October 10, 2021, marks the awareness creation, and advocacy of mental health globally.  The world mental health day is a day set aside by the World Health Organization and World Federation of Mental Health each year since its inception in 1992 to create public awareness and provide education on mental health particularly against social stigma, and for people to be more inclined towards the state of their mental health and to take adequate steps to improve it.

This year’s awareness creation is under the theme “Mental Health in an Unequal world”. This theme is underpinned by the effect of Covid-19 which arguably has deepen inequality and poverty levels all over the world, worsening mental health of many individuals.

My good friend: similar fate elsewhere?  

Today’s mental awareness creation reminds me of my very good friend who suffered severe mental illness. His future aspiration was cut off due to his illness and had to abandon his education to stay home for the rest of his life until his death somewhere 2 years ago. May his departed soul rest in peace.

Despite his situation, he was always helpful. His smile alone was enough to brighten your day although some looked at him with disdain. I admit he wasn’t always tidy, but his persona was second to none. He would always run to me anytime he saw me. However, societal perception of his illness meant he was always alone. I must admit his family was very supportive, but he was for the most part an unwelcome guest to the public.  Like him, many other Ghanaians across the length and breadth of this country suffer a similar fate if not worse.    

Indeed, the statistics are staggering and revealing. The World Health Organization-Ghana estimates that over 650, 000 people in Ghana are suffering from severe mental disorder while about 2,166,000 are suffering from moderate to mild disorder. This is further expected to exacerbate due to the prolonged pandemic which is being felt globally. 

Despite these alarming figures, many people do not see the urgent need to seek mental care. This perhaps could be attributed to self-denial of mental illness, social stigma or inequality/lack of access to mental health care.

Unequal world

In an unequal world such as ours, the relevance of mental health awareness creation cannot be overemphasized. It is not surprising that, the Sustainable Development Goals (SDG) particularly goal 3 which aim to “ensure healthy lives and promote wellbeing for all at all ages” reemphasizes the need for a healthy living including the state of one’s mental health. Particularly, target 3.4 of Goal 3 further states that “by 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and wellbeing”.

Indeed, the world has increasingly been unequal and so is mental health care despite many international commitments. Inequality is as old as creation. Perhaps that’s just how the world was created.

Unequal distribution of resources at the dawn of creation may have contributed to this phenomenon of an unequal world. But what if the creator purposively designed that for man to equitably share such resources for all? If this was the test, then we’ve failed to live up to the creator’s expectations.

Covid-19 may have worsened the gap between the rich and the poor, but what have we done or can be done to correct such imbalance with respect to access to mental health?

It is true that many businesses have been severely hit due to the pandemic with employers having no option than to lay off their employees. Household incomes have been reduced, with some finding refuge only in the streets.   

Mental Health in a Pandemic  

Indeed mental health is a major challenge. For the health care worker providing treatment in a deadly circumstances at the peril of his/her own life; for the children, the disruption of their daily activities with their friends; for the student buying more airtime to take online classes without the usual face to face conversations with his peers and teachers and; for the worker, staying home without work due to layoffs.  There is, therefore, no contention that the mental state of these people has been affected negatively.

As the country continues to grapple with Covid-19, more attention has been given to symptoms such as headaches, cough, chest pains, fever and breathing difficulty just to mention a few with little recourse to mental health of Covid-19 patients. Many health experts and indeed several scientific publications suggest that mental trauma associated with quarantine, self-isolation, and social/physical distancing are some of the mental illness of the novel coronavirus.

Longitudinal studies on the general public show that psychosocial stressors such as life disruption, fear of contracting the virus, fear of negative economic effects particularly among businessmen and women have increased significantly in this pandemic. Quarantine, for example, contributes to stress anger and an increase in risky behaviors.

A recent study shows that one in eight people who have contracted Covid-19 are diagnosed with their first psychiatric or neurological illness within few months of testing positive for the virus. This is more frightening when those having previous neurological history are included.  Also, one in nine Covid-19 patients with mild symptoms suffer from depression or stroke.    

Mental illness; a manifestation of only mad men? 

Unfortunately, like many of us, mental health is underemphasized in our daily activities and health needs. Health to us, is only limited to physical well-being and hardly do we ever pause to reflect on the state of our mental health. This myopic view of health, unfortunately, reverberates in our homes, workplaces and even in schools.

This could partly be attributed to the perception that mental illness is the manifestation of only those we call mad men. Thus, many Ghanaians believe that “mad men” are the only ones suffering from mental illness. This perception undoubtedly makes it difficult for people to access mental health care for the very reason of being referred to as a mad person.

Mental Health and the Ghanaian culture

For some, mental health is a curse, a demonic illness which affect the perceived image of the family. Indeed, men and women experiencing severe or mild mental disorders are shun by society and are increasingly being discriminated at. Some families or societies actually believe that mental illness is a punishment meted to persons or families engaged in some sort of evil deeds.

As a result, many people will not hesitate to cancel or withdraw from people with traces of such illness in their family; be it friends or prospective partners.  Consequently, some pastors have cashed in on persons with severe mental disorders with many chained in prayer camps standing accused of witchcraft. These acts further impedes access to proper mental health care.

What can we do?

To create equal opportunities for accessing mental health care, we should first and foremost see mental illness as it is rather than the perceived notion of a spiritual attack. Mental health should therefore be taken seriously and people should seek regular medical attention.

Societies ought to give people with mental illness the needed help and counselling particularly for those experiencing depression and unusual behaviours. It is worth mentioning that government has shown greater commitments to widening access to mental health care under the flagship programme of Agenda 111.

Government, therefore, intends to construct and rehabilitates psychiatric hospitals. This will create spatial equity in accessing mental health care, and will stop the mass movement of people in the northern sector to the southern sector before accessing mental health care.  This, therefore, requires massive support and dedication from the public as government aim to create equal opportunities for all.