Mentally ill persons are increasing on the streets across the country, threatening the objective to keep cities and communities clean.
According to the Mental Health Authority (MHA), the surge is due to increasing population, coupled with inadequate infrastructure and funding to manage the rising trend.
Daily Graphic’s checks revealed that the situation is worse in the national capital, Accra, while the Bono Regional capital, Sunyani, is also becoming notorious for the menace.
Littering of streets
Such persons do not only litter the streets, as they carry loads of rubbish, including empty cans, plastic bottles and waste paper, but also pose a danger to pedestrians, with some carrying sticks and other dangerous implements.
From nowhere, some appear in front of or at the sides of vehicles in traffic to ‘demand’ money, on many occasions scaring the occupants, especially when there are children on board.
Lack of funds
The Chief Executive Officer (CEO) of the MHA, Dr Akwasi Osei, who confirmed the rise in the presence of mentally ill persons on the streets in an interview with the Daily Graphic, attributed the challenge to the lack of funds to treat and rehabilitate them.
He said although it was unfortunate that mentally ill persons were on the streets, Ghanaians should blame themselves for the problem, as they had not been sensitive enough to call on the central government to act.
Governments had also not been sensitive to listen to the experts, Dr Osei posited.
He said in some instances, rehabilitated mentally ill persons had been abandoned by their families and they find themselves on the streets, begging for alms.
The latest survey on mentally ill persons was carried out about six years ago when the MHA conducted a random rapid assessment of mentally ill persons on the streets in the whole country.
Dr Osei said the assessment found about 15,000 mentally ill persons on streets across the country.
There were about 1,600 of them in Accra and Tema alone, with the figure expected to increase to about 2,000.
The situation has become a worry to many members of the public, who think that such persons should not be allowed on the streets, as some of them attack members of the public without provocation.
They said, for instance, that some mentally ill persons could be seen walking either completely naked or half-naked, a situation that did not help the country’s efforts at making Accra attain its cleanest city agenda.
It did not also teach children any good lessons, they said.
Places the mentally ill persons are usually seen include road medians, pavements, under trees in the capital and under flyovers, generally jeopardising the agenda of making the capital the cleanest city in West Africa.
In Accra, the Korle-Bu traffic lights, along the Mortuary Road, the Ring Road Central, the Nima Highway, the James Fort Prison area, the Arts Centre and around the Efua Sutherland Children’s Park are the places they are commonly seen.
Other places are the Kaneshie First Light at Mataheko, the Tema Station, the High Street, the Accra Sports Stadium and the area around the Kwame Nkrumah Interchange.
During a week-long monitoring of the situation across cities, Daily Graphic teams witnessed a scene at the Liberation Roundabout where a mentally ill man was seen carrying plastic bags full of rubbish while attempting to cross the busy road about 1:30 p.m.
Another incident was when another mentally ill man was spotted smoking under the trees in the median opposite the YWCA, near the Public Records and Archives Administration Department (PRAAD).
A soldier, who appeared shocked at the scene, kept pulling his head out of his car window to take a proper look at the mentally ill person as he drove towards the Kojo Thompson Road.
In Sunyani, the increase in the number of them on the streets has become a concern to residents.
Emmanuel Adu-Gyamerah reports from Sunyani that one of the mentally ill persons was always seen in front of the Cocoa House singing and shouting, with a Bible in his hand.
The activities of these mentally ill persons have become a bother to wayside food vendors, as the former always visit the vendors to ‘demand their share of the food’.
"They will not go until we have satisfied their demands. Sometimes they don’t ask but rather take what they want and walk away,” a food vendor who did not want her name mentioned told the Daily Graphic.
A resident of Sunyani, who identified himself only as Nana Kwasi, said the activities of mentally ill persons on the streets contributed immensely to the creation of filth.
"They carry all sorts of filthy items and leave some wherever they pass. Such is the nature of the situation confronting us,” he said.
He added that some had even pitched camp by the roadside, where they could be seen cooking and bathing.
Nana Kwasi, therefore, called on the government to resource the Mental Health Service to enable it to pick such mental patients from the streets for treatment.
"There is no need for these people who pose a threat to society, particularly children, to be on the streets. Some of them sometimes carry offensive items and they have to be sent for treatment, instead of leaving them to roam in town,” he said.
Dr Osei attributed the increase in the number of mental patients on the streets to the static number of mental health facilities, in the face of a growing population, among other things.
