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Opinions of Monday, 4 July 2011

Columnist: Agyapong & Mantey

Open letter to the President

Open letter to the President of the Republic of Ghana, His Excellency Professor John Evans Atta Mills


Re: Urgent appeal for the passage of Ghana’s Mental Health Bill


Your Excellency,

We trust that this letter finds you in good health.

We would like to appeal to your good office to advocate for the immediate passage of the Mental Health Bill into law by the Parliament of the Republic of Ghana.

Mr President, it is not a secret that despite the fact that one in four Ghanaians suffer from some form of mental health difficulties, mental health care in Ghana has not been given the needed priority.

The World Health Organisation defines health as a state of complete physical, mental and social wellbeing. Unfortunately, in Ghana, successive Governments have laid less emphasis the mental wellbeing of Ghanaians.

Mr President, on your assumption of office in January 2009, you pledged to ‘be a father for all Ghanaians’, which is highly commendable. Unfortunately, Ghana’s capital cities continue to be shamed by the presence of neglected mentally ill persons, often left stranded, unfed and unclothed.

Clearly, no father would expose his children to such inhuman conditions and we trust that these unfortunate Ghanaians also count as your children. We commend you on your unannounced visit to the Accra Psychiatric Hospital almost a year ago. We feel the visit was very timely and appropriate and highlighted the urgent need for reform of mental health service delivery in Ghana. We would like you to follow this significant gesture with an enthusiastic support for the passage of the mental health bill.

Serious under-investment in mental health care, coupled with a seemingly lack of political will to modernise the sector has created a situation where the critical mass of Ghanaians with mental health challenges continue to be left at the precarious mercy of charlatans who exploit, harass and endanger their rights to health.

Many Ghanaians with mental health difficulties also face discrimination on many fronts, including refusal of admission to varied training institutions, refusal of employment rights, even deprivance of their rights to exercise universal suffrage.

Your Excellency, as you are aware, the shortage of trained staff in the field of mental health in Ghana can be blamed partly on the relatively poor morale of staff working in the sector. The truth is that poor remuneration and the stigma attached to mental health professions in Ghana contribute significantly to this sorry state of affairs.








This has put strain on the growth and interest in mental health related professions in the country, which has led to a situation where many psychiatrists working abroad have been unwilling to return to Ghana to work or contribute in any meaningful way to nation building.

In contrast, in more developed health system such as the U.K and Ireland, people working in mental health are very well motivated and respected by all sections of the society including the national Governments. In addition the Governments prioritise the needs of people with mental health difficulties. We dare compare Ghana with these countries because we are confident in the human and material resourcefulness within our dear country and our potential as a people to achieve a feat of greatness.

Ghana is in urgent need of a multidisciplinary approach to the management of patients with mental health difficulties in order to assert the countries rise as a place for social justice and fairness for all its citizens.

Mr President, psychosocial stressors, including poverty and family pressures account for a significant proportion of mental health disorders including depression, anxiety disorders and alcohol/drug abuse. This suggests that these conditions may be more prevalent in Ghana than in the U.K and Ireland. Sadly, these conditions are largely under reported and under treated because of the poor mental health infrastructure in the country, leading to lost productivity of the Ghanaian citizenry.

We have chosen to believe as Pope John Paul II did before us, that “a society will be judged by how it treats it weakest members”. Consequently, we believe that Ghana cannot achieve a middle income status except adequate provision is made to look after its most vulnerable citizens; those with severe and enduring mental health difficulties. Again the government needs to create an enabling environment and provide attractive incentives to attract and retain mental health professionals from both home and abroad.

Passage of the bill would serve many useful purposes including but not limited to: guaranteeing that the fundamental human rights of patients are respected and protected, ensuring that mental health services are adequately and appropriately staffed and resourced, attracting trained Ghanaian mental health professionals from abroad, creating an enabling environment in which mental disorders would be recognised early and treated and more importantly eliminate the phenomenon of mentally challenged patients roaming the streets of major cities.

Mr President, members of Association of Ghanaian professional in Ireland (AGPI) have not just been passive or even critical observers of the deplorable state of mental health care delivery in Ghana. In our own modest way, AGPI have begun to mobilise and create awareness and to bring about positive change in the mental health system in Ghana. We are aware that the issue at stake requires shared responsibility with the need for all stakeholders to come together and play a role. As a beginning of our crusade to campaign for improved mental health care in our dear nation, in collaboration with the Chief Psychiatrists, the Ghana College of Physicians and Surgeons , the Ghana Medical Association, and our partner institutions in Dublin, last year, we launched the maiden inter-medical school public speaking competition to promote psychiatry as a fulfilling career option for Ghanaian medical students.


All the four medical students from the University of Ghana Medical School and School of Medical Sciences in KNUST who participated in the debate have recently undertaken a four week sponsored elective placement in psychiatry at the St John of God Hospital and St Patrick’s University Hospital. This initiative would be an annual affair and would be only one of several initiatives that we believe are required to transform mental health delivery in Ghana. Please read more of how the AGPI is contributing from www.agpireland.org.

It is against this backdrop that we are appealing to you to facilitate the passage of this importance legislation in order to help improve upon mental health care delivery in contemporary Ghana.

Your Excellency, we stand at a sea change of our countries history and we believe that the mental health bill presents a seminal moment in your presidency- the sort of moments where leaders are reborn- where politicians become statesmen- where statesmen become fathers of a nation. History would judge your tenure of office as the President who either championed and supported the passage of a humanitarian law or as one who stood at the corner of history. Supporting the passage of the bill would give true meaning to your leadership and send a powerful message across this nation that the rights of the most vulnerable citizens of our dear country has finally been recognised and Ghana is ready to lead Africa again.

We trust that our appeal would be received most favourably and with the urgency that it deserves.

Thank you very much.

Yours truly


Dr Vincent Agyapong
• Chairperson of AGPI
• Clinical Lecturer, Department of Psychiatry, University of Dublin, Trinity College & St Patrick’s University Hospital
• Visiting Lecturer, School of Medical Sciences, KNUST, Kumasi

&

Mr Mark Mantey
• Director of Policy and Strategic Planning of AGPI
• PhD candidate, University of Limerick