and traditional mental health care and aims to improve mental health facilities to prevent the abuse of people with a mental disorder.  It’s progress, but there is still a long way to go.  The mental health conference is a step in the right direction.

Change starts with survivors like Sitawa; someone who travels the globe to share her story, blogging and tweeting about her experiences along the way. She has started a twitter campaign called ‘Hug Sitawa’ (#hugsitawa), to raise awareness about mental health in Africa.

“All these people with mental health conditions, that’s all they need- they need a hug…the people who have mental illness…they should not be forgotten…I want to show you we can be everything.”

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One thought on “Mental Health in Ghana: Making it Matter

  1. Greg Saville

    Kallan this is an exceptional story about an invisible issue. You have done a service for our hero Sitawa and also for the Ghanians so in need of help. Sitawa’s final quote about “needing a hug” says so much about that which is lacking both there and here in North America. She sounds like a remarkable woman.

    As a criminologist I can add that mental health issues, and lack of treatment, drive a good deal of the crime problem in countries around the world. Far too many of those inhabiting our prisons suffer from various types of mental affliction. I wonder how their world, and ours, would be different if they’d had proper treatment and access to people with training?

    It is a question your article helps us ask with more clarity. Thanks for that.

    Reply

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