Go mental and see

The ground rule for reading this article is to read it out loud, in sober reflection. Allow the message to sink in and then, go mad at the ‘authorities’. But don’t stay mad for too long though. Rather, use whatever strategies that will evolve from positive energy to help effect change on the national level.

Wherever you read my name, insert your own name because this matter is not about me. It’s about all of us. Imagine that I, Doris Yaa Dartey (insert your name) lose my mind – go mental. Many things can drive someone to the edge. My/your heart gets entangled in an amorous relational break-up. I/you lose someone very dear through death and can’t get over the trauma. I/you inherited the mental break-down genes in my/your essential DNA.

Then, I/you begin to unravel. My/your foundation shake. I/you might behave funny and talk to my/yourself. I/you might enter the dark place of life where I/you might hear loud giggling or angry quarrelling in the head and so set out to outwardly behave accordingly in response to the infirmities of the mind. Fact: If I/you go mental, we would receive the hyena treatment of personal isolation from family/friends and fearful avoidance by motorists and onlookers some of who will throw things, insults and mockery at us.

I/you might set off and go hey-wire. Act 1: The stripping to lose my/your aesthetic self and leave things bare to show strange oddities. My/your (if you’re a woman) mighty headgear will drop off, and nappy African hair will become nappier. My eye-glasses which are like permanent furniture on my face will be lost. Then, kaba and brazier will be abandoned and I/you will walk around with tired old sorry mangled hanging breasts. Imagine! If the stripping continues, my/your slit and dross will drop off too and my/your low-lying parts will, in unison, join the high-rise essential body parts to just hang – in reckless abandon.

Act 2: I/you might become a great collector of things and wear as much clothing as possible in the tropical heat. People will gossip about me/you guessing why I/you went mental. Periodically, those who know me/you will make me/you the centre-piece of conversation. The chit chat about me/you will go something like this: “Eh, have you heard? That fine man/woman has gone mad.” “Who did this to him/her?” “Hmm, this life!” Such stream of conversation will soon end and the matter and me/you will rest – forgotten about.

I/you will lose dignity and become simple objects. Losing dignity is tantamount to losing humanity to live on the fringes of society where no one really cares. When human beings are counted, I/you will be left out. Who needs to consider me/you in a population census or in family meetings? After all, I/you will be nothing but a caste away from society. Periodically, someone will extend compassion to me/you. But for the most part, I/you will become the object of fear. I/you will even lose my/your name and simply become, ‘’the mad one’’.

After a while, when no one sees me/you in the areas where I/you were often spotted, they will forget all about me/you and probably assume that I/you simply went away – died. If that happens, I/you will be unmourned by loved ones because my/your very existence was such a deep embarrassment so death constitutes a blessedly good riddance. My/your grave will be unmarked. In our culture, our attitude toward mental ailment can at best be described as medieval. A mentally-ill person is considered a non-person although before going mental, he/she had lovers. We forget that there is a thin line between a person and a non-person. All it takes is a little trigger to cross over.

Worst of all, we have a medieval horror we shamelessly refer to as a mental health system. Undoubtedly, we have a national crisis in psychiatric treatment and care. Here are a few sad, sorry sordid facts about the state of psychiatric resources and care in Ghana.

(1) Our approach toward psychiatric care is institutionalization. This means that if you go mental, you must necessarily be locked-up, like a criminal, away from society and loved ones. This approach is antiquated and uncivilized. This inhumane psychiatric care model has long evolved globally to that of community care that incorporates mental sickness into overall health care. The institutionalization approach comes from a place of fear of the other, and a pretence that we who have not gone mental (yet!) are better than those who, through no fault of theirs, have.

(2) The human resource situation with regard to psychiatric care should frighten every Ghanaian. Currently, 52 year-old Ghana has five (5) psychiatric doctors in active practice within the Ghana Health Service system. Two of them teach at Korle Bu’s Ghana Medical School, leaving three in true active practice. Eleven others are tired and retired but yet, remain in practice as and when they can. Nationally, there are 600 psychiatric nurses. A simple calculation paints the grim picture with clarity.

Of our estimated 23 million population, there is one out of the five psychiatric doctors for every 4.6 million people and one psychiatric nurse for every 38,333 people. The picture is no better for the other core psychiatric personnel. For instance, there is no psychiatric occupational therapist in Ghana. This means, in very simple terms, that once I/you go mental, there are no plans to rehabilitate me/you.

How about facilities? There are three psychiatric hospitals, all located at the Atlantic coastline – two in Accra and one in Ankaful – as if it’s only in southern Ghana that one can go mental! If anyone should lose it anywhere else in Ghana, the choices include taking off into the bushes, climb trees or get onto the highway to begin a long arduous walk toward the Atlantic Ocean either naked or over-clothed. And, these three facilities are despicable places. Go mental and see!

Enduring questions: To what extent does the Ministry of Health appreciate the importance of mental health care for Ghanaians? How does the Ministry justify the woefully inadequate personnel, antiquated facilities and the fixation on the outmoded paradigm of institutionalizing psychiatric patients?

As a people, we suffer deeply from disease stigma. But when it comes to psychiatric ailment, stigmatization flies through the roof. The stigma even extends to psychiatric personnel who are objects of ridicule. Any wonder psychiatric health care is not attracting new personnel?

This is a grim picture of mental health care in Ghana. You think you’re inadequate now and have many problems? Wait until you go mental and enter the twilight zone. We must therefore move this matter from gutter-front humour into government house to be wrapped tightly in progressive policy and big forward-looking actions.

Three or so years ago in The Gambia, an NGO is said to have sued the government for abusing the human rights of mentally sick people by institutionalizing them in congested hospitals. The NGO won. The almighty pus-for-a-brain government was embarrassed. Result? Some changes were effected. (I’m researching this case further). In Ghana, a Mental Health Bill has been crawling on the corridors of power since 2006. This bill must become law as a matter of urgency before I/you go mental! As a people, we must speak to and deal with this repulsive national truth.

dorisdartey@yahoo.com; dorisdartey.blogspot.com