By Freda Twumasi Padilla
Every change of government in Ghana comes with promises for the health sector. At the end of each tenure, the national budget is presented, detailing the national debt, funds allocated to state institutions, and various sectors of the country.
Yet, one sector remains silent, buried under cultural stigma and a lack of awareness, with little to no light shed on it since the colonial era: mental health. It is one of Ghana’s most misunderstood and neglected sectors, one that could not only unlock solutions to many of the country’s social problems but also open a doorway to the nation’s burgeoning insurance industry.
From the inception of the Lunatic Asylum Ordinance in 1888 by colonial rulers to the establishment of the three current state psychiatric hospitals, Ghana’s mental health sector has been marked by instability and a constant fight for relevance. Mental health is often seen as taboo, especially in rural areas where awareness is low.
Cases of human rights abuse, violence, and social stigma have effectively erased it from public discourse. Even within our health institutions, the state of mental health facilities and services is appalling, which discourages new graduates each year from pursuing it as a career.
Due to low morale and widespread dissatisfaction, the Mental Health Act of 2012 proposed a service separate from the Ghana Health Service, yet this separation has not been implemented. The Chief Psychiatrist serves as the national head, responsible for organizing services and advising the Minister of Health.
The system comprises three state psychiatric hospitals, community psychiatric nursing services, and regional and district health administrations. The central issue is that most of these facilities are outdated, congested, and critically under-resourced. A lack of coordination, logistics, and procurement hinders their ability to administer proper care, and the Mental Health Unit within the Institutional Care Division requires urgent revision to align with global trends and WHO standards.
One of the most unsettling aspects is the profound cultural and social stigma that individuals with mental disorders face, not only from family and friends but even from educated professionals. This reveals how unsafe it is for someone to seek treatment and underscores a critical lack of empathy. For too long, people have turned to religious or traditional leaders for help, primarily because the government and state institutions have failed to establish adequate mental health tribunals and advocacy systems.
NGOs like Help Law Ghana and the Human Rights Advocacy Centre, which have championed these rights, have been notably quiet recently. Furthermore, there is a lack of mental health training for legal professionals, no actuarial models to properly assess risk for insurance coverage, and no inclusion of mental health disorders in standard health insurance policies. Problematically, these disorders are often criminalized under the outdated Criminal Code of 1960, which urgently needs amendment.
The financial challenges facing this sector cannot be overstated. It receives only 1.4% of the total government health expenditure, and the doctor-to-patient ratio is an overwhelming 1 to 10,000. For instance, the psychiatry unit at Komfo Anokye Teaching Hospital, a referral center for seven regions, has just twelve beds in total.
Consequently, many patients are turned away due to lack of space and sent back to underfunded community-based care systems which are ill-equipped to treat complex disorders. In 2007, the WHO reported that 3% of Ghanaians suffer from severe mental health disorders and 13% from moderate to mild disorders. These individuals are valuable human resources who are being failed by the system’s myriad hurdles.
Section 88 of the Mental Health Act states that “mental healthcare is free,” but this is hardly the reality. To give mental healthcare in Ghana the relevance it deserves, we must be willing to put aside stigma, raise awareness, and meet our people with compassion.
We must urgently redefine our policies and strategies to address the issues in this sector once and for all. After all, a society’s true strength is measured by how it cares for its most vulnerable citizens, for we can only possess true power, as individuals and as a nation, when we are of sound mind.
Writer:
Freda Twumasi Padilla is a Level 300 Actuarial Science student at the University of Professional Studies.
