Challenges of Reintegrating Adolescents with Mental Disorders into the Madina Community

Abstract

Background: Worldwide, about 450 million people suffer from mental illness. About 10-20% of the total number of persons with mental illness are adolescents. It is estimated that about 2.5 million of the 27 million Ghanaians have mental illness. It is widely expected that after treatment at the psychiatric hospitals they should be able to integrate fully into the community. However, reports from the Pantang hospital records department suggest that 5% of adolescents discharged from the hospital are not easily reintegrated as anticipated. The theoretical framework of this study is the public health perspective, which involves looking at reintegration as a means of reducing risk factors and strengthening those, which tend to improve or maintain health. The objective of the study was to determine the challenges faced by the patients and their families towards their reintegration. The study also looked at the health system challenges of reintegration and the factors in the community that militate against the successful reintegration of such patients. Method: The study method and design was qualitative and case study respectively whilst purposive sampling was used to recruit fifty (50) participants from the Madina Municipality. Interviews and focus group discussions were used to gather data about experiences of adolescents with mental disorders, their relatives, the members of the community in which these adolescents live, and the health professionals who render quality mental health service to them. Findings: The study found community assisted psychiatric nursing services to be very valuable for adolescents in the midst of excessive stigma but also very inadequate to meet the growing demands. The findings also suggested that adolescent’s reintegration is done hurriedly without recourse to proper planning. Furthermore knowledge of family and community members on the need for changing negative perceptions of the mentally ill is lacking. Cost of mental healthcare in the facilities is a burden on the public purse’. Social isolation and low self-esteem have been found to be contributory factors that militate against reintegration. With regards to the health system challenges, lack of capital investments in infrastructure, lack of medicines and the non–existence of community based support systems (halfway homes and independent living homes) etc. have been cited as major constraints to the mental health sector and the reintegration drive. Conclusion: The study provides indepth insight into the challenges faced by adolescents and their caregivers towards their reintegration. It highlighted the need for a collective and collaborative approach amongst the various stakeholders in achieving the goal of deinstitutionalization of mental healthcare.