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Opinions of Saturday, 29 October 2016

Columnist: Akatinga, Malcolm

The Ghanaian nurse: Run from danger ....

The Ghanaian Nurse: "Run from Danger", Pass the LI of the Mental Health Law to Save Mental Healthcare from Imminent Danger.


The continuous hue and cry by healthcare providers in the mental healthcare sector especially psychiatric nurses and doctors for help has reached an unbearable tone and if care is not taken by the appropriate authorities to salvage the sinking image of the sector, the imminent danger faces it will be inevitable.

The continuous 'cries' and 'begging' by the three psychiatric hospitals for support to enable them take care of patients has paddled to an alarming rate and can't continue in this trajectory as far as effective and quality healthcare delivery to their patients and clients are concerned.

The three psychiatric hospitals, the only three state owned; Ankaful Psychiatric Hospital, Accra Psychiatric Hospital and Pantang Psychiatric Hospital are not NGOs, and cannot be left to depend heavily on donations for their survival.

It is the responsibility of the government to ensure the sector is adequately resourced and equipped to deliver effective mental healthcare but this is not the case as the current situations depict a gloomy picture for the sector.

It is apparent that government does not have any priority in mental healthcare. And this is an indictment to government' commitment to the health sector as a whole. Mental health is an integral part of general health and neglecting the sector is like rubbing your body with mud after taking a bathe.

Mental healthcare in this country has over the years faced varying degree of challenges ranging from dilapidated buildings, poor working conditions, inadequate staff, lack of basic equipment, shortage of food and drug supply among others. These challenges seem to have no end in sight despite the arrival of the new mental health law, which is thought to be the panacea for the predicaments in the sector.

In 2014, Accra Psychiatric Hospital for instance embarked on a demonstration to protest against lack of psychotropic drugs and basic logistics at the facility. The situation was not different in 2015.

In 2016, the same problem has reared its ugly head again, hitting harder than before. Paramount among these challenges are the unavailability of psychotropic drugs to the treat patients, shortage of food for patients and basic logistics such as gloves, plasters, disinfectants, detergents etc. This situation poses danger to nurses and doctors attending to the patients since psychiatric patients are unpredictable without medication.

Psychotropic drugs are essential in managing aggressive and psychotic patients on the ward. They are used concurrently with psychotherapy in the treatment process. Without the drugs, the acute ward will turn into a jungle because aggressive and deluded patients will have no time for your sermon. Without the drugs, delusional patients may accuse everyone on the ward as the cause of his or her problem. Without the drugs, aggressive patients may turn the ward into a boxing ring and the nurses will bear the consequence.

If a hungry man is an angry man, what about a hungry 'mad man'?

This is the reason why nurses at Accra Psychiatric Hospital after exhausting all avenues to find a lasting solution to the problem bedevilling them, such shortage of drugs and unavailability of basic logistics, have dubbed their impending strike coming Friday 28th October 2016, if the situation is not resolved, as "run from danger". Indeed psychiatric nurses must run from danger when need be. However, psychiatric nurses and all category of nurses place their patients first but must never put their life in danger in situations like this.

The psychiatric nurse work without risk allowance despite the risk they face each day in their line of duty. They are always alert and looking at shoulder level for possible attack by patients on the ward and at the OPD. Female nurses and pregnant women face similar fate. Some nurses have suffered various degree of injuries, dislocations and fractures from patients' attacks and have not received any compensation or allowance to that effect. Therefore, it is not worth it putting your life in danger for the love of the patient when you are not protected.

It is about not only psychiatric nurses and doctors who are in danger but the three psychiatric hospitals as well. If the Legislative Instrument (LI) is not passed and the hospitals continue to lack drugs, food and basic logistics, they will have no option than to suspend admission or discharge the patients prematurely. This will soar the number of patients on the street and the citizens will be in danger.

The LI, which is in the draft state before parliament will spell out a statutory source of funding or funding mechanism for mental healthcare in the country. It is the new dawn expected to change the phase of mental healthcare and see the full implementation of the mental health law. Until then, the status quo of the mental healthcare has little hope of improvement. This is how the chief executive officer of Mental Health Authority, Dr. Akwesi Osei lamented the situation:

"Now we've managed to get through the
first phase of getting the law passed but the law itself requires another law to
fully implement it, and that's the LI, so,
once you have the legislative instrument; that is what prescribes exactly the funding mechanism. Unfortunately, the LI has been drafted, it's ready but it's not being passed. In fact there is one aspect that once we have that aspect cleared in it, then it can be passed and we can begin to get the money to support it – that aspect is the levy and the quantum of levy that will be determined. So either a new levy, mental health levy or part of existing levy and that is in the bosom of the ministry of finance to decide. ... It's
being there for too long, frankly. Until
we have that resolved, this issue will
forever and ever remain".

The three psychiatric hospitals owe their suppliers more than Ghc10 million and Accra Psychiatric Hospital alone spends about Ghc6,000 daily to procure items to run the facility.

The Writer, Malcolm Akatinga is a nurse at Ankaful Psychiatric Hospital, Cape Coast.

His email address is chibaronet@gmail.com.

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: Malcolm Akatinga