Despite the passage of the Mental Health Act (Act 846) to improve mental health care in the Ghana, challenges associated with mental health in the country continue unabated. Last year a strike by nurses at the Accra Psychiatric Hospital due to lack of funding triggered a public uproar. Businessweek’s MARK BOYE recently visited the facility and reports on the current state of affairs.
Located in the heart of Ghana’s capital, the Accra Psychiatric Hospital, is everything but modern. A first time visitor may mistake the facility for a prison or concentration camp rather than a mental hospital supposed to heal people from all the stress related diseases and other forms of mental illnesses.
In 1906 when the British colonial government built the facility, it life span was supposed to be 50 years but more than 100 years down the line, the facility with an estimated capacity for 800 patients is crying for help as it has dilapidated to an extent that, its structures are nothing but a time bomb.
This is the Accra Psychiatric Hospital for you- the premier mental health facility in the country and one of three such hospitals in the country, which serves as a referral center for patients in Ghana and some West African countries.
The other two are the Ankaful Psychiatric Hospital which was built in 1965 and with a capacity for 500 patients is located along the coast in the Central Region of Ghana and the Pantang Hospital on the other hand, was commissioned in 1975 also with a capacity of 500.
Meanwhile it is estimated that about 2.3 million people out of the population of about 26 million Ghanaians are suffering from various mental challenges.
With the top ten mental illnesses being schizophrenia, substance Abuse, depression, hypomania, acute organic brain syndrome, manic depressive psychosis, schizo-affective psychosis, alcohol dependency syndrome, epilepsy and dementia.
A recent visit to the Accra Psychiatric Hospital by this reporter revealed the gloomy picture of the hospital and further exposed the difficulty at which personnel and patients go through. One of the hospital staff could not help but described the facility as a ‘time bomb’ which can explode any moment soon.
The least said about the unhealthy conditions in some of the geriatric wards the better, as the rooms appears like prison cells with poor ventilation. The wirings in the various departments hang loosely, some of the roofs leaks; the window nets have torn allowing mosquitoes to feed on the hapless patients, whiles the walls appears not to have seen paints since the facility was constructed over a century ago. To add more insult to injury, the toilet facilities have broken down with the bathing waters gushing out anytime a patient takes a bath. This notwithstanding, some corporate and religious organizations from time to time troop in to donate items, such as clothing, toiletries, mattresses, bed sheets and food items. Some of the organizations also adopts the wards and tries to rehabilitate them. But the generosity of these organizations is like a drop in the ocean as the enormity of the challenges of the hospital needs a major governmental intervention.
Ordeal of a patient
According to Eunice Plaha, a 40 year old mother of 5, who resides at Ablekuma, a suburb of Accra, her stay at the Accra Psychiatric hospital has been a nightmare. She narrated to this reporter that apart from the appalling conditions of the wards, mosquitoes have become another pain in the neck. She said mosquitoes continue to bite them every night and to add to their predicament, the rooms are also very hot due to lack of ventilation all these making life at the facility a terrible experience. “Mosquitoes bite us a lot and when we complain they give us anti-psychotic medicines, meanwhile the mosquitoes are also giving us malaria”.
Asked whether the authorities don’t spray the wards with mosquito sprays, Eunice reacted that they do from time to time but due to the torn nets the mosquitoes do have field’s day. “In the evenings the mosquitoes bites us, I urge the authorities to do something about it for us. We also suffer from the heat due to poor ventilation and when they close the doors, they don’t open it on time”, she said sobbing.
Eunice who claimed she has been at the facility for close to a month called on the authorities to release her since she is now fine.
Asked why she was sent to the facility in the first place, she said “I pulled a knife on my mother asking her of the whereabouts of my father. I didn’t mean to hurt her, I was only threatening her but I was dragged here”, she recalled.
We need support
Francisca Ntow, a psychiatric nurse and a member of the Public Relations team of the hospital told this reporter that government must intervene and give the hospital a facelift. “The main problem of the hospital is structural, the infrastructure is bad, and when you enter the wards they look like prisoners. No human being would feel comfortable living in such a condition”.
She continued “we have broken ceilings, broken roofing, the dormitories are very hot but we have no option. That is why most patients when they are brought in here, some of them don’t want to stay; they run away they find their way out”.
The hospital which is supposed to enjoy full governmental support lacks timely governmental subventions even though the Mental Health Act has been passed in 2012, to ensure massive support for mental care in the country.
“Over the ten years that I have worked here, I have not seen consistent flow of funds”, Ms. Ntow said, adding “last year we run into a loss. Suppliers of the hospital decided to stop supplying us because we owe them a huge bill” she said.
According to Francisca they have to go to corporate institutions to beg for support, pointing out that, even though the Mental Health Act is supposed to make mental health care in the country free, the reverse is rather the case.
“These patients had once paid tax, so if treatment of mental health is supposed to be free, then it’s the duty of the government to go for funding to take care of these patients”.
Francisca noted that even though there is a Mental Health Authority and a Board in place as enshrined by the Mental Health Act, but because there’s no Legislative Instrument (LI), the Act has become like a toothless bulldog. Francisca challenged the government to back the law with the LI to enable mental health enjoy the necessary support it deserves.
“This would save us the ordeal of shortage of funding forcing nurses to go on strike. Nurses go on strike not because of their salaries but for the appalling conditions that they work in and the patients that they care for”, she stated, adding patients have to buy their own medications some of which are very expensive because the hospital don’t have.
Personnel not enough
Touching on personnel, Francisca lamented that it’s another major concern, pointing out that, the facility doesn’t have a resident psychologist, saying their prescribers and doctors are all not enough to cater for the volumes of patients that troops in for care every day.
She attributed the situation partly to the low working morale of the facility, saying when some personnel come to work at the place they vacate post after few months of working.
“This is because the place is not encouraging. You come to work and sometimes the meager salary you get, you have to use it to buy some medication to a patient, you have to buy some toiletries and you can’t ignore it too”, Francisca fumed.
Call on government
Francisca made a passionate appeal to the government to ensure the LI is in place to make mental health care delivery easy, accessible and affordable. “The current government made electoral promises regarding mental health; I want to remind them that they should make good their promises. They must be committed to mental health”, she appealed.
One question this reporter continues to ask himself whiles leaving the precincts of the hospital is-how can Ghana develop with a sound human resource when our mental health care is so poor?