Introduction

November was Men’s Health Awareness Month and the purpose of this annual event is to promote awareness and support for those tackling prostate cancer, testicular cancer, mental health, and suicide.

In an effort to shed more awareness on mental health, Life Developers Movement (LDM), a non-governmental organization based in Ghana, partnered with Scientect.org on their monthly spotlight feature.

The World Health Organization (WHO) in 1948 defined health as a “complete state of physical, mental and social well-being and not merely the absence of a disease or an infirmity”.

By this definition, health is to be viewed from a holistic point of view and not just a focus on the biomedical model or approach to disease which seeks to cure or heal people (using various medical procedure mostly with an emphasis on medication regimen).

In the late 1970’s, George Engel and John Romano¹ developed a novel approach that gives credence to the relationship between biological, psychological and social factors that affects our health.

Specialty fields in psychology, such as health psychology, not only strongly advocate and put into practice this model but also makes the individual the central focus of healthcare as they define their health outcomes rather than making healthcare practitioners the pivotal agents in the delivery of care².

Despite all the above, mental health remains one of the neglected aspects of health due to the increased burden of mental illness and the widening treatment gap³.

The problem of neglect is exacerbated by lack of skilled mental health personnel, lack of resources and poor societal attitudes towards mental health.

There is also a growing culture of stigma and discrimination around the subject of mental health, thus, making it extremely difficult for people to share their mental health journey or access treatment.

For example, there is a treatment gap of 98% in Ghana, meaning for every 100 persons who report to a psychiatric facility, only two are likely to receive treatment.

Mental illness can affect people irrespective of race, gender, socioeconomic status or beliefs. Although the prevalence of mental health in men is lower than in women, women are more likely to be open about their mental health than men, thus, receiving treatment compared to men.

Men are more likely to be discreet about their mental health due to various myth and/or culture that perceive men as strong, with no iota of weakness. There are also cultural and social expectations for men to exercise control over their emotions and portray leadership qualities.

The consequence of these expectations is the likelihood for men to suppress their emotions than women, even in the midst of challenging times.

In an attempt to break the silence culture among men, we interviewed two men about their mental health.

The aim of this project is to give a voice to men and to emphasize that seeking help for your mental health is not a sign of weakness but an inherent strength which needs to be nurtured.

Below is a transcript of our interaction with two champions of mental health in Ghana who have decided to share their story with our audience. One of these champions decided to remain anonymous and we applaud both for their courage.

Interview 1

APY: Tell us about yourself

MKA: “My name is Moses Kofi Annor, a 27 year old former student of the Legon Centre for International Affairs and Diplomacy (LECIAD). I live at Pokuase but I am currently working in Kumasi. I am a mental health advocate, currently volunteering with PsychAid and Love Outreach.”

APY: A general overview of your mental health experience: do you have any valid diagnosis, when was it done, how has it affected your social life, academic life, etc

MKA: “I have been diagnosed with depression since January 2018. Being diagnosed with depression has been an eye-opener, it has had tremendous impact on the kind of food and drinks I can take. I have struggled to hold on to some friendships because of regular depressive episodes. In relation to my academics I experienced my first major depressive episode in school. I struggled to wake up every day and go to class without pretending everything was fine, I could not tell any of my friends of my struggles because I was actually coming to terms with the new developments in my life. I also suffered some form of memory loss, and this drastically affected my grades, this even resulted in me requesting for an extension to complete my thesis.”

APY: Growing up in Ghana, how will you rate your experience with using a mental health facility either directly or from what others tell you?

MKA: “I have been fortunate enough to afford a private facility where their services have been excellent, but I have also had the opportunity to visit the Pantang Psychiatric Hospital and I was not impressed with the general state of infrastructure and services provided to patients.”

APY: What is your view on the state of mental health in Ghana?

MKA: “Mental health in Ghana has become like a taboo, we tend to treat it like a foreign concept which is incompatible with our cultural and religious values. This has led to so many people being unable to open up about their struggles and seek professional help (Because of how society will portray such a person; especially if it’s a male).”

APY: The parliament of Ghana recently suggested that decriminalizing suicide will lead to more people wanting to die by suicide. What is your take on Ghana and other nations criminalizing suicide?

MKA: “It is of my view that those who think or attempt suicide want help but do not know how to ask for it, so criminalizing it defeats the very purpose of trying to help such people. Also, people who suffer from some mental health conditions are prone to have suicidal ideations, so if we want to make mental health an important thing in this country I believe we have to decriminalize it.”

APY: Is the media in Ghana doing well in terms of educating the general public about mental health?

MKA: No. They do not even use their platforms to educate Ghanaians on mental health, it is more about making profit and entertainment than education.

