Community-Based Mental Health Care: Experiences of Professionals and Family Caregivers in the Eastern Region of Ghana

Abstract

Mental health services are considerably underfunded. In recent years, Ghana has attempted a shift to community-based mental health care, deemed to neutralise challenges identified with institutional care. Six years after the passage of Ghana’s Mental Health Act (Act 846) of 2012, challenges persisted. Meanwhile, studies on caregiver experiences are limited. This study explored the experiences of professionals and family caregivers in community-based mental health care in the Eastern Region of Ghana. It also examined differences in stress, affiliate stigma, wellbeing and coping strategies among community and institutional family caregivers. Using mixed methods approach (concurrent), individual interviews were conducted with 10 mental health professionals and 10 family caregivers. Also, 280 family caregivers provided quantitative data on stress, affiliate stigma, wellbeing and the Brief COPE measures. Qualitative data were examined with Interpretative Phenomenological Analysis, while Multivariate Analysis of Covariance and Hierarchical Multiple Regression analysis were used to evaluate the quantitative data. Qualitative findings revealed that professionals were the most affected by the challenges with community-based mental health care, whereas family caregivers found the high cost of institutional care more worrying. Quantitative findings showed a difference between community and institutional family caregivers in the combined experience of stress, affiliate stigma and wellbeing, with community family caregivers having a higher wellbeing. Stress and affiliate stigma had a negative impact on caregiver wellbeing, though only stress significantly predicted wellbeing. A relationship existed between coping strategies and wellbeing, though community and institutional family caregivers did not differ in the types of coping strategies used. Implications of findings are discussed.