Providing Sustainable Mental Health Care in Ghana: A Workshop
The global burden for mental, neurological, and substance use disorders (MNS) is significant, and the treatment gap is particularly high in Sub-Saharan Africa (SSA). Less than one percent of national health budgets are spent on MNS disorders, which is disproportionately low compared to the burden of the disease. Competing public health priorities, financial constraints, and poverty are all factors that can negatively affect access to mental health care. Challenges associated with the delivery of care include inadequate health system infrastructure to support mental health care (e.g., beds and medicines), the lack of national policy frameworks for mental health, and deficient information health systems to monitor and evaluate services. The lack of community awareness and stigma around MNS disorders can also negatively affect demand for care and treatment. In addition, there is a need for increasing the number of trained health care providers to deliver evidence-based treatment in both the hospital and community settings. Recognizing the importance of sustainable mental health care, this workshop convened key stakeholders to examine country specific opportunities to improve the health system infrastructure in Ghana in order to improve and develop sustainable access to mental health to ensure that the right patients get the right care and treatment at the right time, in the right setting.
Participants were invited to focus discussions on the following four topic areas:
- The elements of a mental health care system
- Consider the components of a mental health care system that would be needed to provide access to mental health care (diagnosis, treatment, access to medicines, and continuing care) in both rural and urban environments.
- Explore how existing healthcare infrastructure and available resources can be leveraged to enable sustainable access to mental health care.
- Consider mechanisms for how mental health care could be integrated or coordinated with care for co- and multiple morbidities.
- Discuss opportunities to strengthen the health information system infrastructure to ensure adequate tracking of patient- and health facility-level data.
- Articulate the core elements of a near- and long-term plan that would be necessary to develop sustainable mental health services, including what could be included in a demonstration project.
- Engagement of key stakeholders
- Consider the role of governments, non-governmental organizations, the private sector, home health care, faith-based organizations, and traditional medicine in the establishment of an integrated mental health care model.
- Examine current policy, funding and payment practices for each type of stakeholder, including identifying barriers to the development of a sustainable mental health care system.
- Consider how non-health sectors, e.g. telecommunications, energy, and others could serve to strengthen the health care infrastructure.
- Access to medicines
- Identify critical barriers to the delivery, selection, and prescription of medicines.
- Examine successful activities that could be implemented in to increase access to medicines, including characteristics of medicines that may improve patient adherence (e.g. modes of delivery).
- Consider the impact of stigma on the seeking and provision of care and on mental health outcomes and discuss how the mental health care system could be designed with concerns about stigma in mind.
- Examine components of previous or existing anti-stigma campaigns that could be applied in Ghana.