APY: Are there any cultural practices or beliefs that directly contribute to men not opening up about their mental health in Ghana?

MKA: “Yes, our culture of making males look “invincible”, “ultimate problem-solvers”. This culture creates a situation where males dare not/ cannot show their pain and worries. We tend to normalize their fears and problems and this makes it difficult for males to talk about their mental health struggles (I am a good example).”

APY: What will be your suggestion on how to improve mental healthcare delivery in Ghana?

MKA:

I believe the Ghana Health Service can make mental health facilities more readily available in most district or regional hospitals.

The Ghana Mental Health Authority should be more proactive and implement mental health policies rather than sticking to too much rhetoric.

Mental Health education is very important in a country where it seems like a foreign concept. The media (print, electronic and social) could use their platforms start such change.

Mental health services should be less expensive so the ordinary Ghanaian can afford it.

Also mental health practitioners should also be more accessible, especially people in the rural communities.

Mental Health should be made part of the educational curriculum, this will help change the stigma around mental health at a very young age.

Interview 2

APY: Tell us about yourself

SNOA: “SNOA is a 23 year old first year undergraduate student in a UK university”

APY: A general overview of your mental health experience: do you have any valid diagnosis, when was it done, how has it affected your social life, academic life, etc

SNOA: “My mental issues started before a surgery around my groin area as a result of the fear surgery comes with, this fear grew more and more after some factors also combined with the already existing one. The other main factor was as result of me not being enrolled in school when I desired to, due to some family issues and this combined with the already existing anxiety. I was diagnosed with anxiety symptoms in April, 2019 and I had series of treatment section till August, 2019. Previously I used to be an introvert, hardly go out or talk to people, after the treatment I am now able to mingle even among new people and my life has never been the same though I sometimes behave like my old self.” 

APY: Growing up in Ghana, how will you rate your experience with using a mental health facility either directly or from what others tell you?

SNOA: “I realized there was a bit of stigma by people who do not know much about what mental health issues are. Aside that the consultants are professional and I also realized people feel shy to visit the doctor or speak out when they are having mental issues and wait till it becomes difficult to treat.”

APY: What is your view on the state of mental health in Ghana?

SNOA: “There should be more education and more facilities should be made available aside that I feel it is getting better as the years go by.”

APY: The parliament of Ghana recently suggested that decriminalizing suicide will lead to more people wanting to die by suicide. What is your take on Ghana and other nations criminalizing suicide?

SNOA: “I think that Law is not the main reason why less people are committing suicide, people have personal issues than we can think of, the best way is to give out more information about mental health and issue places people can access easy to spill out their issues without feeling shy.”

APY: Is the media in Ghana doing well in terms of educating the general public about mental health?

SNOA: “I think they are not doing enough, in my case I read a lot of health articles before I realized I had to see a professional if I went to live my old life again, what about those in the villages, those who haven’t had a bit of education? How can they get this information by themselves?”

APY: Are there any cultural practices or beliefs that directly contribute to men not opening up about their mental health in Ghana?

SNOA: “None that I know of, I know just know it’s the stigma that causes men not to open up”

APY: What will be your suggestion on how to improve mental healthcare delivery in Ghana?

SNOA: “There should be a special number to reach mental health professionals around you, more education and facilities.”

Conclusion

These two interactions with our champions reveal three critical issues which requires immediate attention to improve upon the mental healthcare delivery system in Ghana.

1. The issue of availability and accessibility of mental health services
2. The quality of mental healthcare delivery
3. The lack of awareness and education on mental health

These issues can be resolved through a collaborative approach which requires all stakeholders (government, NGOs, people with cognitive, intellectual and psychosocial disorders, families, policy makers, etc.) to contribute their quota to mental healthcare delivery.

The government will have to increase funding allocation for mental healthcare in the country whereas NGOs continue with their advocacy and awareness creation activities to influence policy makers to initiate policies that will boost mental health.

Also, people who have a mental health condition can also share their mental health experiences to educate the general public on these conditions and for families to also add their voice to help diffuse any acts of stigma and discrimination towards mental health.

In our next article’ we shall take a deeper look at how to better take care of our mental health and also tackle a very pressing issue which centers on decriminalization of suicide in Ghana.

Reference

1. Engel, G. (1977). The need for a new medical model: a challenge for biomedicine. Science, 196(4286), 129–136. doi: 10.1126/science.847460
2. Thompson, A. G. (2007). The meaning of patient involvement and participation in health care consultations: a taxonomy. Social Science Medicine, 64(6):1297–310. doi: 10.1016/j.socscimed.2006.11.002
3. World Health Report (2001). Mental health; a new understanding, a new hope. Geneva

USEFUL RESOURCE on where to access mental health services in Ghana