The International Journal of Psychosocial Rehabilitation

Psych. Rehab. & Community Care in Ghana

Responsible Institutions
Ministry of health, Ghana

Project Time-frame
1998-1999

Main Goals
To facilitate the development of comprehensive community based mental services through: sensitizing the community to mental problems; reducing the stigma associated with mental problems; and establishing a community based mental health service which can be used as a model for dissemination.

Background
Recently the Ministry of Health in its five year development programme has a policy of providing psychiatric wings in all the regional hospitals and also integrating mental health into the mainstream of care delivery at the primary health care level. However, there are some existing barriers to this approach. The Ghanaian community has little awareness and understanding of issues related to mental health and aspects related to the community care of the mentally ill. The stigma attached to mental illness is so strong that many relatives of the mentally ill will either abandon them in psychiatric hospitals or refer them to herbalists and traditional healers.

Project Description
This project aims to increase the awareness of mental health problems and to reduce the stigma associated with these problems amongst health, non-health workers and communities. There are three major objectives. The first is to sensitize opinion leaders to be involved in addressing mental health issues in their communities. The second is to support community psychiatric nurses in a selected district to create awareness of the problems of substance abuse and mental illness; and the third is to support a district with the aim of integrating mental health in primary health care and creating a network of supporting systems of care providers in the district.
In order to sensitize opinion leaders an operational document will be prepared on the role of opinion leaders and consumers in mental health promotion, prevention of mental illness and community-based rehabilitation. A number of meetings will be held with opinion leaders to discuss the programme and to seek their involvement. A number of activities will be initiated to support community psychiatric nurses in their work, the most important which is to to provide training in mental disorders and psychosocial rehabilitation to psychiatric nurses and other primary care providers.

To facilitate the integration of mental health in primary care, a model for mental health community services in one district polyclinic/health centre will be developed and implemented. The concept of integrated services will be developed by a community action group, comprising clinicians and other care providers and patients, will input into all these activities. A pre- and post-intervention prevalence survey of mentally illness and substance abuse disorders will be implemented to assess the overall effectiveness of the approach used.

Performance Indicators
These will include the reduction in the number of mentally ill persons and drug abusers in the target area; a reduction in the number of admissions from the district to the main psychiatric hospitals; improvement in the quality of services from the perspective of care providers and selected residents; and the number of community self-generated activities on mental health and substance abuse.



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