Stakeholders' perceptions of the main challenges facing Ghana's mental health care system: a qualitative analysis

Mental health remains a low priority in Ghana. No comprehensive studies have assessed the current status of mental health policy, legislation and services in Ghana. This paper presents the qualitative results of a situation analysis conducted as part of the first phase of the Mental Health and Poverty Project. The aim of this paper was to explore what a range of stakeholders perceive as the main challenges facing Ghana's mental health system and the primary ways of addressing them. A total of 81 interviews and seven focus groups were held with key stakeholders drawn from five of the 10 regions in Ghana. The major challenges identified included: inadequate implementation of mental health policy; legislative limbo; inadequate human and financial resource; widespread stigma; dominance of psychiatric hospitals; and insufficient human rights protections for the mentally ill. A range of policy, legislative and service-related recommendations were made for addressing the situation. The results revealed that mental health services in Ghana need to scaled-up to respond to unmet needs in ways that are cost-effective within the budget of a low-income country. Enacting the current mental health bill and identifying strategies for overcoming the barriers to policy implementation will mark significant steps forward