“I just saw people come in and out and a particular day a crowd of people from the neighbourhood and strangers gathered in our house. It was that morning of the gathering that I was given a newly sewed cloth (wax print) to wear and then told that my daughter was going to be married off. I didn’t find it respectful that there was Amariya (Muslim wedding) that I was not told about till that day, but I didn’t talk as I could be accused of exhibiting symptoms of my condition. I am happy my daughter married but I was disrespected because of my mental illness (Aishetu Zakali)”.
This narration of a 48-year-old lady with lived experience of mental ill-health is what justifies the 2023 theme of the World Health Organisation’s World Mental Health Day, which is marked on October 10, each year. Indeed, mental health is a human right. This can be argued and justified in many respects as contained in the United Nations (UN) Universal Declaration of Human Rights, the several UN Conventions, particularly, the Convention on the Rights of Persons with Disability (CRPD). Ghana’s own constitution, along with such legislations as the Mental Health Law (Act 846, 2012), and the Disability Law (Act 715, 2007) attest to the need to recognise, respect, protect and uphold the rights of person living with mental ill-health conditions and to support all with mental health care needs to realise them.
There is no doubt that over the last two decades efforts have more than doubled to address the mental health and human rights of people living with mental ill-health conditions, including caregivers and family members and relatives affected by the mental healthcare needs of those their relations. The efforts have focused on several areas but mainly to realise health rights, rights to social welfare/ social protection, including housing, employment and education and participation. Ghana has not been left out of efforts to enable people affected my mental ill-health conditions to enjoy their rights.
A number of non-governmental organisations (NGOs)/ civil society organisations (CSOs) has actively complemented government efforts, and many ways, led initiatives meant to enhance mental health and wellbeing. BasicNeeds-Ghana is one such entity that have provided assistance to actualise the human rights of people living mental ill-health conditions.
Since 2004, BasicNeeds-Ghana (BNGh), through its New Initiatives in Mental Health and Development, and later programmes, (with two enhanced five-year country strategic plans), have worked to ensure that people with mental health conditions attain good level of health and wellbeing. Regarding health rights, BNGh promoted clinical treatment for people’s mental illnesses. Psychiatrists, Physician Assistants in psychiatry, as well as senior and experienced Community Psychiatric Nurses (CPNs) and Community Mental Health Officers have led teams to locations to screen and diagnose for mental illness and provide treatment. Follow-ups through health workers and community volunteer home visits help to track and ensure prescriptions are adhered to and side-effects, defaults and relapse promptly addressed. This initiative has ensured that people with mental healthcare needs access treatment within proximity of their communities and families. These treatment outreaches have reached the remotest and hard-to-reach rural communities and some deprived urban locations. Altogether, a total of 40,510 (female 28,200 female) have been provided medical treatment through this initiative. The clinical treatment services have been complemented by psychosocial initiatives where Self- Help peer support Group (SHGs) have been found to serve as avenue for peer and emotional support. This non-drug therapy has proven as helpful not just on medical and health groups but as a promoting social cohesion, from the comradeship that emerges from among members, enhanced by the WHO Quality Rights initiative.
People with mental ill-health conditions have a right to employment and source of income. BNGh has worked to actualise this by an active support to vocational and technical skills training of people with mental ill-health conditions, especially those stabilised from their conditions as a result of treatment and other psychosocial therapies that have accessed. Beneficiaries have acquired skills in hairdressing and barbering, masonry and carpentry, gardening and farming, and petty trading. Several people with lived experience of school-going age have been assisted with uniforms and other learning materials to enable to (re-) enrol and stay in school. This has helped address the right of persons with lived experience of mental realise their right to socio-economic rights by the modest but vital interventions of BasicNeeds-Ghana.
The organisation, similarly, has implemented actions that have contributed to enabling participation and decision-making processes at the family and community level(s). Fostering inclusion and participation have been through the SHGs, and an active public awareness and stigma reduction sensitisation drives. Poor public awareness, inadequate community understanding, and low family care and support have been challenged and addressed through drama and songs, jingles, posters, and related infomercials, all aimed to engender a supportive environment that fosters participation and inclusion of people living with mental ill-health conditions. Most of these activities, interspersed with lived experiences of individuals, have helped to inspire the individuals themselves and their families and relations. BNGh has facilitated reunification of people who were abandoned by their families due to their mental ill-health with their families, supporting their resettlement and continued rehabilitation, including having review visits to mental health units for refill of their medications and other services.
These are but a few of the interventions of BasicNeeds-Ghana that amply demonstrate that mental health is a human right worth being pursued and realised. This is particularly so as mental health is yet to gain its rightful place in the scheme of global and national priorities. Ghana has ticked the right boxes when it comes to legislation(s) and policies on mental health, disability and human rights. What is most needed is adequate funding. The UN High Level Meeting on Universal Health Coverage (UHC) highlights the need for a focus on mental health as countries reinvigorate efforts to achieving the ambition. This is the time for Ghana to stand up and be counted. Civil society organisations in Ghana, such as BasicNeeds-Ghana have shown the way. Government of Ghana needs to maximise these best practices and ensure mental health is really a human right.
BY PETER BADIMAK YARO
