20110117
africanews

Six hundred inmates of the Accra Psychiatric Hospital who have been cured of their mental illnesses are to face forced ejection from the hospital. The Chief Psychiatrist, Dr Akwasi Osei, said the 600 inmates had all been declared fully recovered and discharged from the hospital but they had refused to leave and make way for other patients.

Consequently, the hospital has declared a special exercise, dubbed 'Operation 600 Patients Home', under which patients who have long recovered but refused to go home will be forcibly sent to their families.

The Accra Psychiatric Hospital was built in 1906. It has capacity for 800 patients but currently houses 1,200 inmates, including the 600 who have been declared cured.

The Chief Psychiatrist was emphatic that the exercise would be sustained over the next six months to create space for the hundreds of patients, some wandering the streets of the city, who were unable to conveniently access mental health care at the facility as a result of the current congestion there.

"Those patients who have been fully cured of their ailments and are eating and living on our premises will be sent home, wherever they come from," he stressed.

Dr Osei told the Daily Graphic that the exercise would pave way for an in-house patient system, adding that the hospital would consequently encourage community health care that would enable patients to be closer to their families and feel a part of society.

"The stigmatisation of mental patients is one problem that the public must try to avoid, since it does not help the patients to recover and, as happened in Tema recently, this can cause the death of patients," he stressed.

On the passage of the Mental Health Bill, Dr Osei said the Ministry of Health would meet the Parliamentary Committee on Health to discuss issues concerning the bill.

He called on the government to put in the needed logistics and resources to enable the staff of psychiatric hospitals in the country to work efficiently, adding that if that was done, the youth in particular would find interest in applying to study at their training schools and subsequently work with them.

On Thursday, April 1, 2010, President John Evans Atta Mills paid a surprise visit to the Accra Psychiatric Hospital and assured the medical staff and the patients there that the government would improve upon the procurement of medicines and other facilities for better care of mental patients.

Psychiatric hospitals in Ghana

In the early colonial era in the 19th century patients suffering from mental illness in the Gold Coast (now Ghana) were usually kept in prisons (Ministry of Health, 1988). Prior to these period psychiatric patients were left on their own to fend for themselves, or sent off to traditional healers.

In 1888 the colonial government passed a legislative instrument (The Lunatic Asylum Ordinance), signed by Governor Sir Edward Griffiths, to establish a ‘lunatic asylum’ in a vacated High Court building in Accra. It was not until 1904 that a purposeful psychiatric hospital was built, called The Accra Psychiatric Hospital.

The hospital was officially commissioned in 1906, initially to accommodate 200 patients. By the late 1940s, with psychiatric treatment primarily in the form of custodial care, there was soon to be overcrowding. The Accra Psychiatric Hospital has undergone major expansion in the past 50 years and currently houses about 700 inmates; about one-third of them are long-term because they have no place to go.

Between 1929 and 1951 many changes occurred in the Accra Psychiatric Hospital under the successive leadership of Dr Maclagan (1929-1946), Dr Wozniak (1947-1950) and Dr Foster (1951-1976). There were extensive changes to the hospital buildings, and staff training and recruitment were expanded. The application of innovative treatments such as the use of chlorpromazine and electroconvulsive therapy from the 1950s was encouraged. Other reforms introduced were the removal of chains from patients, refraining from punishing patients and discouraging isolation. The Accra Psychiatric Hospital, during this period, was the only established psychiatric facility in West Africa.

A second psychiatric hospital was built in 1950, followed by a third 20 years later. The three hospitals have about 1200 beds altogether. Indeed, many patients from neighbouring West African countries came to receive psychiatric treatment in the Gold Coast in the late 19th century.

Despite recent advances in psychiatric services many citizens still believe in the traditional forms of psychiatric treatment. Up to 70% of patients or their relatives would opt for herbal or traditional treatment (Maame A. F. Ewusi-Mensah, 1996, personal communication).

It is not uncommon for a patient to be unceremoniously removed from hospital by a relative in order to consult a traditional or spiritual healer because of a widely held belief that psychiatric illness is caused by supernatural evil forces that can best be banished by traditional medicine. This is the reality in which psychiatric practice has existed for more than a century in Ghana. In some situations it is almost impossible to determine if a patient's recovery can be attributed to medication or through the intervention of the traditional healer, or both.