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Health News of Thursday, 7 September 2017

Source: Mark Boye

Inside Accra Psychiatric Hospital: The good, the bad, the ugly!

Some patients of the Accra Psychiatric Hospital.

Located in the heart of Ghana’s capital, the Accra Psychiatric Hospital, is everything but modern. A first-time visitor may mistake the facility for a prison or concentration camp rather than a mental hospital supposed to heal people from all the stress- related diseases and other forms of mental illnesses.

In 1906, when the British colonial government built the facility, its life-span was supposed to be about 50 years, but more than 100 years down the line, the facility, with an estimated capacity for 800 patients, is crying for help, as it has dilapidated to such an extent that its structures are nothing but a time-bomb.

This is the Accra Psychiatric Hospital for you - the premier mental health facility and one of three such hospitals in the country, which serves as a referral center for patients in Ghana and some other West African countries.

The other two are the Ankaful Psychiatric Hospital, built in 1965, located along the coast in the Central Region of Ghana with a capacity for 500 patients and the Pantang Hospital, which opened in 1975, also with a capacity for 500.

A recent visit to the Accra Psychiatric Hospital by this reporter revealed the gloomy picture of the hospital and further exposed the difficulties which personnel and patients go through. One of the hospital staff could not help describing the facility as a ‘time bomb’ which can explode any moment soon.

Sad Picture

The least said about the unhealthy conditions in some of the geriatric wards the better, as the rooms appear like prison cells with poor ventilation. The wirings in the various departments hang loosely; some of the roofs leak; the window nets have torn, allowing mosquitoes to feed on the hapless patients, while the walls appear not to have seen paint since the facility was constructed over a century ago. To add more insult to injury, the toilet facilities have broken down, with the bath water gushing out anytime a patient takes a bath. This notwithstanding, some corporate and religious organizations from time to time troop in to donate items, such as clothes, toiletries, mattresses, bed sheets and food items. Some of the organizations also adopt the wards and try to rehabilitate them. But the generosity of these organizations is like a drop in the ocean, as the enormity of the challenges needs not to be over-emphasized. The hospital definitely needs governmental intervention.

Ordeal of a patient

According to Eunice Plaha, a 40-year-old mother of five, who resides at Ablekuma, a suburb of Accra, her stay at the Accra Psychiatric Hospital has been a nightmare. She narrated to this reporter how, apart from the appalling conditions at the wards, mosquitoes have become another pain in their neck. She said mosquitoes continue to bite them every night and to add to their predicament, the rooms are also very hot, owing to a lack of ventilation. Life at the facility is not a good experience, she lamented. “Mosquitoes bite us a lot, and when we complain they give us anti-psychotic medicines, meanwhile the mosquitoes are also giving us malaria,” Eunice noted.

Asked whether the authorities don’t spray the wards with mosquito sprays, Eunice reacted that they do from time to time, but because of the torn nets the mosquitoes do have a field’s day. “In the evenings, the mosquitoes bite us, I urge the authorities to do something about it for us. We also suffer from the heat due to poor ventilation and when they close the doors, they don’t open it on time,” she said, sobbing.

Eunice, who claimed she has been at the facility for close to a month, called on the authorities to release her since she is now fine.

Asked why she was sent to the facility in the first place, she said, “I pulled a knife on my mother asking her of the whereabouts of my father. I didn’t mean to hurt her, I was only threatening her but I was dragged here.”

We need support

Francisca Ntow, a psychiatric nurse and member of the Public Relations team of the hospital, told this reporter that government must intervene and give the hospital a facelift. “The main problem of the hospital is structural, the infrastructure is bad, and when you enter the wards they look like prisons. No human being would feel comfortable living in such a condition.”

She continued, “We have broken ceilings, broken roofing, the dormitories are very hot, but we have no option. That is why most patients when they are brought in here, some of them don’t want to stay; they run away, they find their way out.”

The hospital, which is supposed to enjoy full governmental support, lacks timely governmental subventions, even though the Mental Health Act has been passed in 2012 to ensure massive support for mental care in the country.

“Over the ten years that I have worked here, I have not seen consistent flow of funds,” Ms. Ntow said, adding “Last year, we ran into a loss. Suppliers of the hospital decided to stop supplying us because we owe them a huge bill.”

According to her, they have to go to corporate institutions to beg for support, pointing out that, even though the Mental Health Act is supposed to make mental healthcare in the country free, the reverse is rather the case.

“These patients had once paid tax, so if treatment of mental health is supposed to be free, then it’s the duty of the government to go for funding to take care of these patients,” Ms. Ntow fumed, pointing her fingers at me.

She noted that even though there is a Mental Health Authority and a Board in place, as enshrined by the Mental Health Act, yet because there is no Legislative Instrument (LI), the Act has become like a toothless bulldog. She challenged the government to back the law with the LI to enable mental health to enjoy the necessary support it deserves.

“This would save us the ordeal of shortage of funding forcing nurses to go on strike. Nurses go on strike not because of their salaries but for the appalling conditions that they work in and the patients that they care for,” she stated, pointing out that patients have to buy their own medications some of which are very expensive because the hospital doesn’t have them.

Personnel not enough

Touching on personnel, Ms. Ntow lamented that it is another major concern, saying that, the facility does not have a resident psychologist. According to her, their prescribers and doctors are all not enough to cater for the large number of patients that troop in for care every day.

She attributed the situation partly to the low morale at the facility, pointing out that when some personnel come to work at the place they vacate post after a few months of working.

“This is because the place is not encouraging. You come to work and sometimes the meager salary you get, you have to use it to buy some medication for a patient, you have to buy some toiletries and you can’t ignore it too,” Ms Ntow lamented.

Call on government

Ms. Ntow made a passionate appeal to the government to ensure the LI is in place to make mental health care delivery operational, accessible and affordable. It is estimated that about 2.3 million people out of the population of about 26 to 28 million Ghanaians are suffering from one mental challenge or the other.

With the top 10 mental illnesses being Schizophrenia, Substance Abuse, Depression, Hypomania, Acute organic brain syndrome, Manic Depressive Psychosis, Schizo-Affective Psychosis, Alcohol Dependency Syndrome, Epilepsy and Dementia, the need for mental health support has become more urgent than ever before. According to Ms. Ntow, government has no excuse whatsoever not to support mental health, saying “the current government made electoral promises regarding mental health; I want to remind them that they should make good on their promises.

This story was made possible by courtesy of the Bill and Melinda Gates Foundation.