Local suffering and the global discourse of mental health and human rights: An ethnographic study of responses to mental illness in rural Ghana

Abstract

Background: The Global Movement for Mental Health has brought renewed attention to the neglect of people with mental illness within health policy worldwide. The maltreatment of the mentally ill in many low-income countries is widely reported within psychiatric hospitals, informal healing centres, and family homes. International agencies have called for the development of legislation and policy to address these abuses. However such initiatives exemplify a top-down approach to promoting human rights which historically has had limited impact at the level of those living with mental illness and their families.

Determinants of Psychological Help-Seeking Intentions of University Students in Ghana

“…These somewhat 'unconventional help-seeking pathways', together with steeped negative views and attitudes on mental illness with its associated self-and socialstigma, may contribute to the underutilization of professional psychological and psychiatric services for mental health in general (Fournier 2012;Read et al 2009). Although the contextual situation of mental health-seeking pathways in Ghana as highlighted is important, because it may provide a valuable analytic framework and a useful guide for understanding health-seeking patterns in the general population, a systematic investigation in regard to university students is vital for an explanation of unique factors that may influence their help-seeking intentions.…”

The role of communities in advancing the goals of the Movement for Global Mental Health

“…Read's interrogation of the Movement's goals in the light of the realities of rural lives follows on from an earlier paper (Read, Adiibokah, & Nyame, 2009) in which she discusses the Movement's calls for governments to protect the human rights of the mentally ill. In rural Ghana the common practice of ''chaining the mad'' is widely condemned by western activists.…”

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

“…This situation forces patients suffering from various forms of mental disorders to seek help from traditional healers, pastors, and Muslim Mallams in their communities (Appiah-Poku et al 2004). Read et al (2009) suggest that traditional healers and pastors of the Pentecostal churches continue to deal with the greatest proportion of persons with mental disorders in Ghana. 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.…”

“…Consequently, the limited data discussed in national documents would not include the contributions of family members, religious healers, and traditional healers, who form the backbone of care for the mentally ill in many countries of sub-Saharan Africa, including Ghana (Read et al 2009). Since the majority of persons with mental disorders use mental health services outside formal health institutions, concerns have been raised regarding abuses that mentally ill persons experience during their treatment and residence at these informal settings (Appiah-Poku et al 2004).…”

“…In this regard, the majority of the poor who live in the rural areas and far from the major cities face the greatest challenges in accessing mental health care (Read et al 2009). Health posts run by Community Psychiatric nurses (CPNs) have been instrumental in providing primary psychiatric services across the country and in referring serious cases to the hospitals available (Ewusi-Mensah 2001).…”