Unspoken and Unheard: Mental Health in Ghana
In March, Jennifer Nyarko, a student at the University of Ghana Legon jumped to her death from the fourth floor of student housing. Images of her inconsolable father wrought with grief filled my Facebook timeline, and for the greater part of two weeks, Jennifer’s story sent an entire nation into mourning. More enduring was the unavoidable tone of shame that laced all discussion of her decision.
But not much of this story was new. The week before, another student in the Kwame Nkrumah University of Science and Technology in Kumasi took her own life, and the cycle of media coverage, Facebook shares, and short-lived grief followed.
A year and a half ago, while studying for an exam, a series of mental illnesses drove me to a mental breakdown. A combination of two years of depression and more recent anxiety was compounded by my upbringing in a society that fails its mentally ill. Ultimately, this led to the deterioration of my health and a very long recovery. I was suicidal, and I was scared. When I brought it up to those around me, I was either met with pity or the cold shoulder of stigma, but I was not the first nor last person to feel such isolation. Ghanaian society speaks about mental illness in a way that perpetuates stigma and a fear of those that suffer from it, and most would rather bear in silence than be labeled as “crazy.”
Avoiding Difficult Conversations
Mental health is a seldom-discussed topic in Ghanaian culture. It makes people uncomfortable. When mental illness is talked about, the conversation is lacking in ways that raise awareness, foster advocacy, and lead to meaningful change. Even government spending on mental health reflects the priority attached to the issue, with a mere 1.4 percent of the total health budget allocated to mental health. Isolated, understaffed, and poorly-maintained psychiatric facilities is the only picture of mental health that most are familiar with in Ghana.
When I sit in my public health classes at Mailman, I am faced with similar questions as when I visit family in Ghana: how do we fix urgent public health concerns if people aren’t even willing to talk about mental health? Malaria and cholera are easier, because pills and sanitation are relatively acceptable remedies. But what about an illness whose prevention and treatment are much more complex because they aren’t easily detected?
A Way Forward
While I spent the summer working as a strategy intern at McCann Global Health, I found the obvious answer to the urgent issue of mental illness in Ghana: health communication. There, I worked on different initiatives, from HIV prevention in Kenya to water and sanitation hygiene in Tanzania when itt occurred to me: why not mental health in Ghana? Health communication brings together the environmental, social, and psychological influences on behavior and health. There is a common proverb in Ghana, “Nsa baako nkura adesoa.” That is, a burden is lighter when many carry it. Social infrastructure in Ghana is governed by this phrase, and if the same approach of community and social support is translated to mental health, the positive effects would be resounding.
Ghana needs to openly and honestly talk about mental illness, and the societal barriers that prevent Ghanaians from doing so.
When more people understand the importance of protecting the mental wellbeing of the population, they will demand the policy changes to ensure it. Transparency about mental illness will become a norm, and will gradually render fear and labeling obsolete.
Schools will provide psychological counseling. Religious leaders will consider devoting time to improving the emotional and mental wellbeing of their members. And medical and health-profession training schools will place greater emphasis on mental health education and competency.
The movement toward improved mental health in Ghana is already happening, albeit slowly and shortsightedly. Earlier this year, a temporary suicide prevention hotline was established by the Mental Health Authority. Yet so much more remains to be done. As a public health professional and a Ghanaian citizen, I look forward to and work in anticipation of a time where health communication positively and sustainably changes the state of mental health in Ghana.
Essie Quakyi is a second-year MPH student in the department of Sociomedical Sciences. She graduated from Brown University in 2014 with a degree in Human Biology and is the founder of Imagine Ghana, a non-profit aimed at providing underserved young students with career guidance. Following graduation, Essie plans to move back to Ghana to create policy and structural changes in public health.
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