With a population of almost 30 million, the West African country of Ghana is one of the more populated countries on the continent. With a great amount of people comes a great need for strong systems, particularly that of healthcare. Ghana boasts an universal health care plan which covers all Ghanaian nationals within the country; however, despite its existence, only 40% of its population are enrolled in this system. Various factors intertwine to decline the client experience and result in fewer people enrolling in a plan. The plan also carries an economic burden in some families, especially to those seeking mental healthcare.

Despite being covered under the healthcare system, mental health is still a constantly overlooked problem in Ghana. There are around 3 functioning psychiatric hospitals, and only 12 practicing psychiatrists. Various officials have been cited claiming that mental illness “does not kill people”, and use that as an excuse to not further develop mental healthcare facilities. That could not be further from the truth, and the numbers speak otherwise: over 600,000 suffer from severe disorders, and at least 2 million suffer from mild to moderate mental health issues. There is a clear disconnect between the data and the actions officials are taken, which can be attributed to the extreme stigmatization of mental illness; this in turn perpetuates a cycle of maltreatment and abuse. Understanding Ghana’s colonial and religious history, how the stigma stems from religious beliefs, and how it influences the interactions of Ghanaian people within their own communities will give more insight into these current issues, and how they can best be tackled.

History and Context

Similar to many other countries throughout the world, Ghana found itself subject to imperialism, as European colonists made their way into the land, and with them, brought the religion of Christianity. The most successful evangelism occurred by the hands of Presbyterian and Methodist missionaries, who laid the foundation for the first official Christian church in Ghana. The church was later maintained by natives after missionaries were expelled from the Cape Coast following the start of World War I. These missionaries had brought educational reforms in addition to western biological advances and medicine and, as a result, Christianity in Ghana has always been tied to healing. The center figure of the religion, Jesus Christ, was described by many Biblical accounts to be a gracious and welcoming healer who performed miracles for those who had faith. This ideology, in combination with traditional religion and beliefs created a form of synthetic religion, one that is still widely practiced throughout Ghana. Their religion is essential to their way of life; it guides their actions, shapes their morals, and it is these morals that affect how the native people interact with each other and treat others in their local communities. Those who are afflicted with mental illnesses are believed to be under spiritual attack, which affects those around them. As a result, these people are cast out from their communities.

Being cast out left few options for treatment. Few psychiatric hospitals are open, and even those who are admitted to the facilities faced extreme abuse and maltreatment. Therefore, many are often given up to prayer camps against their will, which were the site of many human rights violations. The vast majority of the traditional healers and pastors that work within these camps do not believe in modern medicine, and instead believe in the power of fasting and prayer. As a result, the ill are chained up and forced to live in crowded conditions as they were prayed over, day and night. As a result of this absence of regulation, conditions in these camps are poor, often to the extent that they violate many human rights laws. After some pressure, the government passed the 2012 Mental Health Act as a form of intervention, which proclaimed that people with psychosocial cannot be subjected to torture, cruelty, forced labor and any other inhumane forms of treatment. However, not much changed. Lack of implementation of regulatory systems allow these camps to run regardless of any laws that have been passed.

Solution?

A solution to these issues lies in reforming the inherent structure of the government. Unlike many Western countries, the line between church and state in Ghana is barely, if at all, defined. Those who hold religious power in church institutions are able to enter positions within the government, and can therefore pass legislation that does not serve the people’s best interests, but rather aligns with the ideologies of the church, which can cause harm. As the Ghanaians are a very spiritual and religious society, any treatment method or intervention that completely alienates their cultural and traditional beliefs is one that will be negatively received by the people; therefore, it is important to find a perfect balance. People should continue to be educated on the topic, and then continue to raise awareness and advocate for the mentally ill. The ill must be “rehumanized”, which can be made possible by fostering positive interactions between healthcare providers and those within their care. Funds must be reallocated towards building more suitable hospitals for the mentally ill, and towards alleviating the economic burden healthcare places on the family of these people. Those who wish to seek out traditional treatment in addition to the treatment they receive in hospitals should be allowed to, but they have to be treated under safe, regulated conditions.

With education comes power, and as people continue to be educated on the topic, the country will become better equipped to fight the crisis, and support its people.

Sources

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https://www.hrw.org/news/2018/10/09/ghana-oversight-needed-enforce-shackling-ban

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The Crossroads of Religion and Medicine: Mental Healthcare in Ghana