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from Africa
Published online by Cambridge University Press: 02 January 2018
Ghana is a West African state that attained independence from Great Britain in 1957 and became a republican state in 1960. Its population is about 22 million (2004 estimate), distributed in ten regions. The World Health Organization (WHO) has estimated that 650 000 of the population are suffering from severe mental disorder and 2 166 000 are suffering from moderate to mild mental disorder (see http://www.who.int/mental_health/ policy/country/ghana/en).
Mental health activities started with the enactment of the Lunatic Asylum Ordinance in 1888 by the colonial government of the Gold Coast (as Ghana was then known). The ordinance allowed law-enforcement agencies to arrest people suspected of having a mental illness (at least those who were roaming about in towns, villages or the bush) to be confined in an abandoned prison in Accra. That facility soon became overcrowded, necessitating the provision of the Lunatic Asylum in 1906. The Asylum eventually became Accra Psychiatric Hospital (Ewusi-Mensah, 2001). Two other purpose-built psychiatric hospitals, the Ankaful Psychiatric Hospital and Pantang Hospital, were opened in 1965 and 1975, respectively. The first President of Ghana had a vision of making Pantang a pan-African mental health village for research into neuropsychiatric conditions but his vision was not realised before his overthrow in 1966.
Mental health policy and legislation
Ghana's mental health policy was formulated in 1994, and revised in 2000 and 2004. The policy objective is to provide facilities at the tertiary, regional, district and sub-district levels for the management of psychiatric cases. In pursuit of this, each regional hospital is meant to have a psychiatric wing with 10–20 beds.
The policy of the Ministry of Health is to shift the focus of mental health treatment from institutionalised care to community care, integrated into general healthcare (according to the draft Mental Health Bill 2010). Decentralisation of mental health services has been pursued with the aim of increasing access, which has involved training more psychiatric nurses, medical officers in the district hospitals and non-mental health personnel. Ten general duty doctors were trained to head the regional wings, but only three of them could be engaged in the regions, while the others have augmented the staff at the specialist hospitals.
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