He said about six years ago, the Accra Psychiatric Hospital went out of its way to take five patients from the streets at a time, treated them at the facility and reintegrated the rehabilitated persons in their communities within three months.
“We were able to pick up about 100 within a year or two, but it all required money to be able to go to the streets and bring them,” he said.
Dr Osei explained that the exercise required human resource, including security (police) for protection, nurses to sedate them when they became aggressive and people to clean them, as well as medication and feeding for the period of the rehabilitation.
In caring for the mental patients, the psychiatrist said, some might even require surgery.
“For now, you probably require about GH¢10,000 per patient to do this,” he said.
To be able to raise money to run the authority and deal with such a problem, he said, the Mental Health Levy, as captured in the Mental Health Act, 2012 (Act 846), must be operationalised in order to generate the needed funds to tackle the situation.
Once in a while, he said, the authority went out of its way to solve part of the challenge, but generally there was the need for systematic funding for such an exercise.
Dr Osei gave an assurance that with such funding in place, all persons with the condition could be treated and rehabilitated.
According to him, the MHA had the requisite personnel and know-how to handle the situation.
“We have the Mental Health Act that applies to all these; we have enabling legislation; we have drawn up a very beautiful Mental Health Policy that outlines all these things. What we don’t have is the money to back all these,” Dr Osei reiterated a point he had made on many occasions.
Social welfare system
The Executive Director of Basic Needs-Ghana, a mental health and development advocacy organisation, Mr Peter Badimak Yaro, said mentally ill persons on the streets were an indication of a system failure.
“Every human being gets ill at some point in time and it is how the system helps the person to recover from the illness that determines whether he/she will recover,” he said.
It was a system failure because the country’s mental system was not adequately resourced to attend to mental health cases, he explained.
“Our social welfare system too is not adequate to respond to people who need support,” he said, saying that the situation was compounded by a breakdown in the nuclear and extended family systems, thereby compromising the ability to support people who were in need of care.
“That’s why we have people with mental illness on the streets,” he said, and underscored the need for more attention to be paid to mental health.
For the Basic Needs-Ghana executive, psychiatry facilities were the worst in the healthcare system when compared with others.
Commenting on the issue, the Public Relations Officer of the Ghana Psychological Association, Mrs Joy Anima Debrah, said the presence of mentally ill persons on the streets posed a danger to pedestrians and motorists.
She said although the government had an obligation to deal with the challenge, individual families also had a role to play in caring for their relatives who showed signs of mental problems before their situation became worse.
At the early stages, Mrs Debrah said, families should be able to help their loved ones to enable them to undergo treatment before their condition became worse.
“These mentally ill persons are from families, and when their situation starts getting worse, the families should not look on unconcerned but show a little care to the people by taking them to the hospital for treatment.
“They should also visit them regularly to show them love and affection to get better, rather than abandon them,” she said.
The World Health Organisation (WHO) estimates that 10 per cent of Ghana’s population, meaning 10 out of every 100 people, had one form of mental disorder or another.
The Minister of Health, Mr Kwaku Agyeman-Manu, who disclosed this to Parliament in July this year, said persons suffering from mental health conditions were in the categories of those in treatment facilities, those in traditional/faith healing centres and those in houses or organisations whose conditions had not been recognised as such.
He said it had been clearly established that 41 per cent of Ghanaians had psychological distress — mild, moderate or severe — and that cost the nation seven per cent of GDP loss.
The Daily Graphic has, in the past year, focused attention on some pressing social issues that affect the environment, health and safety of citizens and the national purse.
Some of the issues required urgent intervention of either the government and its agencies or some individuals in the public or private sector to correct them.
We have combined investigative and storytelling skills to shine light on these issues to catch the attention of the institutions or individuals with the mandate to correct them.
Some of the areas of focus are indiscipline by some motorists, especially on the Accra-Tema Motorway, malfunctioning and substandard streetlights.
Some of the stories include;
• Motorway menace on increase, published on December 18, 2020
• Indiscipline unabated: Accra-Tema Motorway without rules (March 17, 2021)
• The lights go dim; Accra-Tema Motorway in focus (April 15, 2021)
• Motorway lights substandard – GSA (April 16, 2021)
• Faded markings pose threat to road users (February 16, 2021)
• Aftermath of rains: Sordid state of some roads in Accra (July 28, 2021)
• Spilled concrete threatens motorists- Ministry of Roads takes action (September 07, 2021)
• Invasion of streets by child beggars: Are authorities helpless? (September 1, 2021)