QUALITYRIGHTS…A WHO approach to curbing abuses in the Care of Persons with Psychosocial, Cognitive and Intellectual disability in Ghana

The Human Rights Watch in 2012 released an incriminatory report that found that persons with mental illnesses in Ghana experiencea range of human rights abuses in mental health facilities and traditional and faithbased healing centres across the country.

These abuses are taking place despite the fact that Ghana has ratified a number of international human rights treaties, including the Convention on the Rights of Persons with Disabilities (CRPD).

The abuses range from the denial of food and medicine, inadequate shelter, involuntary medical treatment, and physical abuse amounting to cruel, inhuman and degrading treatment as well as neglect.

Also incriminating was the fact that only few government-supported community-based mental health services, including housing, employment, healthcare and medical care existed in the country.

A good number of service users interviewed by Human Rights Watch within the period indicated that their preference on treatment was more towards visiting on an outpatient basis while living with their families.

Towards improving mental health service delivery in Ghana

The Ghanaian society and successive governments in Ghana have in recent years taken some steps to improve the care of people with mental disabilities. One major step was the passage of the Mental Health Act in June 2012.

For the first time, a legal document of this nature recognized the absolute need to respect the rights and privacy of persons with mental illnesses and laid out a clear procedure for persons with mental disabilities to challenge continued unwarranted detention.

As a result, a conscious attempt was made to reduce overcrowding in state psychiatric facilities. Efforts to regulate traditional health practices that are based on theories, beliefs, and experiences indigenous to different cultures have culminated in the enactment of the Traditional and Alternative Medicine Act.

Having ratified several international conventions such as the Commission for the Rights of Persons CRPD and the Universal Declaration of Human Rights (UDHR), Ghana is obligated to respect the rights of persons with disabilities under these international and regional legal instruments.

It is, however, bound to do same under the national constitution and other local legislation. Despite these legal provisions, Ghana has done little to ensure that protections for persons with mental disabilities are in place and enforced.

Persons with mental illnesses in Ghana still suffer various forms of abuses in their homes, work places and care facilities. These abuses include stigma and discrimination; lock up, chaining, denial of food and adequate health care, physical and verbal abuse, overcrowding, poor hygiene, involuntary admission, prolonged detention and other forms of violations as well as neglect.

Dealing with abuses against persons with mental illnesses

As part of its recommendations to deal with the various forms of abuses against persons with mental illnesses, the Human Rights Watch report sanctioned that steps are taken to immediately address issues relating to the provision of some basic needs such as acceptable food, shelter and health care for persons with mental disabilities.

It also recommended civil and criminal penalties for abusive practices such as chaining, starvation in the form of fasting, prolonged seclusion, and other forms of cruel and degrading treatment in hospitals and prayer camps.

QualityRights to the rescue

It is towards curbing these injustices and abuses to persons with mental disabilities in Ghana and several countries of the world that the World Health Organization conceptualized the WHO QualityRights initiative.

The initiative is set towards instituting respect for persons with mental disabilities in an attempt to ensure speedy recovery in a client-led recovery approach.

QualityRights aims to empower individuals and organizations for persons with disabilities to know their human rights and to advocate for change to enable people to live independently in the community and receive appropriate supports.

The initiative seeks to promote rights that are often denied to people with mental and intellectual disabilities, including the right to access appropriate mental health services in the community, the right to choose, the right to have a family life, the right to live in the community and the right to be active citizens.

QualityRights therefore presents a valuable contribution to our collective efforts to shape and influence policies and practice of mental health care, which in essence will enable everyone to be included in their communities.

The initiative presents a paradigm shift in the provision of tools and strategies for mental health care with the highest standards of respect for human rights.

It appraises dignity and well-being as closely related concepts and outlines an interdisciplinary and holistic outlook in which subjective discomfort is addressed without undermining the dignity and ability of the person to make decisions, even in critical situations.

This, according to QualityRights should be the foundation on which new mental health care models are constructed, respecting the principles of the CRPD.

By Cliff Ekuful