Mental illness is largely neglected and an invincible illness. The symptoms of mental illness cannot be detected in a simple blood test and it does not get passed on from one person to another by coughing or touching and these illnesses are shrouded in shame and stigma. The most affected persons are the poor in the society. Some reports have stated that, in Africa 9 in 10 people who are reported to suffer from epilepsy go untreated and unable to access simple cheap anticonvulsant drugs. Patients are often taken to witch doctors and subjected to violent beatings and treatment to chase away the evil spirit they simply suffer in silence or in chains. Also one in four people suffer from a mental, neurological or substance misuse disorder at some point in their lives. However many cannot get access to basic medicines and basic mental health care. Human resources are particularly crucial in mental health, especially Africa. The Migration for development in Africa (MDA) has come at the right time as an opportunity for policy maker to grab and encourage mental health professionals to migrate back to Africa and support the development of mental health care.
In Ghana for instance there are only three major psychiatric hospitals namely the Accra Psychiatric Hospital, the Ankaful Mental Hospital and the Pantang Mental Hospital. There are however, psychiatric wings or units attached to all the regional general hospitals and the Polyclinics and these have contacts with the Accra Psychiatric Hospital which is the oldest and the main one. The Hospital, which is almost a hundred years old, has twenty-four wards with about one thousand, one hundred and sixty two patients currently on admission. The Accra Psychiatric Hospital was built like a prison by then British colonial Government to house patients who were uncontrollable and difficult to deal with. Ankaful and Pantang Hospitals are fifty and forty years respectively. The country currently has an estimated population of about 24 million and with just three mental hospitals which are situated in the south does not seem right. This has resulted to overcrowding and strain on admission at the three hospitals. It is pathetic to relate that owing to insufficient beds in the wards, some patients have had to sleep either on the bare floor or on mats spread thereon. In some cases when there are no spaces in the wards, patients have inevitably had to be made to sleep on the balcony and this exposes them to the vagaries of the weather and deadly mosquito bites. Aside these woeful situations, patients have had to live with pests such as rats, mice etc.
There have been numerous occasions that patients have been refused leave patient leave the family and friend to deal with their difficult symptoms. These families in some occasion sustain serious injuries in deal with the violent behaviour patients. This frustration and difficulties force families and carer to seek other forms of care and support e.g.; fetish shrines and prayer camps
These facilities at this second option mental health care have no formal training for its attendants in management of violence and aggression in mental health. In an attempt to manage violence behaviours emanated from their illness, patients are restrained in chain and ropes under the mercy of the weather. The chains and ropes sometimes cause wounds which when not treated in time cause tetanus infections and gangrene. These then may end in amputation or even cause death of the patient.
Those patients who are fortunate to get admission are suppose to be fed three times a day with fruits being added to their meal. It is however sad to tell that most often due to inadequate funds, the hospitals are unable to provide enough food and the fruits to satisfy the patients. In most circumstances relatives and friends have to bring along some food to supplement with what is being served by the hospital. The case of patients with poor families is another sad story to narrate. And those who do not have any relative seeing to their welfare tend to force their way out or sneak out to look for food through begging on the street to supplement what is provided.
In conclusion, like many of the problems in Africa today, the key to improving Psychiatric care in Ghana is funding. The fundamental requirement for facilitating any change in practice is a change in attitudes towards people with mental health problems.
Caring for mental illness relies on trained health workers not costly technology or equipment. The country needs two or more mental hospital facility in the Ashanti region and the northern region of Ghana, without this objective, improving the mental health care in the country will be almost impossible. Mental illness is treatable and treatment is affordable. We simply cannot afford to ignore the global burden on mental health. After all there is no health without mental health.