Tag: University of Ghana


Fade To Black: Suicide Among Ghanaians

PANews_P-083e410e-484a-4fb1-97b5-ae8691cebef5_I1Sam Sarpong was a young man who tirelessly worked his way into the fashion and entertainment realms of Hollywood, his face recognisable in fashion shows, MTV or BET – one of the most established bright Black Stars on the diaspora. On the surface, he was a man living the dream. And yet, as October 2015 drew to a close, this same gentleman found himself on a bridge in Pasadena, California. After a deliberation of 7 hours, and despite the pleas of family and law enforcement, Sam’s world literally came crashing down.

After the initial shock of the premature loss of one of Ghana’s brightest exports, came the questions. Why would he do it? He had it all, right? He had no reason to, right? Then came the whispers – it’s such an un-Ghanaian thing to do. Suicide is a selfish act – how could he do it when his family loved him? But you see, that is where a big problem comes in – when we attempt to apply reason and rationale to one of humanity’s most irrational of acts.

It is the incomprehensible nature of how a human being who lives to exist would find themselves at a point where they would willingly extinguish the flame of their own lives, which grants suicide an element of mystery. Those who have ever been truly suicidal will identify with the gravity, the darkness, the single-mindedness of suicidal ideation. They will note how life seems at a literal dead end. They will tell you how things become so desperate, all they can think about is release, and relief, and escape.

 

More than 800 000 people die by suicide worldwide every year – around one person every 40 seconds. alone-for-the-holidaysSuicide is much more rampant in Ghana and among Ghanaians than you would initially expect or believe. Mental health experts estimate that in Ghana, five or more people take their own lives each day. Available statistics on suicide in Ghana indicate that Greater Accra region has the highest number of deaths by suicide. The network for Anti-Suicide & Suicide Prevention found 531 people between the age of 9-19 kill themselves in Ghana every year. Approximately 1500 cases of suicide occur in Ghana annually – constituting about 7% loss in GDP. And those are just the reported cases, with it being suggested that there are four unreported cases for every reported case – so you’re looking at more than 6000 suicides in Ghana each year.

But, anybody who attempts to commit suicide in Ghana commits a criminal act (as per section 57, clause 2 of the Criminal Offences Act of Ghana). The Mental Health Society of Ghana (MEHSOG), has asked the Constitutional Review Committee and the Ghana Law Reform Commission to revise this. People who attempt to commit suicide likely suffer some form of mental disorder and should rather be referred to the appropriate mental health facility for counselling and treatment.

According to Mavis Darko-Gyekye, a lecturer in social work at the University of Ghana: “Suicidal behaviour and threats of suicide have been ignored in the country even though they exist. These are issues that no one talks about because suicide is considered a taboo.” Because they are not talked about, the silence engineers an environment where warning signs are missed and alarm bells fail to be heard. And as I have stated in previous articles, there is a general taboo which surrounds mental health as a whole, which means that there are so many out there who do not seek the help they need – simply because it is not available, or because they believe nobody cares. Mavis Darko-Gyekye goes on to say how “Unfortunately, we are training personnel that are not being utilized because people do not want to be associated with anything that would lead to associating them with mental illness.”

 

o-DEPRESSION-BLACK-facebookSuicide is still deemed a taboo and abomination among Ghanaian ethnic groups and faiths. It can be deemed a ‘bad death’, and social reproach can be observed by behaviours such as discouraging prolonged and public mourning, and in some places even observing decontamination rituals to purge families or communities of the taboo of suicide. Dali (2007, cited in Adinkrah, 2011) has found out that among some groups in Northern Ghana, when suicide occurs inside a house or an apartment, the corpse must be removed through a window or a special aperture in the wall. This is because conveying the body through the doorway permanently desecrates the doorway for the living. In this way, Ghanaian culture attempts to discourage people from taking their own lives.

Despite the taboos and intolerance, suicide still plays out. The vast majority of those who complete suicide amongst Ghanaians are male (Adinkrah, 2010) – indicative of the cultural finding that males are less likely to discuss their issues and find it feminine to seek social support. Literature also shows that males are more likely to employ ‘immediate-lethal’ methods such as gunshots while females prefer less violent methods such as taking poison or overdosing on drugs. Dr Dan-Bright Dzorgbo, Head of Sociology at the University of Ghana, has noted that the suicide trend is increasing in Ghana, believing that social inequality and the wide gap between rich and poor exacerbates issues people may have in terms of dealing with poverty and trying to move up the social ladder.

So many issues. So many contributory factors. So many lives being lost. And yet the silence surrounding suicide and the apathy regarding its prevention is a lullaby leading many to cut their lives short. We must fight the tide which is causing many Ghanaian lives to fade to black too soon. It’s time to break the silence and shine a light on the subject – who knows how many lives will be saved if we do so.

Feeling depressed or suicidal? Don’t suffer alone – please contact Samaritans.org or if you’re in Ghana, contact 233 244 846 701 (24/7 hotline)

 

By Dr. Jermaine Bamfo (@Dr_Jabz27)

Mental Health: The Dark Age in Ghanaian Society

The image will never leave me. A young lady – she must have been not much older than I am now. Chained to a stone wall, in a room which wouldn’t look out of place in Elmina castle or any of the historical slave-holding castles dotted around Ghana. Legs shackled, she lay slumped in the damp darkness. No energy left to act out the distress her face betrayed she was still feeling. Sat helplessly in a concoction of excrement and feminine fluid which looked so putrid I could swear blind the stench emanated out of the photo on the website and through my laptop screen.

