On 10th October every year the world assembles to celebrate the world mental health day which prolongs for a week. The theme for World Mental Health Day 2021, which is ‘Mental Health in an Unequal World’ has been chosen to underscore the point that the world is increasingly polarized, with the very wealthy becoming wealthier, and the number of people living in poverty still unacceptably high.
Today, many people with a mental illness do not receive the treatment that they are entitled to and deserve and together with their families and carers continue to experience stigma and discrimination in our communities. The gap between the ‘haves’ and the ‘have nots’ grows ever wider and there is continuing unmet need in the care of people with a mental health problem.
Worse of all, Service Users in Ghana are ignored or discriminated against when it comes to the composition of the Mental Health Board. Much as the recently dissolved Mental Health Board had a User on board, the subsequent ones did not. There is therefore the tendency that the yet to be constituted and inaugurated Board might not include a Service User. This contributes to the inequality in the area of mental health.
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Way Forward
Call for Inclusion Service User on Board of Mental Health Authority
It is in this light that the MEHSOG together with the Alliance for Mental Health and development are leading the advocacy for a “permanent seat” on the governing board of the mental health authority. We are using the occasion and this publication to call on the Minister of Health to, as a matter of urgency, consider the inclusion of mental health service users on the governing board of the Mental Health Authority which will soon be constituted and inaugurated, pursuant to with Section 4 of the Mental Health Law (Act 846 2012).
We are confident that the announcement of the Governing Board will include at least one service user. This is because Section 4(i) allows the Minister of Health to nominate three non-governmental persons to the eleven-member Board. Our call is in line with the relevant section of the Mental Health Law.
Fortunately, following the dissolution of the previous board a new is yet to be named. This is why we find it prudent to dutifully ask the Minister to ensure inclusiveness when constituting the new governing board. We ask that the governing board should include service users because they are very critical stakeholders in mental health and that every effort be made to avoid discrimination and unequal treatment.
MEHSOG, a service user organization with membership across the country, believes that action on this petition will help to remove public perception that policy makers are not keen to integrate the needs of service users in health system development. We believe that the collaboration with users at that high place would provide key inputs to the health system to deliver quality services that meet their needs. For example, a governing board member who is a service user can share his/her lived experience (e.g. with stigma, service seeking and the attitudes of service providers towards people with mental illness) and this information can be used to improve health reforms and service delivery.
Service User representation on the governing board of the Mental Health Authority will not only ensure equal access of service users onto the board, but will also further foster inclusionary practices within mental health services in Ghana.
Mental health service user involvement in decision making could be an important strategy for advocacy and improving service delivery. Besides, the involvement of service users on the board will help improve the responsiveness of the Mental Health Authority to respect the actual needs of the users and reduce stigma. The phrase “Nothing About Us Without Us” ignites a vision for people with disabilities that represents pride and power rather than stigma and pity. What mental health service users are implying is that there cannot be any discussions concerning them without them as end users. Indeed, service users are those who patronize services and can make contributions/inputs into discussions that can change the face of mental health in Ghana, and not people who have not used the service before. Also,
we believe that the place where they can make those inputs (that is advocate for their welfare) and to influence policy in their favour most is on the governing board of the Mental Health Authority.
As we talk about unequal treatment meted out to mental health it is important to note that there is a very strong moral case for the Ministry of Health to support service user involvement in the management of mental health in Ghana. It is a fact that mental health service users tend to be invisible, marginalized and until recently when the Mental Health Society of Ghana was formed, they were not mobilized as a group. Structural barriers, including stigma and low funding, exacerbate the situation. This is why the Minister for Health would have taken a huge step forward towards effectively engaging users in mental health systems strengthening in the country by appointing at least one service user onto the governing board of the Mental Health Authority.
By Esenam Drah
