An overview of Ghana’s mental health system: results from an assessment using the World Health Organization’s Assessment Instrument for Mental Health Systems (WHO-AIMS)

Abstract

BackgroundThis survey provides data on the Mental Health System in Ghana for the year 2011. It supplies essential planning information for the implementation of Ghana’s new Mental Health Act 846 of 2012, a renewal of the Ghana 5 year plan for mental health and it contributes to international knowledge base on mental health. It provides a baseline from which to measure future progress in Ghana and comparison data for use in other countries. In addition to reporting our findings we describe and analyse deficiencies and strengths of the Ghana mental health system.MethodsWe used the World Health Organization’s Assessment Instrument for Mental Health Systems (WHO-AIMS) to collect, analyse, and report data on the mental health system and services for all districts of the ten regions of Ghana. Data was collected in 2012, based on the year 2011.ResultsIn 2011, Ghana was a lower middle income country with a population of approximately 25 million. A mental health policy, plan and legislation were in place. Mental health legislation was outdated and no longer in line with best practice standards. Services were significantly underfunded with only 1.4% of the health expenditure going to mental health, and spending very much skewed towards urban areas. There were 123 mental health outpatient facilities, 3 psychiatric hospitals, 7 community based psychiatric inpatient units, 4 community residential facilities and 1 day treatment centre, which is well below what would be expected for Ghana’s economic status. The majority of patients were treated in outpatient facilities and psychiatric hospitals and most of the inpatient beds were provided by the latter. There were an estimated 2.4 million people with mental health problems of which 67,780 (ie 2.8%) received treatment in 2011. The were 18 psychiatrists, 1,068 Registered Mental Nurses, 19 psychologists, 72 Community Mental Health Officers and 21 social workers working in mental health which is unbalanced with an unbalanced emphasis on nurses compared to what would be expected.ConclusionsThe main strength of the mental health system was the presence of a long established service with staff working across the country in outpatients departments and hospitals. The main weakness was that government spending on mental health was very low and the bulk of services, albeit very sparse, were centred around the capital city leaving much of the rest of the country with almost no provision. Service provision was dominated by nurses with few other professions groups present.

Disponibilidad de medicamentos psicotrópicos en establecimientos del Ministerio de Salud del Perú, 2011

“…La proporción de establecimientos de atención primaria que alcanzó esta meta fue de 57% en Uganda (24) , 40% en Ghana (25) y entre 21 y 50% en México (26) . Considerando los establecimientos de todo nivel, McBain et al encontraron una tasa de 71% en una muestra de 63 países de bajos o medianos ingresos (27) .…”

The predictors of treatment pathways to mental health services among consumers in Ghana

“…In particular, legislation and policies, which have a sustainable impact on consumers of services, have historically received little priority. Until 2011, the mental health services had relied on an outdated mental health policy of 1994 and a revised mental health strategic plan . Similarly, until 2012, when the Mental Health Act 2012 (Act 846) was enacted, mental health services have functioned on the outdated Mental Health Legislation of 1972 (Draft, 2006).…”

Stigma, Discrimination, and Social Exclusion of the Mentally Ill: the Case of Ghana

“…There is the need for proper training and recruitment of psychiatric and other mental health personnel, such as doctors, nurses, and social workers and in addition to increased funding for mental health services to augment the challenges of inhuman treatment, stigma, and discrimination associated with mental illness in the country (Roberts et al 2014).…”

“…A previous 2008 study revealed that Ghana had ten psychiatrists compared to 13,074 physicians (Doku et al 2012). The annual budget allotted to mental health is 1.4% of the health budget (Roberts et al 2014) compared to 10% or more of national health budgets allotted to mental health in the Western world (Lurie 2014).…”

“…Ofori-Atta et al (2010) conclude that in countries such as Ghana, many persons in need of mental health treatment do not reach psychiatric services at all, but seek care from informal community mental health services such as traditional and faith healers and family members. As of 2011, clinicians working in mental health in Ghana comprised of 18 psychiatrists, 1256 nurses, 19 psychologists, 21 social workers, four occupational therapists, and 546 other mental health workers (Roberts et al 2014).…”