If the hospital does reduce its capacity to 600 inpatients by the summer, then it is well on the way to reaching the ultimate downsizing goal of 300 inpatients, what Dr. Osei wants most to happen for his hospital. Upon hearing news of the repatriation, more families are inquiring about the possibility of picking up their once abandoned relatives. Social welfare workers and CPNs are in charge of bringing the patients back home safely. Mind Freedom Ghana fully supports Dr. Osei’s repatriation of patients. They trust that sending patients back into society will help lower the stigma of mental illness by making their families reaccept them and by showing the public that survivors can become productive members of the community. Right now Mind Freedom is searching for someone to fund a project that would help teach, empower, and rehabilitate the patients who are being sent home. The repatriation is noted as a sign of improvement in the mental health care system and Mind Freedom thinks that the decongestion act should be replicated by the Pantang and Ankaful hospitals. Mind Freedom believes that Dr. Osei and Dr. Dzadey have a lot of energy and passion for the mentally ill and are doing the best they can with the resources available. Despite challenges, many achievements have been accomplished by Dr. Dzadey and the Pantang Hospital. In 2007, a revenue-producing Rehabilitation Vegetable Garden opened and is now tended to by patients and national service personnel who have a background in agricultural science. In 2009, a Drug Treatment and Rehabilitation Unit was created and in 2010 it was recognized by the World Federation of Therapeutic Communities.
It is totally inappropriate to group addicts with other mentally ill patients, seeing that drug abusers who do not consider themselves mentally ill will steer clear from entering psychiatric hospitals. Because of the initial lack of focused addiction counselling,cannabis square pot users would often return to the hospital shortly after they were discharged. Henceforth, this Drug Rehabilitation unit was the first step taken to take care of addictions separate from the mainstream patients in the wards. Addicts pay to reside at the hospital and partake in this structured 6 am–10 pm program at the Drug Rehabilitation Centre, where they receive therapy from a well trained staff for a minimum of six months. Occupational therapy assistants involved in VSO now help assess the therapeutic needs of the patients, teach bead making, and collaborate with the wards. A nursing assistant even started an initiative for engaging the patients in physical activities and successfully organized a week long inter-wards sports competition a year ago that was well received by both staff and patients. Also, the general supply of new generation anti-psychotics improved and two boreholes were built by the National Security office to help create an independent water supply in 2010. Awareness, stemming from mental health workers and the birth of mental health NGOs, is undeniably increasing. Before the year 2000 there were no NGOs in Ghana that directly focused on issues in mental health, and now there are at least six very active ones. Basic Needs, Mind Freedom, PsychoMental Health Foundation, the Mental Health Society of Ghana, and the Ghana Mental Health Association are the most prominent. Still, the number of NGOs for mental health is miniscule compared to the number of NGOs for malaria and AIDS. The media also began getting engaged with the movement towards improvement of mental health when journalists became more radical rather than being obsequious to the government.
With the help of NGOs, the media, and certain mental health professionals, the National Development Planning Commission of Ghana finally adopted mental health as a developmental agenda for 2010–2013. MindFreedom, one of the Mental Health NGOs, began in the home of Director Janet Amegatcher in 2004 with Nii Lartey Adico as Co-Director and Dan Taylor as Executive Secretary with the mission to advocate for the rights and dignity of persons with mental disabilities in Ghana. The three were each personally affected by mental illness either directly or through a close relative. All of the three were so dismayed by the callous popular opinion and the condition of the psychiatric hospitals that they searched for a way to educate and sensitize the Ghanaian public. Originally the NGO was funded by the World Health Organization but is now funded by America’s international Disability Rights Fund. In July of 2008, the company moved into a permanent building in Osu, Accra and is open for counselling during normal working hours. The director is trained in counselling and Mind Freedom has both a clinical psychologist and a psychiatrist as board members who are utilized for referrals. The NGO also puts on advocation and awareness events in Accra about twice a year. For three years, Mind Freedom has organized annual street marches through popular roads in downtown Accra, the most recent being in 2010 with 700 participants, in order to fight mental health stigma and to bring attention to the Mental Health Bill and the UN Convention on the Rights of Persons with Disabilities. They try to change perception through education by discussing mental health issues on the air, radio, and newspapers and by posting small posters and stickers around the city. The NGO also puts on training workshops for journalists, judges, lawyers, the police, prison service, and other workers who have direct or indirect contact with the mentally ill, to teach them about how to appropriately deal with the mentally ill and to educate them on current policies.
