Jordan Ellis
Ghana has a population of around 22 million, with an estimated 650,000 people suffering from severe mental health disorders and 2,166,000 suffering from moderate to mild mental health issues. Despite these figures, the country only has 13 psychiatrists in practice, and the mental health service in Ghana faces many challenges, including a lack of resources, the stigma surrounding the profession, and emigration of trained professionals. Ghana currently has three psychiatric hospitals, with the first opening in Accra in 1906, followed by the Ankaful Psychiatric Hospital in 1965, and Pantang Hospital in 1975.
| Characteristics | Values |
|---|---|
| Number of psychiatric hospitals in Ghana | 3 (Accra Psychiatric Hospital, Ankaful Psychiatric Hospital, and Pantang Hospital) |
| Year the first psychiatric hospital was opened | 1906 (as the Lunatic Asylum) |
| Number of psychiatrists in Ghana | 13 |
| Population of Ghana | 22 million (2004 estimate) |
| Number of people in Ghana suffering from severe mental disorder | 650,000 |
| Number of people in Ghana suffering from moderate to mild mental disorder | 2,166,000 |
| Year psychiatry was introduced in Ghana | 1951 |
| Year Ghana's mental health policy was formulated | 1994 |
| Year Ghana's mental health policy was last revised | 2004 |
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What You'll Learn
Ghana has 13 psychiatrists for 22 million people
Ghana has 13 psychiatrists for a population of around 22 million, according to a 2004 estimate. This equates to one psychiatrist for every 1.7 million people, indicating a huge treatment gap for patients requiring professional psychiatric attention.
The history of psychiatry in Ghana is relatively recent. Before 1951, there were no psychiatrists in the country, except for a brief period in 1929 when Dr Maclagan was appointed alienist to the Asylum at Accra. The first African psychiatrist to practice in the country arrived in 1951, marking the beginning of scientific treatment for mental illness in Ghana. Since then, the country has established two additional purpose-built psychiatric hospitals: the Ankaful Psychiatric Hospital and Pantang Hospital, which opened in 1965 and 1975, respectively. Ghana's mental health policy, formulated in 1994 and revised in 2000 and 2004, aims to provide facilities at tertiary, regional, district, and sub-district levels for psychiatric cases.
Despite these developments, psychiatric facilities and services in Ghana remain extremely limited. The country's mental health service faces several challenges, including a stigma attached to the profession, emigration of trained health personnel, and insufficient government funding. As a result, psychiatric wards are often overcrowded, and there is a lack of resources for patient care. Furthermore, the low detection rate of mental health issues by healthcare workers in primary care settings contributes to missed opportunities for early intervention and treatment.
To address these issues, it has been suggested that training in anthropology, social psychology, and trans-cultural psychiatry should be incorporated into the curriculum for psychiatrists intending to practice in Ghana. This would better equip them to understand and address the diverse cultural contexts within the country. Additionally, improving diagnostic practices and increasing research efforts can help bridge the gaps in mental healthcare and better serve the population's needs.
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Psychiatric hospitals: Accra, Ankaful, Pantang
Ghana has three psychiatric hospitals: Accra Psychiatric Hospital, Ankaful Psychiatric Hospital, and Pantang Hospital.
Accra Psychiatric Hospital
The Accra Psychiatric Hospital is a psychiatric care and medical facility in Accra, Ghana. It has a close relationship with the University of Ghana Medical School, which has a faculty established in the hospital for undergraduate training in psychiatry and postgraduate training under the West African College of Psychiatrists (WACP). The hospital also offers 6-month proficiency training in psychiatry for nurses from across the country.
Ankaful Psychiatric Hospital
Ankaful Psychiatric Hospital provides compassionate care and expert treatment to support the mental and physical well-being of its patients. The hospital focuses on patient experience, offering support from mental health professionals, structured therapy, and a safe environment to aid recovery. Patients often engage in individual and group therapies while being monitored for safety and progress.
Pantang Hospital
Pantang Hospital is the largest of Ghana's three psychiatric hospitals. Commissioned in 1975 by General I. K. Acheampong, it was built as a 500-bed facility with a Pan-African Mental Health Village in mind. The hospital is situated close to Pantang village, about 1.6 kilometres off the Accra-Aburi road and 25 kilometres from Central Accra. In addition to psychiatric care, Pantang Hospital also provides general medical services and mortuary services.
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Mental health activities began in 1888
Ghana, a country with a population of about 22 million people, currently has three specialised psychiatric hospitals: Accra Psychiatric Hospital, Ankaful Psychiatric Hospital, and Pantang Psychiatric Hospital. However, the history of mental health activities in Ghana goes back to the 19th century.
During the early days of colonial rule in the 19th century, individuals with mental illnesses in Ghana, then known as the Gold Coast, were primarily confined to prisons. Those who avoided incarceration either managed on their own or turned to traditional healers for support. This situation changed in 1888 with the introduction of the Lunatic Asylum Ordinance by Sir Griffith Edwards, the then Governor of the Gold Coast. This ordinance, also known as the 1888 Mental Health Law, marked the beginning of formal mental healthcare activities and institutional care for the mentally ill in Ghana.
On February 4, 1888, the old High Court at Victoriaborg was converted into the first lunatic asylum in the Gold Coast. Unfortunately, patient records from this early period are scarce. By 1904, the number of inmates had risen to 104, and the following year, the hospital had 80 patients, including 61 males and 19 females. The challenges of overcrowding soon emerged, necessitating additional institutions to address the growing demand for mental health care.
