MENTAL HEALTH-RELATED STIGMA AND DISCRIMINATION IN GHANA: EXPERIENCE OF PATIENTS AND THEIR CAREGIVERS (original) (raw)
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A Study of Stigma, Discrimination and Reintegration of Mentally Ill Persons in Ghana
2021
Mental health is the foundation of human capability that makes each life worthwhile and meaningful. There has been great progress in mental healthcare in Ghana over the years but too many people are still left behind from reintegration into society after recovery due to discrimination and stigma. In order to harness the full potential of the human resource, there is the need to reintegrate all treated mental health persons. It is for this reason that the Christian Health Association of Ghana which operates over 280 healthcare institutions in Ghana is seeking to deconstruct the way mental healthcare is delivered. The programme seeks to shift from institutional care to community-based care involving interventions by health professionals, peers and key members of the community. The purpose of this study was to gauge knowledge and attitude to stigma, discrimination, and community-based mental healthcare. The country was divided into three zones; coastal, middle and northern. From each zone, an urban and a rural site were selected. Using mixed method approach, qualitative data from caregivers and religious leaders was purposively generated while quantitative data from Junior High School students and nurses was randomly collected. Results showed that age, ethnicity, education, religious affiliation, and occupation were some of the key variables which influence reintegration of treated mentally ill persons. The study concludes that stigma and discrimination against the mentally treated person is a complex issue which needs multifaceted and multidisciplinary approach including community and home care to solving it.
Stigma, Discrimination, and Social Exclusion of the Mentally Ill: the Case of Ghana
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The authors examine treatment and society's perception of mental illness through the lenses of stigma, discrimination and social exclusion, and human rights. We argue that being diagnosed with mental illness in a developing country has a significant impact on virtually every area of one's life. The challenges faced by individuals with mental illness in Ghana are due to the prevailing culture and societal practices that tend to stigmatize, discriminate, and socially exclude these individuals from living normal lives. The lack of resources and political will continue to compound this problem. The paper argues for the importance of embracing individual, cultural and institutional training and change in attitudes, perceptions, and funding of services to address these issues of mental illness.
African Journal for the Psychological Study of Social Issues, 2018
The increasing social stigma and discrimination against individuals with mental disorders have been reported to be of global public health concern especially in the developing countries. We investigated experiences of stigma and discrimination among individuals with mental disorders carried out by family members, friends, general public, co-workers and employers. Narrative interviews were conducted on 50 randomly selected patients from the outpatients' clinic of the
Annals of General Psychiatry
Background: The stigmatization of mental illness is currently considered to be one of the most important issues facing caregivers of severely mentally ill individuals. There is a dearth of information about the prevalence and associated factors of perceived stigma among caregivers of people with severe mental illness in the study area. Objective: To assess the prevalence and associated factors of perceived stigma among non-professional caregivers of people with severe mental illness, Bahir Dar, northwest Ethiopia. Method: Institutional based cross-sectional study was conducted from May to June, 2016 at Felege Hiwot Referral Hospital among 495 caregivers of people with the severe mental illness. Pre-tested structured family interview schedule questionnaire was used. Binary logistic regression was applied to identify factors associated with perceived stigma and interpreted using odds ratio with 95% confidence interval. Statistical significance was considered at p value < 0.05. Result: The overall prevalence of perceived stigma was found to be 89.3%. Being female, rural residency, lack of social support, long duration of relationship with the patient and currently not married were found significantly associated with the perceived stigma of caregivers. Conclusion: Prevalence of perceived stigma is very high in the current study. Thus, stigma reduction program and expanding of strong social support should better be implemented by different stakeholders for caregivers of people with severe mental illness.
American Journal of Clinical and Experimental Medicine, 2021
Background: Stigma associated with mental illness is a psychosocial consequence that causes indescribable suffering for the victim. Therefore this study aimed to assess the magnitude and factors associated with level of perceived stigma among caregivers of persons with severe mental illness in Jimma city, Ethiopia. Methods: A cross-sectional study was conducted with a face-to-face interview from September 20 to October 20/2012 G.C. Family interview schedule was used to assess perceived stigma. A total of 289 participants were recruited using a consecutive sampling technique. Data were analyzed using SPSS version 16 software. Results: The most frequently endorsed item was having felt grief or depression because of having a mentally ill family member or relative (96.5%). The mean stigma score was 17.8±6.9 and the majority of the respondents (54.7%) had a high stigma score. Caregivers/Family members who were spouse to the patient (AOR=4.25, 95%CI: 1.12-16.13) and longer duration of illness (AOR=3.60, 95%CI: 1.42-9.44) were associated with higher stigma. But a person with mental illness who had verbal/physical violent behavior towards caregivers/family members and other people at the time of the illness (AOR=0.34, 95%CI: 0.17-0.70) and among those family members who attributed the cause of mental illness as the loss of properties and unsuccessful life (AOR=0.27, 95%CI: 0.08-0.89) at p=0.032. Were associated with low stigma respectively. Conclusions: Perceived stigma was found to be a common problem among caregivers of persons with severe mental illness. Becoming spouse of the person, duration of illness, patient with violent behavior and, those caregivers who attributed the cause of mental illness as the loss of properties and unsuccessful life were significantly associated with perceived stigma.
