The Humans who have no Human Rights: Inside the horror-filled world of mentally ill persons excluded from cure

The chronicles highlight untold tragedies involving mentally ill persons in Ghana.

There is an unmarked grave at Zorkor, a rural community that lies to the west of Bongo, a district in Ghana’s Upper East Region.

Inside that grave rest the mortal remains of a widow, Atampoka Akagiire, who was attacked and gruesomely killed by her mentally ill son, Kingsford, on Friday, 5 February 2016.

The tragedy struck unexpectedly around midnight, four years after Ghana passed the Mental Health Act to protect the rights of persons with mental disorders.

“The last thing our mother heard on earth was her own scream during the gory midnight attack,” one of the widow’s sons, Clement, told the author of this story at his mother’s graveside.

Clement Akagiire stands in front of his mother’s grave at Zorkor.

Natives of the community believe the bloody attack was foretold inside the community’s main market a few hours before it happened.

Three elderly men were in the market prior to that moment. They ran their own separate shops there and had stayed back for an emergency meeting after the day’s trading.  

As their conversation dragged dangerously late into the night, one of them checked for time on the screen of his mobile phone.

“Sanga la de la 11:32,” he announced the time in Gurune, the language spoken by the Frafras in the region.

The discussion ended abruptly. They remembered that travelling back home through the dark could expose them to an attack from road bandits who often ambushed traders particularly on market days. They also remembered that they had a long journey ahead through lonely roads that had no streetlights.

A Google map showing the Zorkor Market

They rose from a flat rock, where they were sitting together, and shut their shops at a quick pace to leave the market at once. As they were strapping their sacks to their donkey-drawn carts, they heard the cry of viinsilensi’o, a bird whose cry is believed among the Frafras to foretell death.

Many of the believers have never seen the bird in the region but they have heard its kii-yoo cry— a sound it repeatedly utters mostly from treetops at night. 

‘Ki yoo’ in Gurune means ‘dig a grave’. Some of the natives call the bird Akiyoo, a colloquial name coined from its kii-yoo sound.

Brave hunters who claim they have sighted the bird deep in the forests say it looks more frightening than an owl and it often places both wings on its head while crying and walking about in the jungle on both feet like a human.

A road to the Zorkor Market.

And whenever its sound is heard in communities, people who consider it an evil bird generally respond by firing stones at it from catapults. It goes quiet when a stone is thrown in its direction. But when the stone misses it, it continues to cry.

One of the three tradesmen in the market reached for a catapult, which he carries mostly at night, and launched a stone from it with wrath into the branches of a baobab tree, where they suspected the bird was. He missed. And the cry continued.

After another unsuccessful attempt by another man, who grabbed a heavy stone nearby and tossed it with a bare hand like a shot-put throw, they ignored the bird and focused on their journey home.

As their overburdened donkeys pulled the carts cumbersomely through bumpy roads in the dark, the men pondered over the ill omen. And their silent fear gained more weight when they looked up at the sky in motion and the bleak face of the full moon, flanked by a rare forked lightning at intervals, struck them like a crystal ball showing in advance an ominous picture akin to the future the earlier cry of the frightening bird had captured.    

A midnight attack and running footprints of blood

About two kilometres from that market stood a mud house occupied by the widow and her seven children.

The dry-season heat in northern Ghana, which usually reaches its highest point between February and April, was unbearable everywhere that night.  

Because her bedroom was too warm, the widow spread a mat in the cemented yard of the house and lay on it. Shortly afterwards, she composed herself and slept, her non-smartphone placed by her head.  

Around midnight, while she was deep asleep, her mentally ill son returned home from his usual visit to the market, barefoot and dressed only in his familiar boxer shorts.

The mud house stands alone, not close to the next house.

He appeared at the main doorway to the yard, standing there, threateningly mute and carrying a stone. For a while, he stared at his sleeping mother from where he stood, still carrying the stone. His shirtless body glistened with sweat under a full moonlight.

Suddenly, he walked to the mat. He raised the stone above his own head and threw it down with great force at the widow’s head, smashing it.

“The stone was so huge he must have lifted it with both hands before he crushed her head with it,” Clement recounted further at the graveside and paused to hold back tears.

