Accessible and quality mental health care for poor and marginalised persons with mental disabilities

This is a 36 month project funded by STAR-Ghana. It is intended to improve community mental health treatment through increased funding to mental health services. This will be achieved through influencing the Ministries of Local Government and Rural Development (MLGRD) and all MMDAs, Finance (MoF) to commit resources to community mental health care; working with health care providers to improve community mental health care services; facilitating active involvement of public and mental service users in mental health care advocacy; and advocating for the approval of the Legislative Instrument (LI) of the Mental Health Law (Mental Health Act, 2012, 846). It is the expectation that once all of these are done, it will lead to an effectively functioning community mental health system in Ghana.

BasicNeeds-Ghana is implementing this project in collaboration with key implementation partners. These partners are NORSAAC, Mental Health Society of Ghana (MEHSOG), MIHOSO International (MIHOSO), and the Ghana Alliance for Mental Health and Development (Potential GESI national mental health partners comprised of Human Rights Advocacy Centre [HRAC], Coalition of NGOs in Health and the Ghana Education Coalition (GNECC).

A combination of strategies is applied to realise the results and objectives of this project. The strategies emphasise engagements and meetings, monitoring and tracking resourcing of the mental health sector, as well as media-based collaborative activities and other relationships, with active involvement of groups of persons with mental illness or epilepsy and their carers.

The project will adopt ‘Engagement and collaboration with MLGRD, MoF and MMDAs to improve/ increase resources committed to districts and across the country for mental health services’ Engagement meetings are unique opportunities for building trust and reaching consensus in a much effective way than would be the case of written correspondence. With face-to-face direct deliberation of issues it makes it possible for rights holders and duty bearers to appreciate each other’s positions and reach the compromises and consensus to forge on addressing the issue(s) at stake. In this regard, in this project, the engagement meetings will make it possible for MMDAs to deliberate on how, they, as local authorities, should support the building of community mental health care services. It will enable the project implementation organisations [BasicNeeds-Ghana (BNGh), Mental Health Society of Ghana (MEHSOG), MIHOSO International Foundation (MIHOSO)] as well as persons with mental illness or epilepsy and their carers and families to collectively exchange ideas and agree best options for developing community based mental health care services in Ghana. The collaborations with the government agencies will allow for the project to take advantage of ongoing meetings at the ministries and MMDAs to discuss increased investments in mental health. Engagement meetings with national and local government officials, particularly Ministers and Chief Directors of relevant/ appropriate ministries, officials of District Coordinating and Planning Units (CPUs) (chief executives of MMDAs, coordinating directors, planning and finance officers) Regional Health Directorates and Members of Parliament (MPs) of the Committee of Parliament on Health.

Another strategy to be applied in this project is ‘strengthening voice, participation and influence of mental health service users and care-givers in mental health’. The project will work with the existing community Self-Help Groups (SHGs) of persons with mental illness or epilepsy, particularly through the Mental Health Society of Ghana (MEHSOG), the national association of persons with mental illness or epilepsy and their carers to advance their visibility, advocacy and influence on increased funding for community mental health in Ghana, and mental health policy and service in general.  The SHGs and their representative district associations and national mental health and service user association will be actively involved in meetings and engagements in ministerial and/ or inter-ministerial meetings and engagements, especially with the MLGRD, MoF, MoGCSP, Parliament, and with MMDAs. A strong voice of mental health service users and their carers is vital to a concerted and sustainable engagement on mental health and development issues. A strengthened voice and participation of SHGs and their respective district and national association(s) is important to realising the assertiveness and proactivity required to keep government and duty bearers responsive and accountable to their needs and rights.

Through the project, other individual and CSO networks will be galvanised to, together with the SHGs, maintain such engagements so as to articulate the investments required to improve mental health care and respect of the human rights of the mentally disabled

The third strategy will be ‘participatory monitoring to ensure effective utilisation of resources to enhance mental health service provision’. BNGh and the co-implementation partners will work collaboratively with the district and regional health facilities to monitor resource allocations for community mental health their utilisation. There will be regular discussions.

Yet another strategy this project will adopt is ‘Mobilising/ liaising people, facilitate spaces and advocate for relevant state institutions to ensure Parliament approves the draft LI’. BNGh and project implementation partners will, through the national mental health alliance, establish an LI CSOs working group to work out and maintain engagements with the Parliamentary Committee on Health, Ministry of Health (MoH) and/ or the Attorney General’s Department to build a more informed idea of the status of the draft LI and advocate its approval. The status and influence of NGOs/ CSOs is well known and their collective interest in adding to the need for urgency in the approval of the mental health LI. The media will be included in this working group to take advantage of their media platforms and spaces to raise awareness on the need for the approval of the mental health LI to be expedited.

The media, being the fourth realm of the state, is an influential institution to use to influence public discourse, as well as attitudes and practices. The media will be handy to help propagate the need for community mental health to benefit from the needed investment so as to have the comprehensive one-stop health care services at the primary health care level.