In 1906, the Lunatic Asylum in Accra was established, marking the beginning of institutional psychiatric care in Ghana. This hospital, later known as the Accra Psychiatric Hospital, became a pivotal centre for mental healthcare in the country. Over time, as Ghana underwent significant social and economic transformations, the demand for mental health services increased. This led to the founding of two additional specialised psychiatric hospitals after Ghana's independence in 1957: Ankaful Psychiatric Hospital in 1965 and Pantang Psychiatric Hospital in 1975.
These three hospitals, situated in the relatively developed southern region near the nation's capital, formed the backbone of Ghana's psychiatric care infrastructure. However, their southern concentration presented access challenges for individuals in northern and remote areas. Despite these developments, Ghana continues to face challenges in mental healthcare, including a shortage of mental health professionals and the stigma associated with psychiatric professions.
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Stigma deters people from joining the psychiatric profession
Ghana has a population of about 22 million, with an estimated 650,000 people suffering from severe mental disorders and 2,166,000 suffering from moderate to mild mental disorders. The country has only 13 psychiatrists, which represents a significant treatment gap for those in need of professional psychiatric attention. The mental health service in Ghana faces numerous challenges, including the stigma associated with the profession, which deters people from joining it. This stigma not only affects those seeking treatment but also extends to the psychiatric profession itself.
The limited literature available suggests that stigma negatively impacts the productivity of mental health nurses, especially community psychiatric nurses (CPNs). A study conducted in the Greater Accra region of Ghana found that stigma affected CPNs' work in both hospital settings and their communities. Some nurses recounted that they had considered leaving the profession due to the harmful impact of stigma, with some transitioning into other areas of nursing such as general nursing, midwifery, and anaesthesia. Others faced difficulties in locating patient homes due to poor addresses, a lack of transportation, limited logistical support, and an irregular supply of medication. These challenges deter many young potential nurses from pursuing community psychiatric nursing.
The stigmatization of psychiatric nurses in Ghana is influenced by sociocultural factors, including beliefs and attitudes about mental illness. Participants in a qualitative study shared that they faced stigma and disrespect from society, with people's expressions and questions about their job changing when they disclosed their profession. This stigma is not limited to nurses but also affects other mental healthcare providers such as psychiatrists, mental health counselors, and therapists. The lack of regard for psychiatric professionals contributes to the challenges in mental healthcare advocacy, policymaking, and healthcare provision.
To address these issues, research and advocacy efforts are crucial. Studies that explore the impact of stigma on mental healthcare providers are important to develop effective solutions. Additionally, increasing awareness about the services that psychiatry offers and improving facilities for mental health care and treatment can contribute to reducing stigma and enhancing the future of psychiatry in Ghana.
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Ghana's mental health policy was formulated in 1994
The history of psychiatry in Ghana is relatively recent. Before 1951, there were no psychiatrists in the country, except for a brief period in 1929 when Dr. Maclagan served as an alienist at the Asylum in Accra. Mental health activities in Ghana began with the enactment of the Lunatic Asylum Ordinance in 1888, which allowed law enforcement agencies to arrest and confine people suspected of mental illness in an abandoned prison in Accra. This facility soon became overcrowded, leading to the establishment of the Lunatic Asylum in 1906, which later became the Accra Psychiatric Hospital.
In 1946, Dr. G. Tooth conducted a survey of mental illness in Ghana (then known as the Gold Coast), which sparked government interest in the issue. This led to the appointment of the first African psychiatrist in 1951, who was posted to the mental hospital in Accra. Over the years, two additional purpose-built psychiatric hospitals were opened: the Ankaful Psychiatric Hospital in 1965 and the Pantang Hospital in 1975.
The 1994 mental health policy in Ghana sought to improve the management of psychiatric cases by providing facilities at the tertiary, regional, district, and sub-district levels. Each regional hospital was intended to have a psychiatric wing with 10-20 beds. The policy also aimed to shift the focus from institutionalised care to community care, integrated into general healthcare. This shift was further emphasised in the Mental Health Bill of 2010, which sought to address concerns such as aggressive patients being chained or locked up and facing discrimination in the workplace.
The Mental Health Authority (MHA) in Ghana has made significant progress in delivering mental health services, and the policy now views mental health as an essential indicator of the overall health status of the population. The MHA has worked to improve human resource production in mental health staff, with a recent addition of 2100 Registered Mental Nurses (RMN) to the workforce. The MHA has also facilitated the recruitment of occupational therapists, clinical psychologists, and pharmacists, while providing in-service training for community health workers, doctors, and physician assistants.
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Frequently asked questions
Ghana has three psychiatric hospitals: Ankaful Psychiatric Hospital, Pantang Hospital, and Accra Psychiatric Hospital.
Psychiatric services in Ghana are facing several challenges, including a lack of trained professionals, emigration of trained nurses, and overcrowding in wards. Ghana has 13 psychiatrists for a population of around 22 million, and the hospitals rely on insufficient government funding. However, there is an increasing awareness of psychiatric services among the population.
Mental health activities in Ghana began with the Lunatic Asylum Ordinance enacted in 1888, which allowed people suspected of mental illness to be confined to an abandoned prison in Accra. This facility became overcrowded, leading to the establishment of the Lunatic Asylum in 1906, which later became the Accra Psychiatric Hospital. The first African psychiatrist in the region arrived in 1951.
