Understanding of mental illness and mental healthcare in Ghana : opportunities for collaboration and challenges

Thesis (MPhil)--Stellenbosch University, 2021.ENGLISH SUMMARY : Ghana has a vibrant pluralistic health system. Unfortunately, the mental health sector is dominated by an ineffectual biomedical mental health system. Professional and lay mental health systems coexist; key among them is the faith healing system. There have been several calls for collaboration between different providers of mental health services to provide holistic mental health care, which has led to a research interest in understanding the factors that shape collaborative efforts among various mental health practitioners. This study explored social constructions of mental illness within the faith-based healing system in Ghana, how these shape diagnosis and treatment practices, and the possibility for collaboration with biomedical practitioners. Three objectives were addressed: understanding of mental illness in faith-based centres, healing processes and practices for mental illness, and the possibility for collaboration with biomedical practitioners. A qualitative method was used, with data gathered through ethnography, involving interviews with 20 purposively selected participants, in combination with observation. A thematic analysis of the data showed that the respondents made sense of mental illness using symptomatology and categorisation. Healing processes and practices involved diagnosing origin, determining the category and administering healing and treatment. Collaboration between faith-based and biomedical practitioners provides several opportunities, but is also impeded by several barriers (differences in diagnostic and treatment practice, control, autonomy and power in biomedical mental health practice, and recognition and respect of faith-based practice). The findings are discussed within the context of providing comprehensive and holistic mental health care in Ghana.AFRIKAANSE OPSOMMING : Ghana het ‘n lewendige pluralistiese gesondheidstelsel. Ongelukkig word die geestesgesondheidsektor deur ‘n swak bio-mediese geestesgesondheidstelsel oorheers. Professionele -en lekegeestesgesondheidstelsels, waaronder die geloofsgenesingstelsel van kern belang is, bestaan sy-aan-sy. Verskeie oproepe vir samewerking tussen verskillende geestesgesondheidsdiensverskaffers, om holistiese geestesgesondheidsorg te verskaf, is al uitgereik, welke oproepe gelei het tot ‘n navorsingsbelangstelling om die faktore, wat samewerkingspogings tussen verskeie geestesgesondheidspraktisyns vorm, te verstaan. Hierdie studie het die sosiale konstruksies van geestessiektes binne die geloofsgebasseerde genesingstelsel in Ghana ondersoek, hoe dit diagnose en behandelingspraktyke vorm, en die moontlikheid vir samewerking met bio-mediese praktisyns. Drie doelwitte is aangespreek; die verstaan van geestessiektes in geloofsgebasseerde sentrums, genesingsprosesse en -praktyke vir geestessiekte, en die moontlikheid van samewerking met bio-mediese praktisyns. Kwalitatiewe metodes is aangewend, deur data deur middel van etnografie in te samel, wat onderhoude met 20 doelgerig-gekose deelnemers, in kombinasie met waarneming, behels het. Uit ‘n tematiese analise van die data blyk dat respondente sin van geestesiektes, deur die gebruik van simptomatologie en kategorisering, gemaak het. Genesingsprosesse en -praktyke het die diagnosering van die oorsaak, bepaling van die kategorie en toediening van genesing en behandeling behels. Samewerking tussen geloofsgebasseerde en bio-mediese praktisyns bied verskeie geleenthede, maar word ook deur verskeie hindernisse belemmer (verskille in diagnotiese- en behandelingspraktyke, beheer, outonomie en mag in bio-mediese geestesgesondheidspraktyk, en erkenning en respek vir geloofsgebasseerde praktyke). Die bevindinge word binne die konteks van die verskaffing van omvattende en holistiese geestesgesondheidsorg in Ghana bespreek.Master