How we’re championing mental health and human rights in Ghana

Access to health care is a fundamental human right.

At Sightsavers, we believe that people with disabilities should have access to quality, inclusive health services and be able to use them without fear of stigma or discrimination.

This is the driving force behind our involvement in the Ghana Somubi Dwumadie programme, which has a specific focus on mental health. Ghana Somubi Dwumadie (Ghana Participation Programme) is a four-year disability programme in Ghana, with a specific focus on mental health. This programme is funded with UK aid from the UK government.

We know from project research that 85-98 per cent of people experiencing mental health conditions in the country cannot access the treatment they need due to a lack of service provision, lack of trained mental health professionals, inaccessible services and the stigma surrounding mental health.

In an update on its landmark report 10 years ago, Human Rights Watch has helped bring to light that the practice of putting chains on people with mental health issues still exists in Ghana, in both faith-based and traditional healing camps and centres. The initial report, along with advocacy efforts, had helped to create a shift in attitudes among mental health workers. It also led to the government taking action, the establishment of mental health regional visiting committees to monitor prayer camps and orthodox mental health facilities, along with a mental health tribunal. However, implementation has been slow.

We are proud to have helped ensure that the visiting committees are now operational. In December 2022, we provided technical assistance to Ghana’s mental health authority to design and deliver pilot training for members of these committees in five regions.

The committees, made up of committed professionals including civil servants, lawyers and mental health workers across Ghana, are tasked with inspecting mental health facilities – an activity that is vital in protecting the human rights of people with disabilities and mental health conditions.

This is also a cause close to my heart. Having served on the United Nations Committee on the Rights of Persons with Disabilities (UNCRPD) and the UK Equality and Human Rights Commission, I drew extensively on my experience to help deliver the training and felt enriched by the stories shared by the trainees, some of whom were former service users.

The training, which Sightsavers delivered in five out of 16 regions in Ghana, sought to uphold the standards set out in the UNCRPD and the guidance offered by the World Health Organization’s Quality Rights toolkit to ensure the highest attainable standard of health. Adapting these for the Ghana context, we trained committee members in how to carry out a proper inspection of mental health facilities. This ensured their approach could be adapted to work in a range of different environments, from outpatient units and psychiatric wards to forensic units and – most importantly – unorthodox settings, including prayer camps.

A crucial part of the training was equipping participants with the knowledge, skills and confidence to carry out an inspection of a whole mental health facility. This includes inspecting the quality and accessibility of the infrastructure and built environment, ensuring that it complies with national law, as well as confirming that consent is obtained and clinical records are properly documented. Members of the committees also needed to feel confident in carrying out interviews with staff at every level and with any visitors to the facilities.

At the start of the training, participants told us that they did not feel confident in taking on such a big responsibility. By its conclusion, attendees reported that they felt motivated, enthusiastic and equipped to go in to inspect mental health facilities in range of settings. They also seized the opportunity to co-create, with the mental health authority, a new code of conduct for visiting committee members to use.

The training was underpinned by the UNCRPD’s principles relating to an adequate standard of living; the right to physical and mental health; the ability to exercise legal capacity; freedom from cruel, inhumane or degrading treatment; and the right to live independently.

The participants were taken step-by-step through team building for each region, understanding their legal basis, safeguarding, the theory and framework of an inspection and their roles, responsibilities and function. The training concluded with extensive role-playing exercises to ensure all participants were ‘inspection-ready’ for their vital remit.

I’m immensely proud that there is now a group of extremely dedicated committee members ready and able to protect and promote effective mental health provision and human rights in Ghana.

Our call now is for the committees to be granted independent status. With this, they can operate under the same conditions as other national human rights institutions and ensure that people with disabilities and mental health conditions can exercise their human rights.

Author

Diane Kingston OBE is Sightsavers’ global technical lead on disability inclusion and mainstreaming. She is based in the UK.