His Excellency President John Dramani Mahama, 05/07/2013
President of the Republic of Ghana
Flag Staff House
Osu, Accra
Ghana

Re: Open letter to the President- Establishment of the Mental Health Authority Board-

Your Excellency,

I trust that this letter finds you in good health.

I write to you today to urge you to as a matter of urgency, constitute and inaugurate the board of the Mental Health Authority. Before I make a case for the urgency of my request, I will like to thank the previous Government of which you served as Vice President and also the previous parliament for the courage and vision to pass the Mental Health Bill into law last year. I will also like to thank you immensely for your personal pledge in August 2011 to ensure that the mental health of all Ghanaians is adequately looked after. To refresh your memories, I will quote a section of the publication relating to your pledge in August 2011:

“Last week, Vice President of Ghana, John Dramani Mahama gave the assurance that mental health will be adequately cared for in government's plans to upgrade all national, regional and district health facilities”.

The full reportage of this singular historic commitment from your good self can be read from the link below: http://news.yale.edu/2011/08/10/ghli-assists-mental-health-care-reform-ghana .
There are many other reports relating to this pledge all over this internet and I will like to commend you once again.

Mr President, unfortunately, a year on since the signing of the Mental Health Bill into law, not much has changed on the ground and our people continue to suffer the consequences of what appears to be a lack of political will to modernise mental health infrastructure and mental health care delivery in Ghana.

It may be worth noting, Mr President, that according to the World Health Organisation, one in every four persons worldwide will suffer from a mental disorder at some stage in their life. This effectively means that at least 8 million Ghanaians will suffer from a mental disorder at some stage in their life. Furthermore, in 2007, the World Health Organisation estimated that of the 21.6 million people living in Ghana, 650,000 were suffering from a severe mental disorder and a further 2,166, 000 are suffering from a moderate to mild mental disorder. Ironically, the WHO reports that in 2007, only 32,283 people received treatment, resulting in a treatment gap of 98% of the total population that had a mental disorder that year(WHO 2007).

Mr President, studies have also established that about 75% of mental disorders in adults actually have their origins in childhood. However, regrettably, there is not a single facility in Ghana to treat mental disorders in children. Furthermore, it has been established by researchers that psychotic conditions like Schizophrenia and Bipolar Disorder have poorer outcomes (prognosis) if they are left untreated for more than one year from the time that people begin to show signs and symptoms of the condition. This means, Mr President, that since the signing of the Mental Health Bill into law in June last year, thousands of our fellow country men and women who have since shown these symptoms and could actually benefit from effective treatments with reasonably good outcomes so that they could contribute productively to Ghana’s advancement are still not receiving any treatment. This I believe is as a direct result of the lack of implementation of the new mental health law which will otherwise compel the state to provide the appropriate treatment for such individuals.

Mr President, whilst I agree that your government have many other urgent matters to address, I will like to humbly submit that no Ghanaian should be left waiting even a day longer to access appropriate mental health care. A visit to the ‘Special care ward’ at the Accra Psychiatric Hospital last year drew uncontrollable tears from my eyes and I will urge you to visit this ward to learn at first hand the conditions under which our fellow countrymen and women who are mentally challenged are kept. Mr President, we cannot as a nation continue to treat our most vulnerable under these conditions. Furthermore, conditions in the psychiatric hospitals do not inspire many up and coming young doctors to consider a career in psychiatry, a situation which I believe is gravely affecting the human resource base within the mental healthcare delivery system in Ghana.

Consequently, I plead with you, Mr President, to consider taking the following urgent actions to remedy the situation and to place your government firmly in its proper place in history as a government of conscience:

1. Establish and inaugurate the Mental Health Authority Board without any further delay.
2. Fulfil your pledge made in August 2011 to ensure that mental health is adequately cared for in government's plans to upgrade all national, regional and district health facilities.
3. Place the development of mental health infrastructure under your ‘presidential priority areas’ initiative.
Mr President, I have previously proposed that your government should consider starting to address the human resource crisis within mental health care system at the district and constituency levels by assuming that a multidisciplinary team comprising a psychiatrist, mental health nurse, occupational therapist, social worker and clinical psychologist are in place in each of the 275 constituencies in Ghana who are being paid by the government. In this way, the budget for salaries and expenses related to these personnel if they were in place could be set aside annually and used to train prospective mental health workers selected and sponsored from their districts and constituencies. Please see a like to an interview with this proposal on YouTube: http://www.youtube.com/watch?v=Q8M0vGvotcg .

Mr President, it is hard to understand how we can feel comfortable as a nation and accept it when there is no mental professional team in place at each constituency to look after the mental health needs of our people and yet, we feel it is unacceptable not to have a Member of Parliament in any constituency, although both groups of professionals are equally important.

Mr President, you have a unique opportunity to make history by improving mental healthcare delivery and to give hope to the 8 million Ghanaians who will develop a mental disorder at some stage in their life. Successive governments since the overthrow of Ghana’s first president Dr Kwame Nkrumah have not paid any attention to this sector; a situation which I think is a national embarrassment. Mr President, you now have the singular honour to redeem our country’s image and to establish Ghana as a state that cares about its most vulnerable. You have an opportunity to demonstrate that your parties much touted social democratic credentials can have real meaning in the lives of Ghana’s most vulnerable citizens.

I trust that you will treat this request with urgency and please do remember that every any minute that passes without action being taken in this regard is a collective failure on our part to give one Ghanaian a chance in life.

Many thanks

Your’s sincerely,


Dr Vincent I.O Agyapong
BSc MBChB DCP DHSM MSc MRCPsych MCPsychI MFFLM PGDip MD
Chairperson of the Association of Ghanaian Professionals in Ireland (www.agpireland.org)
Consultant Psychiatrist and Clinical Senior Lecturer, School of Medicine, University of Dublin, Trinity College Dublin
Email: israelhans@hotmail.com