An arrow showing where the widow slept before the attack.

The attack drew a terror-stricken crowd to the widow’s home, where it was revealed that the boy became mentally ill after completing his studies at the Bongo Senior High School and his condition worsened because his family could not afford the cost of treatment.

The widow was rushed from Tarongo-Atiabiisi― the electoral area where the incident happened― to the Bongo District Hospital in an unconscious state. A girl, believed to be her daughter, sobbed and shivered in horror at the scene. A man put his arm around her and held her head to his chest with the other arm.

The Bongo District Hospital, Upper East Region.

The unconscious woman was ambulanced to the Tamale Teaching Hospital (TTH) for a head surgery, according to Clement. But she did not make it. On Thursday, 16 June 2016, doctors pronounced the 52-year-old widow dead.   

“When he (Kingsford) saw blood spilling out from our mother’s head and saw an angry crowd gathering around, he sensed that there was no way the people would spare him. So, he fled the house immediately,” added Clement.

“His feet were stained with the slain widow’s blood,” recounted an eyewitness, Nicholas Nsobila. “The following morning, you could see footprints of blood in the yard, footprints of blood left behind on the ground as he fled the house to an unknown location.”

Atampoka Akagiire was laid to rest near her home at Zorkor.

News of the attack travelled like lightning beyond the community, and left many in horror. Among those who heard about it were the three men who had heard the bird’s cry inside the market and had expected such news in consequence.

“These are not issues we can go to bed and sleep over,” the Assembly Member for Tarongo-Atiabiisi, Patrick Aduko, reacted after the attack.

“When hallucinations set in, a mentally ill person can kill. Authorities, including mental health organisations and other stakeholders, need to act now,” he added.

Assembly Member for Tarongo-Atiabiisi, Patrick Aduko.

Mentally ill man raids cemetery, breaks grave open, carries dead body to town

There have been several deadly attacks― and threats of attack― from mentally ill persons found in many communities across the district.

Mental health authorities say an estimated 800 mental health cases are recorded every year at the Bongo District Hospital alone.

Bongo became a district in 1988.

Most of the cases in the district, they say, are rooted not only in the familiar cause— drug and substance abuse— but also in prolonged stress, financial hardships and chronic depression.

They say the conditions of any mentally ill persons generally are bound to get worse, leading to such dangerous outcomes as deadly attacks or horrifying actions at any time, if they are not treated early.

A mentally ill man on a street in Bongo.

In 2019, another woman, aged 75, escaped being ‘cremated’ alive by a mentally ill son, Atampubire Ayambire, who suddenly set fire to her two-room mud house at night at Kanga, a suburb of Bongo.

The woman, Azaare Ayambire, told the author of this story she lived in fear as her 42-year-old son continued to terrorise her.  

Azaare Ayambire stands on the veranda of the burnt house.

On Saturday, 31 December 2022, he attacked her at dawn, whacking her heavily in the waist with a rough stick about the size of a pestle.

“Following the fire attack, I began to fear for my life and I resolved to leave the house. Then, I packed my belongings,” she said in her native Gurune. “But I reconsidered the decision because I couldn’t go and leave a biological son behind in his condition.”

Standing in front of the partly burnt house with the same stick her son had used to hit her waist, she told Media Without Borders she hardly had enough sleep because she feared he might attack her suddenly while asleep.

Azaare Ayambire narrating her ordeal.

“He is often emotionally charged. He can be in that mood all night, walking up and down in the house, talking loudly to himself and acting violently.

“I hardly close my eyes on such occasions for fear that he might suddenly break into my room and attack me. His actions strike terror in my heart. Scarcely do I get enough sleep,” Azaare added, her voice quavering as if another violent attack was about to happen.

One of the rooms set ablaze by Atampubire Ayambire.

The Assembly Member for Kanga, Prosper Atogyire, expressed sympathy for Atampubire (the mentally ill young man) but also feared for the safety of those who lived under the same roof with him.

“It’s very serious. I feel sorry for him and the family. The trauma that the mother and the aunt are going through is very pathetic. He has been beating them.

“His brother’s wife came to stay in that house. She was pregnant. He beat her up. She has run to a different place. He has broken all the walls around the house. I fear for their lives,” he said.

