Ghana deserves a better mental health law. (Mirror)

Jan. 23, 2010

WHEN the death of Georgina Akweley Pipson and her five children hit the airwaves, my mind quickly went to the former Chief Psychiatrist, Dr J.B. Asare, the current one, Dr Akwasi Osei and also Mrs Estelle Matilda Appiah, Director of Legislative Drafting at the Ministry of Justice as well as the many other personalities who have over the years tried so hard to get a better mental health law for Ghana.
Knowing how passionate these individuals are in their quest to get better mental health care for Ghana, I knew for sure that they will definitely feel let down by the death of six vulnerable people within hours. Yes, they were all vulnerable because the mother was sick and could not reason properly and the children, as innocent as they were, accepted what their mother offered them though it was deadly.
Like other developing countries, many mentally ill people in Ghana are sent to pastors at prayer camps or traditional healers for treatment instead of hospitals, where the right diagnoses and treatment could be provided. There is also the issue of a lack of adequate care even if one is sent to the hospital.
That can be said because of the fact that currently Ghana’s state of the psychiatric services is said to be comprised of only 1500 beds for admissions in the three public mental hospitals situated in Accra, Pantang and Ankaful, all along the coast. There are also about 40 beds available in regional hospitals and some private clinics nationwide.
Another important issue is that currently, there are less than 10 psychiatrists working for the state for more than 22 million people, whereas, in the United States of America and the United Kingdom, more than 7000 psychiatrists are available for the same population size.
The number of psychiatric nurses provide services to the mentally ill are also nothing to write home about.
To protect the mentally ill against human rights abuses and to improve state services, Ghanaian health professional and advisors have drafted a new Mental Health Bill to replace an outmoded one. The bill, when passed is expected to regulate the treatment of mental illness even by traditionalists and also vastly improve the public psychiatric services.
In spite of its good intentions which it is said to have been commended by the World Health Organisation (WHO), the Mental Health Bill which started in 2006, has been severely held up. Officials of the Accra Psychiatric Hospital say the bill has seen 10 different drafts since the drafters began to work on it.
As a nation, we have over the years toyed with our mental health services. There have been instances where people who are mentally ill and need our support have been left uncared for to the extent of harming themselves or others. It is a fact that we will need some more funds to be able to implement what the bill contains, but we at least need to start from somewhere so as to save ourselves from the effects of mental illness.
A typical case was when we woke up on January 21, 2010 to hear the story of five children, suspected to have been killed through poisoning at Nyanyano in the Central Region by their own mother, Georgina Akweley Pipson who was an alleged mental patient.
The bodies of the murdered children, Kwaku Osae Asante, 11, Yaw Ofori Asante, nine, Angel Asante, six, Kofi Asante, four, and Esi, one, were deposited at the Police Hospital morgue in Accra and later buried.
The question is, could we as a people have saved Georgina and her five children if we had had a better mental law? The answer is yes.
The new Mental Health Bill, as it stands now, seeks to improve the care of the mentally ill in the country. It will also address human rights abuses suffered by those who have mentally ill patients under their care. The bill addresses decentralisation of mental health care at the community, spiritual and traditional setting and also allows supervision and revision of mental health care practices.
On a number of occasions that I have listened to Dr Akwasi Osei, he had repeated that between 30 to 40 per cent of the population of a country suffered from various forms of mental illness, a situation Ghana could not run away from.
Dr Osei explained that people tended to ignore issues of mental health because they always associated it with those who suffered the severest form of the illness and ignored the commonest ones such as depression and dementia ( disorder impairing a person’s capacity to function normally and safely), which affect many people.
At an advocacy training programme for journalists in Accra late last year, Dr Osei reiterated an earlier call on people in position to effect changes in mental health care since the general public stands to gain when there are better services. The care, which if had been in place, could have protected Georgina and her five children.
That, according to the Chief Psychiatrist, was necessary since mental health was no respector of persons, but could affect any one at a point in his or her lifetime.That, to him, is the reason why Ghana needs better laws to regulate mental health care.
When the new Mental Health Bill is passed, Ghana will have Mental Health Authority under a Mental Health Service, which will be separate from the Ghana Health Service (GHS) and that will also ensure that adequate logistics are provided for better health services. There would be a Mental Health Review Tribunal to rule on abuse of rights of mental patients. There will be Visiting Committees to ensure the right things are being done for mental patients as well as availability of Voluntary Treatment and Involuntary Treatment to take care of people with mental illness.
Other conditions under the bill are rights of persons with mental disorder, protection of vulnerable groups who suffer from mental illness and any other condition which the law would prescribe.
Unlike other existing laws on mental health care, the new law will provide for adequate human rights provision, basic human rights, incapacity and human rights, standard of treatment, seclusion and restraint, complaints and treatment management, confidentiality, privacy and autonomy as well as access to information and employment rights.
The bill was sent to the Ministry of Health as far back as 2006. It is now left for it to be sent to Cabinet and then to Parliament for consideration.
According to Dr Osei, although Georgina was given adequate care at the Psychiatric Hospital when she was admitted on three occasions, lack of enough community psychiatric nurses in the country and the breakdown of family support systems, coupled with a lack of a Mental Health Law were contributory factors that led to the unfortunate incident at Nyanyano.
Mental illness is estimated to become the second largest non-communicable disease in the world by 2010, with as many as 154 million people suffering from depression and 121 million suffering from anxiety and stress-related problems around the world, according to statistics of World Health Organisation (WHO).
According to the world body, although mental and behavioural disorders are estimated to be 12 per cent of the global burden disease, majority of countries including Ghana have mental health budgets which constitute less than one per cent of total health expenditure.
So now Georgina is dead and gone, but there are lot more Georginas in our cities, towns, villages and homes who need care but have been ignored because there are no laws to ensure their adequate treatment and survival.