 

A modern-day re-enactment of crimes against humanity performed on our shores centuries ago? A depiction of torture?

 

No. She was simply a mental health patient. In a mental health facility. In Ghana. In the 21st century.

 

mentally ill in chains

mentally ill in chains

In Ghana, mental health remains massively stigmatised and grossly misunderstood. And in the depths of misunderstanding and ignorance does not lie bliss, but rather a platform upon which traditionalist ideologies perform. The demonization of those with severe mental illness causes people to legitimise horrible treatment. A Human Rights Watch report on Ghana and BBC investigation into an Accra psychiatric facility found patients going without food or even clothes, being kept behind bars, and subjected to degrading physical treatment. It’s easier to perceive those with mental illness as animals, rather than understanding that these people need a greater, more intensive and careful degree of help than most.

Despite some progression over the years, you can tell that mental health provision remains an after-thought, almost a nuisance. That is why psychiatric nurses in Accra embarked on a nationwide strike to bring to attention the fact that the majority were in salary arrears (it’s also interesting to note that despite a news article reporting this being hosted on one of the biggest and most active of Ghanaian news sites, the comments in the comments section stood at a grand total of 0…).

Mental health workers  are underpaid and overworked, with facilities badly under-resourced. Ghana records at least 1500 suicide cases annually – which constitutes about 7% loss of Ghana’s potential Gross Domestic Product (GDP) yearly! And those are just the reported cases – with suggestions that for every reported case, there are four unreported cases of suicide. However, only 2 out of every 100 Ghanaians with a mental illness will get the care they need.

Government spending on Psychiatry is very low and the bulk of services, albeit sparse, are centred on Accra, leaving much of the Ghana-007rest of the country with almost no provision.  Ghana has only THREE psychiatric hospitals nationwide catering to Ghana’s population of 25 million – and ALL THREE are on the southern coast (2 in Accra, 1 in Central Region). Imagine how those in the Northern region feel, an area with the biggest mental health burden in the country. Logic.

While the UK is looking to spend a whopping £1.25 BILLION on mental health services over the next 5 years, Ghana spends a meagre £3million a year. Accra Psychiatric Hospital is a 700 bed unit – and yet, it houses more than 1200 patients….Go figure.

With few options for care outside these facilities, many people resort to prayer camps & traditional healers whose treatment methods can be inhumane at best. There is such a heavy stench of superstition and fear around psychiatric illness in Ghana. Don’t believe me? Here’s a bit of homework for you. Next time you’re in Ghana and an auntie asks you about job aspirations, tell her you want to be a Psychiatrist…

A paper published in the International Journal of Mental Health Systems found that while there are more than 1000 registered mental health nurses, there are only EIGHTEEN registered psychiatric doctors – NATIONWIDE. That works out at 0.07 psychiatrists per 100,000 Ghanaians. And those are just the registered – some of those 18 may not even be in active service. If these numbers fail to horrify you…

5450930078_fbe25c23ea_bDr Sammy Ohene, Head of Psychiatry at the University of Ghana, recently decried the ‘cash-and-carry’ culture which has seeped into the Accra Psychiatric Hospital, noting that Ghana law suggests costs to provide treatment should be covered by the taxpayer, not paid at the point-of-care. He goes on to suggest that those who cannot afford the new service fees will turn to herbalists and spiritual healers in an attempt to get psychiatric care. There is already a problem with the provision of medication, with some patients acknowledging having to take much lower doses of their medicines in order to make their medicine last as they cannot keep up with costs.

And that is the last thing you need. To begin to drive people away from facilities which can best cater to their needs and back towards the stone-age dark areas of the country where they will be further demonised. But who cares right? Because according to the Accra Psychiatric Hospital, the only reason they have resorted to ‘cash-and-carry’ is because the central government isn’t providing money to cover costs of treatment and keep the hospital running…

trapped for being mentally ill

trapped for being mentally ill

The Mental Health Act 2012 seems to be just a means of simply keeping the watching international community off of our backs. The prospect of paying extortionate costs for care, and the ongoing stigmatisation and rampant traditional beliefs, are roadblocks preventing those who need care presenting themselves to receive it.

Listen – mental illness can happen to any of us. 1 in 4 will have some sort of psychiatric illness in our lifetime, of varying severity, regardless of race, nationality or creed. The people in the hospitals and those wandering the streets were once teachers, traders, hardworking wives or husbands, lovely children of parents and families. The social stigma so often associated with mental illness, allied with poverty and inadequate healthcare facilities, has conspired to rob these people of the care and support they deserve. Psychiatric care continues to suffer neglect in terms of practical, sustainable action that could benefit poor, marginalized people with mental illness. Will the image I described at the beginning of this article ever become a footnote in the legend of our nation? We have so much to do before we create enough light to drive out the darkness…

 

The paper ‘An overview of Ghana’s mental health system: results from an assessment using the World Health Organization’s Assessment Instrument for Mental Health Systems (WHO-AIMS) ‘ is available at http://www.ijmhs.com/content/8/1/16


By Dr Jermaine Bamfo (@Dr_Jabz27)