The Assembly Member for Kanga, Prosper Atogyire.

Miles away from Kanga is Anafobiisi, an electoral area where the assembly member, Albert Akanmiim Agariga, lamented what he described as unprovoked attacks people suffered at the hands of mentally ill persons.

He spoke about a mentally ill man who reportedly exhumed a body at a cemetery in Bongo and carried the decomposing corpse on his shoulders to town.

“One of the mentally ill people went to a graveyard, dug a grave open, picked out a dead body from the grave and carried the corpse on his shoulders to town. They had to chase him.

“The same mentally ill man goes round burning people’s houses. What can you do? The court cannot deal with the person. The police cannot deal with the person. Everyone is at the risk of being attacked anytime. A stray bullet does not discriminate,” he said.

Albert Akanmiim Agariga, Assemblyman for Anafobiisi.

Mentally ill man warns parents to chain him to avert looming attack

Mentally ill persons, according to a mental health nurse at Zorkor Health Centre, Norbert Akayeti, cause harm not only to others. They cause harm to themselves, too.

He told this author about a mentally ill young man who once attempted to take his own life in a dam at Zorkor because of perennial stigma and discrimination.

As he was briskly heading towards the dam alone, he was obstructed in time by an observer who was just around at the time and suspected his action was a suicidal move.  

A mentally ill man in Bongo.

He was later placed under a regular home health-care inspection. But his family gradually ran out of resources and his condition, for a lack of sustained treatment, deteriorated.

One day, he told his parents that there was a build-up of an urge in him to harm anyone or himself and warned them to chain and lock him up in a room to avert the looming attack.

Although his parents took the advance warning into account, they fell short of putting any measures in place immediately to forestall any attack.

Days after the warning was issued, he appeared at the door to his parents’ room and, with a threatening tone, demanded that his father come out. He was armed with two iron rods held in both hands.

A mentally ill man in Bongo

“The father was fortunate that the door was already locked. When I visited the house later, he was in chains. Nobody can convince the family to release him from the chains.

“Meanwhile, the same area has a history of a mentally ill person drowning himself in a dam. Mentally ill persons can be fatally harmful to themselves, too,” remarked the mental health nurse.

Several families choose chains over medicines

Families of mentally ill persons are aware that there are oral medications and jabs at health facilities in the district for the treatment of mental health disorders.

And on paper, Section 57 (4) of the Mental Health Act, 2012, Act 846, says “A person with mental disorder shall have access to psychotropic drugs and any other psychosocial rehabilitative interventions at different levels of care as appropriate”.

But on the ground, many families cannot afford mental health services at the facilities for their mentally ill relations.

A mentally ill person in Bongo.

The medications are administered periodically, generally on a monthly basis, to keep the patients or clients calm and to prevent them from relapsing until they are fine.

The costs of the medications and the injections vary. Depending on the medicine and the brand, they range between Gh¢30 (equivalent to $3 in 2023) and Gh¢200 ($17), or more.

Families who cannot afford the orthodox treatment generally resort to chaining up their mentally ill relations to prevent them from causing harm to life and property.

Chaining has become a solution to mental illness for poor families in the district.

They say chaining is less expensive because the chain is bought just once and it lasts for a very long time. But the orthodox medicines, they say, cost a lot more because the necessary full-length treatment requires multiple doses of pills or jabs and they are administered over a long period of time.

Such families travel to the Bolgatanga Central Market, which is about fifteen kilometres far from Bongo, to buy locally made handcuffs and shackles from blacksmiths to chain up their mentally ill relations.

A blacksmith at the market, Awuntenga Ayambila, told this author a pair of such handcuffs and an iron shackle cost Gh¢200 ($17) and Gh¢250 ($21) respectively. 

A blacksmith at the Bolgatanga Market demonstrates how the chains are fixed on the hands of a mentally ill person.

Chained for life

The inability of those families to afford orthodox cure has kept a number of mentally ill persons in the district, some of whom have no shelter, in perpetual shackles and in prolonged neglect.

Kingsford, the mentally ill young man who smashed his mother’s head with a stone at Zorkor, was captured later and chained in both hands and feet after the attack.

Kingsford Akagiire in chains after his attack led to his mother’s death.

