Challenges in Increasing Access to Mental Health Services in Communities in Bawku West District

Abstract

Background: Ghana as a country has witnessed different mental health regimes reflecting prevailing global trend, from incarceration in the colonial era through to NRCD decree of 1972 and recently mental health Act 846 of 2012.Critical to the Mental Health Act are the provisions on mental health authority, mental health board, mental health fund, mental health tribunal, regional and district committees and especially increasing access to mental health services in communities. The study sought to explore challenges in implementing the Mental Health Act 846 of 2012's provision of increasing access to mental health services in communities such as Bawku West District in the Upper East Region of Ghana; Methods: The study was descriptive qualitative, and it involved 32 in-depth interviews of stakeholders in mental health service in the Bawku West District who were purposively sampled. The interviews were digitally recorded, transcribed verbatim and coded into themes using a matrix before NVIVO version 10 software to facilitate further analysis. Framework on health seeking behaviour was used to analyse the findings of the study. Findings: There was a general low understanding of Mental Health Act 846 of 2012; the activities of traditional healers, stigmatization, family support, poverty, medication, mental health education, nonoperationalisaton of mental health Act were the challenges identified in increasing access to mental health services in the communities in the Bawku West District. Conclusion: The study identified key stakeholders as health professionals, assembly members, patient relatives, traditional healers, volunteers, representatives of media and government departments and agencies. The individual/social factor identified to be influencing access mental health service are activities of local healers, family support stigmatization, poverty and mental health literacy. Institutional/system factors on the other hand include, nonoperationalisaton of mental health Act, human resource, medication, transportation funding of mental health service and mental health literacy. Improvement of human resource. stakeholder engagement. dialogue between media and health sector, decentralization of mental health institutions, NGO collaboration and passing of Legislative Instrument for the mental health Act were the recommendations for the study. Conclusion: The study identified key stakeholders as health professionals, assembly members. patient relatives, traditional healers, volunteers, representatives of media and government departments and agencies. The individual/social factor identified to be influencing access mental health service are activities of local healers, family support stigmatization. poverty and mental health literacy. Institutional/system factors on the other hand include, nonoperationalisaton of mental health Act, human resource, medication, transportation, funding of mental health service and mental health literacy. Improvement of human resource. stakeholder engagement, dialogue between media and health sector, decentralization of mental health institutions, NGO collaboration and passing of Legislative Instrument for the mental health Act were the recommendations for the study.