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30.10.2005 Health

Moves to enhance community involvement in care of the mentally ill

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Ankaful (C/R), Oct 30, GNA- Dr Tom Awua-Siaw, Director of the Institutional Care Division (ICD) of the Ghana Health Service (GHS) on Saturday expressed happiness that the mental health law in the country was being reviewed to reflect active community support and introduce modernization of mental health care delivery.

He observed that the model for mental health care, had over the past half century, changed from institutionalisation of the mentally ill, to a 'community care approach', except with acute cases. Dr Awua-Siaw stated these in a keynote address at a durbar of management and staff of the Ankaful Psychiatric Hospital, to climax its 40th anniversary celebration, on the theme: " the role of the community in managing mental illness".

He said in this case, care of the mentally ill in the community, means that services will be close to the home, carers and to relatives, and are coordinated between mental health professionals and community agencies.

He deplored the fact that illness was still being attributed to evil spirits and curses and that unlike the physically ill, the mentally ill are subjected to stigma, prejudice and exclusion from access to social services and health care, due to public ignorance. He stressed that the concept was therefore based on respect for human rights and on use of updated interventions and techniques, to ensure that some protective functions of the "obsolete" asylum were fully provided in the community, and the negative aspects of institutions, not perpetuated.

Dr Awua-Siaw however, regretted that in Ghana, its successful implementation was being hindered by factors like stigma, inadequate resources, and the un-preparedness of professionals to accept their changing roles.

He in this regard, tasked all health care providers to enhance understanding of the illness, which he said, had risks and was subject to prevention and treatment.

Dr. Awua-Siaw, also reiterated that the GHS was "steadily and purposefully reviewing" the health system to address problems like poor remuneration and assured the management and staff of the hospital that they would definately be catered for.

The Acting Chief Psychiatrist, Dr Akwasi Osei, who is also the immediate past Medical Director of the hospital, underscored the need for the nation to attach importance to the mental health needs of the people to enhance productivity and wealth creation.

He echoed concerns about inadequate staff in the health institutions, and said the "human resource deficit", remained the greatest challenge in health care delivery in all three psychiatric hospitals in the country, stressing that with some 300 patients on admission, two doctors and 49 doctors at post at the hospital "was woefully inadequate".

He therefore, called for a "more deliberate effort" to entice people into mental health, adding that this would only be possible if "differential salary structure and incentive package to compensate for the risks and stress of the job", were instituted.

The Acting Chief Psychiatrist said this was imperative, because mental health workers were now "a rare species, and psychiatric nurses in particular, a dying species", and observed that if care was not taken, mental health service in the country would be "history" within the next five years.

Dr Osei hinted that to reverse the situation, a 'national forum on mental health' comprising all stakeholders, would be held next month to brainstorm on ways of enhancing mental health delivery in the country. He also acknowledged challenges facing the psychiatric hospitals such as the lack of ambulances, and promised an ambulance each for the hospitals by the end of the year.

In an address read for him, the Central Regional Minister, Mr Isaac Edumadze, commended the hospital for its invaluable services in mental health care delivery.

He also bemoaned the ill treatment of the mentally ill, and cautioned that everyone was at risk of being mentally ill, and echoed calls on the need for society to treat victims of mental illness with respect and dignity.

Mr Edumadze further underscored the importance of accepting and integrating such persons in society after treatment and stressed that family members specifically had an onerous responsibility in helping to facilitate this.

He assured the management and workers that the water shortage, which the hospital faces, would be alleviated when the dredging of the Brimsu dam to enhance water supply to Cape Coast and its environs, was completed.

In his welcoming address the Medical Director, Dr Kwaw Armah-Arloo, said the hospital was understaffed and had just two doctors and 49 nurses at post, thus resulting in the running of two instead of three shifts. He said the hospital's structures were also in deplorable states, and called for the provision of a water tanker to augment water supply.