Currently Mind Freedom Ghana has 154 members, either mentally ill or survivors of mental illness, most of whom have now luckily stabilized enough to return to work. Because of funding and the price of transportation,trim tray the members can only meet every three months to discuss their issues and their progress. Mind Freedom is now submitting a proposal for a three year reintegration and rehabilitation program to help those discharged from the psychiatric hospitals. The mission of Basic Needs, a worldwide mental health NGO, is “to initiate programmes in developing countries which actively involve mentally ill people and their carers/families that enable them to satisfy their basic needs and exercise their basic rights. Under the management of Badimak Peter Yaro, BasicNeeds Ghana was established in 2002 with the purpose “to enable people with mental illness and epilepsy to live and work successfully within their community. Over the past nine years, BasicNeeds Ghana has affected the lives of 18,838 sufferers of mental illness or epilepsy, and 17,603 of them are still receiving regular treatment and counselling thanks to the NGO. BasicNeeds has helped create 182 community self-help groups for the mentally ill and their primary carers. The NGO has trained or is currently training 4,681 beneficiaries in some form of vocational training while also hosting several public awareness events a year. In the winter of 2010, a march took place in the Upper East Region of Ghana for the celebration of the World Mental Health Day, a community durbar was held in Accra in order to increase awareness of Self-Help Groups for people with mental illness and epilepsy, and a photo project took place in 12 different districts to visually capture the conditions the mentally ill people live in. Most importantly, Basic Needs puts on quarterly community outreach clinics in the north of Ghana, specifically in poor communities in the three northern regions where there is no permanent psychiatrist. The most recent clinic, in the last quarter of 2010, reached 155 mentally ill people from five districts in the Upper West Region. Basic Needs strongly believes in community care and has helped many mentally ill people gain access to professional treatment. Through funding from the European Union’s project “Ensuring Secure Livelihoods for Poor Mentally ill People and their Primary Carers in Ghana, Basic Needs organized a secure livelihoods module and assists CPNs and self-help groups in the assessment of skills priority and livelihood options of stabilized members who are then subsidized by the specific group they belong to. Common livelihood options and skills priorities users pursue include farming, animal rearing, grain storage and sale, petty trading, food processing, tailoring, hairdressing, weaving, and bicycle repairs.
This sustainable project encourages social, human, and economic development, while positively changing the attitude regarding the mentally ill and their carers by showing the society that they can be productive. Over the past two years, BasicNeeds has conducted one to two day workshops on procedural and financial training for self-help groups, epilepsy training for medical practitioners, mental health training for master craftsmen arranged to teach skills to the mentally ill, mental health training for Agric Extension Workers who have contact with mentally ill workers on farms, and policy and human rights training for security officers in the Ghana Armed Forces, Ghana Police Service, Ghana Immigration Service, Ghana Prisons Service, Customs Excise and Preventive Services, Ghana National Fire Service, City Guards Unit of the Tamale Metropolitan Assembly Task Force, and Bilchinsi Taskforce. A quiz competition with questions on various aspects of mental illness also took place between four Junior High Schools in Tamale and was broadcast on the radio. In addition, BasicNeeds Ghana conducted research on mental health financing, lobbied Ghana’s Parliament to promote a speedy passage of the Mental Health Bill, and helped build a multipurpose psychiatric facility in the Upper West regional capital, Wa, with the help of Ghana Health Services and three other charities. The past ten years have seen the most significant increase in awareness of mental illnesses, which Mind Freedom attributes to the birth of mental health NGOs. The first street march Mind Freedom organized in 2006 presented neatly dressed, seemingly normal mentally ill patients and survivors, which subsequently shocked citizens and helped bring media attention to the plight of the mentally ill. When the executives were younger, mental illness was not talked about and one of the executives mentioned that he fearfully walked on the other side of the street when passing by the psychiatric hospital to avoid the mad people and the evils associated with them.Mind Freedom dreams that Ghana will have mental health care as reliable as in the West in regards to human rights, access to treatment, and access to medication. They want everyone to know that anybody can be stricken by a mental illness, and they kept mentioning a proverb: “You shouldn’t wash your dirty linens outdoors, but if you keep them inside, the room will stink. By this they meant that families should not keep their disabled ones hidden in a room but should bring them out and not be ashamed of them. Like in most developing countries, access to mental health in Ghana, where schizophrenia, depression, alcohol and cannabis abuse, and epilepsy are the most common diagnoses, remains low because of the limited number of treatment centres and the high mental patient to mental doctor ratio. Due to the discriminatory stigma, the low fatality of mental illness, and the alleged significance or discrepancy of physical health over mental health, the government in Ghana holds mental illness as a very low priority even though it is a leading component of the global burden of disease. The lack of priority lead to insufficient funding and outdated mental health policies which in turn caused a severe lack of mental health personnel and incentives to gain personnel, low employee morale, shortages of psychotropic medicine, human rights violations, congestion of institutionalized hospitals, poor condition of decaying facilities and inadequate equipment, lack of community care, lack of preventative and rehabilitative services, absence of research-based evidence, and the lack of an aggressive education and awareness campaign. All of these challenges need to be addressed in order to decrease the number of relapses and increase prevention and the rate of recover but unfortunately mental health professionals are often too busy to lobby for the implementation of change. Most importantly the psychiatric hospitals need to be decongested, the mental health staff strength needs to increase, community care and rehabilitation needs to be emphasized, and the Mental Health Bill needs to be passed.