Before Ghana Asks People With Lived Experience to Speak, It Must Ask Which Words They Are Being Asked to Use

On World Mental Health Day, the Ghana Psychological Association asked that people with lived experience of mental health conditions help shape policies and services, treated as contributors to care and not only as recipients. I agree, and I want to ask a question that comes before the invitation. When we ask someone to share what they have lived, whose words must they use to describe it?

The Ghanaian philosopher Kwasi Wiredu spent a career on a version of this problem. He called it conceptual decolonization: the habit of examining the concepts we inherited through colonial languages and schooling, and asking which of them we hold because they are true and which because they arrived with the textbook. His point was not that everything foreign is wrong. It was that a people who never inspect their borrowed ideas end up thinking about their own lives in someone else's terms. Mental health is a good place to apply the test, because the phrase is young, imported and doing a great deal of work.

So let me try to say what it means in a way a 10-year-old could follow, and see where the explanation strains.

Imagine your body is a house. When the roof leaks, nobody calls you weak. You find the leak and fix it. Now imagine the house also has a feeling-room and a thinking-room, and sometimes the lights in those rooms flicker for a long time, so that you cannot sleep, cannot eat, or cannot stop being afraid. That flickering is what the textbooks call a mental health condition. Wellbeing, on that picture, is the house working well: lights on, doors that open, windows to let the world in. Most children understand this at once. A flickering light is not a punishment or a curse or a lack of character. It is something that can be looked at, talked about and repaired.

That explanation works, and it is also the problem. It is a picture of one person alone in one house, and the 10-year-old who grew up in a Ghanaian compound will notice what is missing. Where are the other people? In the world most of us come from, nobody lives in a house by themselves. The grandmother, the uncle, the neighbour, the pastor, the elders and the ancestors all have a key. Wiredu's own work on the Akan idea of a person insisted on exactly this: a person is not a sealed container but someone who becomes a person through relationships and obligations to others. If that is right, then a feeling that flickers is not only a fact about one individual's inner rooms. It can be a fact about a family, a quarrel left unsettled, a debt, a loss, a place. The Akan word ahotɔ, often translated as ease or peace of the self, points that way, and it does not map neatly onto the English word wellbeing.

This matters for the people the Association wants to include. Suppose a young woman in Kumasi says she has not been herself since her father died and the funeral rites were never completed. The clinic hears a symptom list: low mood, poor sleep, loss of appetite. The family hears an unfinished duty. Both are describing the same lived experience, and each is accurate, but the form she is asked to fill in only has boxes for one of them. If we invite her to speak and then hear only the words that fit our boxes, we have collected a voice without listening to it.

There is a second strain in the explanation. The house picture splits body from mind, as if the roof and the thinking-room were different kinds of thing. Wiredu was careful in arguing that the Akan way of speaking about thought and the self does not simply copy the Cartesian split between a physical body and a separate mind, and that treating the two as identical is a translation error. I would not claim more than that here. The wider point is that when we say mental health in English, Twi, Ewe or Dagbani, we may not be pointing at the same thing, and the work of finding out belongs to the people who speak those languages, not to a ministry circular.

None of this is a reason to throw out the clinic. The figures are real. The Mental Health Authority recorded 36,196 cases across five major conditions in the first half of 2026, up from 29,782 a year earlier, and the Association cites a national survey in which 32.2 percent of adults aged 18 to 69 screened positive for probable depression. The Authority itself cautions that the rise may reflect more people seeking help, and that its figures leave out those kept away by stigma. People are suffering, and medicine can help many of them. The claim is narrower: before we count lived experience, we should check that the counting instrument can hear it.

Three steps would make the theme more than a slogan. First, the Mental Health Authority and the Ghana Psychological Association should commission, with linguists, elders and faith leaders, a plain-language glossary in at least the major Ghanaian languages, built from how communities actually describe distress and flourishing, and then use it to test whether national surveys and screening tools mean what they say. Second, any lived-experience panel the Authority convenes should include people whose experience is described in a community or spiritual idiom, and should record their account in their own words alongside the diagnostic code. Third, the next national survey should ask what people call their trouble, who they go to, and what they want, before it asks them to rate a symptom.

A 10-year-old can tell you that a word is a tool, and that a tool made somewhere else may need sharpening before it fits your hand. Wiredu asked Ghanaians to do that sharpening with every concept we inherit. If we want real voices to bring real change, we must first make sure that the language they are invited to speak in is one in which they can be heard.

By Noah Boakye-Yiadom | [email protected]

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