Several mentally ill persons currently are roaming in chains and, sometimes, without clothes in the district. Nearly each of them does not have a shelter. They were not in shackles until they began to cause serious harm to people after their conditions, for lack of treatment, took a turn for the worse.

Some of them are in handcuffs for the ‘crimes’ they have committed unknowingly, for the ‘crimes’ they are yet to commit and for the ‘crimes’ they, perhaps, may never even conceive.

The chaining contravenes Section 57 (3) of the Mental Health Act, 2012, Act 846, which states that: “A person with mental disorder shall not be subjected to torture, cruelty, forced labour and any other inhuman treatment.”

Two mentally ill men, who are regularly seen at the Bongo Central Market, have been in chains for donkey’s years.

One of them, Anaba Azure, gained notoriety for attacking people at Atampiisi, one of the populous electoral areas in Bongo, before his feet were shackled.

Anaba Azure.

“Some men overpowered him and chained him at the family’s request,” said Anaba’s aunt, Julifata A. Azure. “Even with the chains on his feet, he is still dangerous. We still fear going near him to change his clothes.”

Julifata A. Azure.

“We don’t have the money to treat him. When his violent attacks on people in public places got out of control, all we could afford was a chain to bring him under control,” added Azure.

Unlike Anaba who has only his feet chained and weeps in his shackles, the other mentally ill man, Apodola Abenaba, has both his hands and feet locked in chains.

He frequents the central market, walking with a restricted stride and begging traders for food. Where nobody seems to have any leftover food for him, he turns to the market’s dustbins and selects a diet from the garbage.

He was chained up after he unleashed a string of attacks on people, including one near-death attempt on his elderly mother at Anafobiisi.

Apodola Abenaba.

“One night, he attempted to strike me with a stick. As he held the stick in front of me, I told him to let me lie down so he could kill me. I asked him to just take my life, having already reconciled myself to the reality that life was no longer worth living because of the shame and the pain I had suffered because of his miserable life on the streets,” his mother, Asampana Abenaba, told this author. 

She continued: “He was raising the stick; then, he paused and stared at me. After a while, he threw the stick into a corner in the room. Then, he withdrew from the room in silence.”

Asampana Abenaba.

The chain on Apodola’s feet, which he has worn and carried to many places in the district for years, has peeled off parts of the skin around his ankles.

There are old bruises on the ankles, caused by the shackles. While his hands are chained, he scratches the bruises with his fingers until he begins to bleed from them.

Apodola Abenaba.

“I weep each time I see my own son at the market this way,” said his mother. “He was extremely violent, hurling stones at people and at any vehicles he saw parked or passing. We, the family, didn’t have money to treat him. But we had two options: to chain him permanently now or to have ourselves to blame later. We chose the first.”

Asampana Abenaba.

There are households that cannot even afford a chain. Azaare, the aged woman whose mentally ill son almost killed her in a midnight fire at Kanga and later struck her waist on New Year’s Eve with a near-pestle-sized stick, says it is difficult for her to raise even Gh¢5 (42 cents) in a month.

Azaare Ayambire holding the stick her mentally ill son used in hitting her waist.

Her dreaded son, widely known by his nickname “Blackie Adoctor” in the area, is not in chains and has remained a source of constant terror to his mother and other members of the community.

Atampubire Ayambire.

Chains have no place in human rights circles—  CHRAJ

After taking his mother’s life, Kingsford initially did not receive any medical treatment as his family could not meet the cost.

He kept struggling in shackles in the streets of Zorkor, mostly wearing only a particular pair of underpants everywhere, until Akayeti, the mental health nurse mentioned earlier, put him under medical treatment, the nurse footing the bills himself.

Kingsford Akagiire.

“While I make sure he (Kingsford) takes the oral medication or the jab every month so that he does not relapse at any point, I also expect that the family would do away with the chains,” Akayeti told Media Without Borders.

“But the family does not want to take chances,” he noted. “And I shouldn’t force them, either. I want to avoid a situation where I would be blamed should they unchain him and anything unpleasant happens in the future.”

Clement says he keeps sorrowing as the shackles pose restrictions to his brother and stigma to the family. He says he wishes Kingsford regained his freedom but there is little or nothing he can do because the decision to chain him up was taken by an entire family.