Family Medicine & Primary Care Review, 2017
Background. Mental illness is becoming an inevitable part of life with an estimation of over 150 million cases occurring worldwide, commencing as early as age 15 and leading to disability and impairments. Caring for patients with chronic mental illnesses is increasingly becoming an unending fastidious task. The goal, which is often to help improve functioning and relieve symptoms, often places many demands and eventually leads to some form of burdensome experiences for the caregivers. The magnitude of this problem among caregivers, however, remains largely unknown in sub-Saharan Africa. Objectives. the study sought to describe the level and correlation of the burden experienced by caregivers in the families of patients with chronic mental illnesses, to determine the relationship between family functioning and the level of caregiver burden and, lastly, to determine the prevalence of stigma by association/family stigma in the study population. Material and methods. A total of 402 family caregivers of patients with chronic mental illnesses attending the outpatient clinics of the Federal Neuro-psychiatric Hospital, Yaba, were interviewed using a socio-demographic data collection sheet, family functioning (APGAR) scale, the Zarit Burden Interview (ZBI) instrument and questions measuring the psychological effects of being a relative of a patient with severe mental illness. Results. The results of the study showed that 42% of the subjects experienced a high level of burden, and this was significantly associated with the gender of caregivers, their level of education, familial relationship of the caregivers to the patients, income, distance of residence from a health facility, family functioning and experience of family stigma. Conclusions. Chronic mental illnesses are associated with a high level of caregiver burden in nearly half of the study population. A low level of income is an important predictor of high burden that could be addressed through occupational rehabilitation of patients and provision of employment with a view to improving family income. Introduction of support groups and continuous advocacy against stigmatisation of individuals with mental illnesses and their families are essential.
Enhancing mental health service use: insights from caregivers, providers, and managers in Ghana
Academia Mental Health and Well-Being, 2024
Globally, there is a significant challenge in the acceptability and utilization of mental health services. This issue is particularly pronounced in low- and middle-income countries (LMICs). This study, grounded in the socioecological model, explores the recommendations and perspectives of family caregivers and service providers on improving mental health service utilization in the Bolgatanga Municipality of the Upper East Region of Ghana. A descriptive qualitative research design was employed to explore the views of 15 family caregivers, two service providers, and two mental health service managers on strategies to improve mental health service utilization. From February to March 2023, individual in-depth interviews were conducted, with data collection and analysis occurring concurrently. Participants recommended interventions at multiple levels. At the community level, they suggested increasing mental health awareness. At the organizational level, they emphasized the need to improve staff attitudes, address staffing shortages, and resolve transportation challenges. At the policy level, key suggestions included incorporating mental health services into the National Health Insurance Scheme (NHIS) and increasing access to specialist mental health services. The study provides actionable recommendations to improve mental health service utilization. These include enhancing community awareness about mental health, increasing staffing levels, addressing negative attitudes among health professionals, ensuring the availability of specialist mental health services, and integrating mental healthcare into the NHIS. Implementing these recommendations could significantly enhance the uptake of mental health services in Ghana.
BMC health services research, 2024
Background Mental health service utilization remains a challenge in developing countries, with numerous barriers affecting access to care. Albeit data suggest poor utilization of mental health services in the Bolgatanga Municipality in Ghana, no studies have explored the barriers to the utilization of mental health services. Therefore, this study explored the perspectives of family caregivers, service providers, and mental health service administrators on the barriers to mental health service utilization in the Bolgatanga Municipality, Ghana. Methods A qualitative descriptive design was employed for the study. Nineteen participants were purposively sampled from two hospitals including fifteen family caregivers, two service providers, and two mental health administrators. Data were collected through individual in-depth interviews using a semi-structured interview guide. Audio-recorded interviews were transcribed verbatim and thematically analyzed using NVivo 12 pro software. Results Five main themes emerged including individual-level barriers, interpersonal barriers, community-level barriers, organizational-level barriers, and policy-level barriers. At the individual level, lack of insight, poor treatment compliance, and financial challenges were prominent barriers. Interpersonal barriers included family pressure influenced by cultural and spiritual beliefs. At the community level, stigma and mental health illiteracy were identified as significant barriers. At the organizational level, barriers encompassed inadequate staffing, limited space, and staff attitudes. Policy-level barriers included the neglect of mental health in policies and the non-inclusion of mental health services in the National Health Insurance Scheme. Conclusion This study highlights the complexity of barriers to mental health service utilization and underscores the need for a comprehensive approach to address them. Collaborative efforts involving healthcare providers, policymakers, communities, and families are essential to mitigate these barriers. It is imperative to consider these barriers when developing strategies to improve the utilization of mental health services in Ghana.