Ghana Has Made Three Mental Health Promises This Year

Between March and May, Ghana announced three developments that, taken together, signal the arrival of a mental health system. On 31 March in Accra, the Mental Health Authority and the World Health Organization launched the country's first Maternal Mental Health Policy. Dr Eugene Dordoye, the Authority's chief executive, called the mental health of mothers "not a private matter but a national asset," and the Parliamentary Select Committee on Health committed to financing it. In May, Dr Dordoye said the National Health Insurance Authority will now cover four conditions: anxiety disorders, depressive disorders, bipolar disorder and schizophrenia. Also in May, the Jubilare Group and the Authority, with eighteen partner organizations, launched a campaign centred on what it describes as Ghana's first 24/7 digital mental healthcare platform, with licensed therapists and psychiatrists a screen away.

On 10 October the world marks World Mental Health Day under the theme Lived Experiences Heard: Real Voices, Real Change. I think that theme is a test, and Ghana's three promises should be graded against it. Not on whether they were announced, because they were, but on whether a person living with a condition could say this year that something changed for them.

Start with the scale of the need. Ghana's mid-2025 figures, reported in April, recorded 1,173 suicide attempts in six months, against 1,170 in the whole of 2024, and 88 confirmed deaths by mid-year against 134 across all of 2024. Dr Dordoye is clear that better reporting after the 2023 decriminalization of attempted suicide explains part of the rise, which is the right reading. A 2023 survey found that 3.8 percent of adults had contemplated suicide. The figures come from the Authority and the District Health Information Management System, a facility-reporting system, so they count only what reaches a facility. Greater Accra recorded 290 attempts and 9 deaths. Eastern Region recorded 139 attempts and 19 deaths. Northern Region recorded 11. I cannot tell from the headline numbers what explains those differences, and nobody should pretend to. But eleven attempts in the Northern Region reads more like a measure of reach than a measure of need.

That is the first thing the three promises share: each assumes that someone arrives. Insurance pays a facility that treats a patient, and removing the cost at the counter matters, most of all for people with schizophrenia or bipolar disorder who need medication for years. But as reported in May, billing and claims mechanisms still need to be built, facilities still need to align with them, and no launch date has been announced. A coverage decision that cannot yet be claimed is, today, a statement of intent. And insurance cannot pay for a clinic that does not exist, in a country whose three psychiatric hospitals are all in the south.

The maternal policy has the same shape but a sharper edge. Reporting at the launch put the share of pregnant women in Ghana experiencing a mental health condition at roughly half. If that is even close, the number of women the policy must reach is larger than any psychiatric service will ever see, and the places to find them already exist: the antenatal clinic, the family compound, the naming ceremony, the aunt who arrives when the baby does. A policy that tells the country where to look is worth having. But the coverage I reviewed names a political commitment and no cedi figure, no first-year list of facilities, and no date. I have written in this series that the Mental Health Act of 2012 also carried a promise of money, in the form of a Fund and a levy, and that neither has ever been put into operation. A pledge from a committee is the kind of sentence this series has learned to read twice.

The digital platform is the one promise that reaches beyond the facility door, and it deserves a fair reading. A mother in Takoradi or a student in Tamale who cannot reach a psychiatrist can, in principle, reach a screen. But the campaign targets a little over a thousand mothers, students and professionals through December. Its named participating institutions are in Accra and Cape Coast, and the platform's launch was expected in the third or fourth quarter of this year. A thousand people is a pilot, and a pilot is the right size for a pilot. I could not find reporting that the platform has gone live. It also assumes a phone, data, and a person who thinks of their distress as something a therapist handles, even though the argument of this series is that for most Ghanaians that step is first taken by a relative, a pastor or an imam.

This is why the lived-experience theme bites. It is easy to adopt as a slogan and hard to adopt as a design rule. As a design rule, it would mean that the first thing each of these instruments reports is not an announcement but contact: how many mothers were screened at an antenatal visit, how many insurance claims were paid for a patient's medication, how many people who attempted suicide were followed up in the following week, and in which region. It would also mean asking the people on the receiving end what happened.

Three asks follow, each specific enough to be checked by 10 January. First, the National Health Insurance Authority should publish the date from which claims for the four conditions can be filed, along with the tariff for each, so families and facilities can plan with something firmer than an announcement. Second, the Mental Health Authority and the Ministry of Health should publish a costed first-year plan for the Maternal Mental Health Policy, turning the Select Committee's commitment into a figure and a budget line, and including antenatal clinics and trusted community leaders as screening points from the start. Third, the Authority should release suicide-attempt data every six months by region, age and sex, along with the number of people who received follow-up care, and invite survivors and bereaved families to sit on that review. Not a sentence about hearing their voices. A seat.

A promise is a document until someone holds it. Ghana has three of them this year, and on 10 October there will be speeches about each. The better question for the day is the plainest one: which mother, which patient, which person who survived an attempt has received one, and what did they say when someone asked?

By Noah Boakye-Yiadom | nboakye.phd@gmail.com

The writer is a Ghanaian-Canadian mental health promotion researcher with the University of Calgary and an Assistant Professor of Psychology at Burman University.

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