Clement Akagiire.

“I feel sorry to see him this way. He was a brilliant student at the Bongo Senior High School. He completed there with good grades at his final exams.

“Nobody knows what caused the mental disorder. No individual can take off the chains because the decision to chain him was an entire family verdict,” he said.

Several individuals in the district are in the same dilemma as Clement. They say chaining has been “a necessary evil” to which families of mentally ill persons, who cannot access orthodox cure, resort so that mentally ill persons and those found around them can co-exist without harm.

Bongo District.

While mentally ill persons are chained up for safety reasons in the district, some observers also consider the actions as unjustifiable violations of their human rights.

Some years ago, a mentally ill man died of suspected malaria while in chains at Namoo, one of the district’s border communities. His death drew not only posthumous sympathies for him from a section of the public but also a wave of condemnation for the neglect he suffered in chains.

The mentally ill man was abandoned to die and he died.

Ghana’s Commission on Human Rights and Administrative Justice (CHRAJ) told the author of this story that chaining of mentally ill persons constituted a human right transgression.

“Everybody has the right to the highest attainable standard of mental health. People living with mental health conditions are human and have rights and protections and as such deserve to be treated with dignity and respect. It is important to underscore the fact that every human being, no matter his health condition, is entitled to all the fundamental human rights recognised by the UN Bill of Rights,” said CHRAJ’s Deputy Commissioner, Mercy Larbi.

CHRAJ’s Deputy Commissioner, Mercy Larbi.

She stated further: “These rights are universal, inalienable, non-discriminatory and interrelated. Human rights are inherent and the dignity of every human being is, therefore, inviolable. Persons with mental health conditions continue to suffer dehumanising treatments such as languishing in overcrowded state hospitals, chaining, sterilising and denial of services in the hands of religious/traditional healers since their situations are attributable to curses or spiritual causes.”

A catalogue of more mentally ill persons waiting to be chained in Bongo District

There are a number of mentally ill persons in the district who are not in chains because they have not demonstrated any violent behaviour yet.

But their families, who cannot bear the costs of orthodox treatment, say their conditions are deteriorating and may descend into a level of aggression where chaining them would be the only remedy.

The Mental Health Unit of the Bongo District Hospital.

Examples include a mentally ill man who is often seen on an untarred road that links Gowrie and Vea, two close communities in the district. Whenever he is on that road, he cleans the underneath of his footwear with a handkerchief repeatedly while walking.

A mentally ill man in the Bongo District.

There is a mentally ill young woman within the same vicinity. She is mostly found unclothed around the Gowrie Senior High/Technical School.

Another example is Theresa Amoah, a 41-year-old woman at Atampiisi who became mentally ill when she was 22 years of age.

Theresa Amoah.

Her elder brother, Emmanuel Baba Amoah, told Media Without Borders her mental illness began after she took two senior-level examinations without success.

Another relation, Joseph Amoah, says he doubts that Theresa’s mental illness is linked to failed examination sittings.

Emmanuel Baba Amoah.

She has her own room, where her belongings are always found in disarray. According to Emmanuel, she verbally assaults people, mostly accusing them of sorcery and sabotage.

How Theresa Amoah’s things are arranged in the room.

The writer of this report has visited the family three times. Her condition is rapidly deteriorating for lack of regular treatment. 

“In my electoral area alone, we have about twelve people with mental disorders. Some of the mentally ill people are breadwinners in their families. You see them roaming, unconscious of where they are and causing problems to their families,” the Assembly Member for Atampiisi, Asampana Mba, told Media Without Borders.

The Assembly Member for Atampiisi, Asampana Mba.

“The youths are the most affected. They need to be taken to hospital and given drugs. But some families cannot afford the drugs because they are poor. I want to appeal to the Government of Ghana and the Ghana Health Service to come to the aid of these families at least by supporting them with drugs. I believe they will become normal and help society if they get the drugs,” added the assembly member.

In Atampiisi also lives another mentally ill person, called Asale Atanga. His wife, Ndigura Atanga, told Media Without Borders her husband’s illness began in 2014 when he returned home from a market screaming and raving about being chased by an imaginary aircraft. He reportedly kept pointing at the sky as he ran for cover in a zigzag pattern inside the yard in front of his bemused family. According to his wife, nobody else but Asale saw the alleged aircraft in the sky.  

Asale Atanga.

“Since then, I have been looking after the family alone,” said Ndigura.

She was sitting on the ground, removing shells from some groundnuts heaped by her side, while talking to this author. Also seated on the floor behind was Atanga, interrupting his wife as she granted the interview.

Ndigura Atanga.

She continued: “I am a farmer. The farm has been our source of survival. He does not consume anything we harvest from the farm. He does not allow me and the children to eat anything from the farm, either.”

“We normally sell our harvests and use the proceeds to buy food. There is no peace in the house. An entire family’s burden is squarely on my shoulders. I’m taking care of him and the children alone,” she added.

Felix Giba, another mentally ill man, lives in the same electoral area, in a house near the office block of the Bongo District Assembly. His brother, Peter, told Media Without Borders that Felix was a successful kola-nut businessman until his goods were seized twice at a border checkpoint in the late 1980s.

Felix Giba.

“He became frustrated and developed a mental disorder following that experience between 1988 and 1989. He still sells kola-nuts at the market but he’s doing it this time on a small table.

“Sometimes, he abandons the kola-nuts on the table and starts roaming everywhere. When he returns home at night, he starts talking alone. His condition started slowly and graduated into the current state. We are afraid it might get worse with time if we don’t get timely help,” Peter said.

Peter Giba.

Once upon a rescue mission

Some years ago, Ghana’s Mental Health Authority (MHA) embarked on a nationwide mission to rescue all mentally ill persons from the streets and reintegrate them into their original communities.

Dubbed ‘Operation Clear the Streets’, the project was launched after a rapid study undertaken by the MHA in 2015 revealed that there were as many as 6,000 mentally ill persons on the streets of Ghana nationwide.

But, after a promising start, the programme encountered a sudden flop. Like a stillborn baby, the operation ‘died’ soon after inception. The reason: there was no funding to sustain it.

The immediate-past Executive Director of the MHA, Dr Akwasi Osei, told the writer of this story that all mentally ill persons would have been out of the streets today if the programme had continued.

Former CEO of the Mental Health Authority, Dr Akwasi Osei.

“We went to the streets across the country. We brought 5 patients at a time to the hospital and treated them. Within one or two months, they were well. We sent them back to their communities, not the streets, and reintegrated them. Then, we looked for another set of five. All over the country, we treated 600. A time came when we could not continue because we didn’t have funding coming from the central government and the civil society also was not supporting.

“So, we had to stop, unfortunately. If we had continued, by now there would be no single person on the streets to be causing the havoc that we are hearing. These are real security issues. If you give us the money we need, we will take all these patients from the streets within two years and treat them,” he said.

A mentally woman in Bongo.

He added: “I won’t be surprised we might be hitting between 10,000 and 12,000 of such patients on the streets today. That is the situation. It’s a huge problem. We need to give public education that mental illness is treatable. People need to understand that mental illness can affect anybody.”

Hard push by stakeholders for insurance cover

Public discourse on mental health in Ghana, of late, has been centred on a lack of awareness of the mental health needs of the population and the challenge of inadequate funding for the sector.

When Ghana celebrated the 2023 Mental Health Week, themed “Mental Health is a Universal Human Right”, the MHA’s Board Chairperson, Estelle M. Appiah, said the state was under “an overarching responsibility to ensure that mental health services are accessible, available and of good quality”.

MHA’s Board Chairperson, Estelle M. Appiah. Photo courtesy: Mental Health Authority.

Speaking at the same event, the Deputy Executive Director of the Christian Health Association of Ghana (CHAG), Dr James Duah, said the number of mentally ill people CHAG facilities received nationwide in 2022 alone exceeded 33,000.

He cited unavailability of “psychotropic medicines” at mental health facilities and non-inclusion of some mental health services in the national health insurance coverage as major factors affecting mental health campaigns in Ghana.

CHAG’s Deputy Executive Director, Dr James Duah. Photo courtesy: Mental Health Authority.

On Monday, 2 October 2023, the current MHA’s Executive Director, Dr Adwoa Pinaman Appau, told stakeholders that her outfit and the Ministry of Health had plans to withdraw more mentally ill persons from the streets.

“The Mental Health Authority together with the Ministry of Health will soon be rolling out a programme to address the issue of supporting these persons off the streets and restoring the dignity and respect due them as citizens of this nation.

“We must rally all stakeholders to support advocacy efforts and provide logistical support in implementing this well-planned strategy. Together, we can restore dignity and improve the overall wellbeing of our brothers and sisters who have been neglected for far too long,” said Dr Appau.

MHA’s Executive Director, Dr Adwoa Pinaman Appau. Photo courtesy: Mental Health Authority.

Stakeholders believe that even when the streets of Ghana are clear of mentally ill persons, poor families will continue to patronise blacksmiths’ shops for chains and shackles because they cannot afford mental health medicines for their relatives.

The stakeholders believe that one major way by which the chains and the shackles can be broken— and by which the country can enjoy a wealthier economy through a healthier workforce— is adding mental health treatments to the list of services covered by the National Health Insurance Scheme (NHIS).

A mentally man in chains in the Bongo District.

And calls for the National Health Insurance Authority (NHIA) to help break the chains and put an end to all forms of abuses mentally ill persons suffer have never been louder.

But on Tuesday, 7 November 2023, the author of this report asked the Chief Executive Officer of the NHIA, Dr Bernard Okoe Boye, if his outfit would incorporate mental health services in the NHIS.

He did not respond. Further efforts made to hear from him have not yielded any response from November 7 to date.

Chief Executive Officer of the NHIA, Dr Bernard Okoe Boye. Photo courtesy: Ghana News Agency.

A similar question was posed by this author to the Minister of Health, Kwaku Agyeman-Manu, on Thursday, 16 November 2023. He did not respond, and he has not provided any answer up to now.

Minister of Health, Kwaku Agyeman-Manu. Photo courtesy: MyJoyOnline.

Warnings about the future

BasicNeeds-Ghana, a mental health and development advocacy organisation, told Media Without Borders authorities had failed to prioritise mental health because they believed “it does not kill like any of these infectious diseases”.

“It could also be a reflection of the general stigma of mental health where people say these people are mentally ill and do not deserve a lot of attention,” said the organisation’s Head of Programmes, Dokurugu Adam Yahaya.

“Mental health service is supposed to be provided free in Ghana. We have to admit that mental health is still highly underfunded in Ghana. We have to admit that we still have frequent shortages of psychotropic medicines for those whose conditions require medications.

“There is a need for community mental health to be developed by increasing resource allocation to community mental healthcare delivery at the Ministry of Health. At the moment, we have less than 2% of the health budget being spent on mental health. It is a trend which is not just applicable to Ghana but in most third-world countries,” he stated.

A mentally man being held in chains for a jab.

Failure to make mental health a priority, he warned, would result in dire consequences not only for individuals and communities but also for the country as one.  

“There are dire consequences. There are severe consequences. When people are unable to get the needed care for their mental health conditions, the conditions simply get worse.

“And when they get worse, some of the behaviours they exhibit is what we are seeing. They end up either harming themselves or they become a danger to society. The consequences are real. We are experiencing them as individuals, as communities and as a country,” said Yahaya.

He added: “If mental health is not prioritised, very soon, as it is unfolding, we are going to have many more people getting mentally ill who are not able to contribute to production and are rather a burden on the national purse and on the already-burdened national economy.”

Stakeholders want to see promises fulfilled to save poor families from further mental health-related catastrophes.

The Sustainable Development Goal (SDG) 3.8 target is to “achieve universal health coverage, including financial risk protection, access to quality essential health care services, and access to safe, effective, quality, and affordable essential medicines and vaccines for all.”

The 17 SDGs.

Every nation, Ghana included, is racing towards achieving the goal and the target by the 2030 deadline and finishing line.

But the failure on the part of government or the state to move beyond promises and to ensure that everybody in Ghana has access to not just mental health services under the NHIS but access to quality and sustainable mental health services on the NHIS remains not only a hotbed for mental health-related catastrophes but also a barrier to achieving the SDG 3.

Source: Edward Adeti/Media Without Borders/


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