Ghana: Monitor Mental Health Facilities

The government of Ghana should ensure that its newly formed Mental Health Authority closely monitors all mental health facilities to end the widespread mistreatment of people with mental disabilities, Human Rights Watch said today.

The United Nations special rapporteur on torture, Juan Mendez, in his report today to the UN Human Rights Council, said that people with mental disabilities in Ghana are frequently detained in inhumane conditions in psychiatric hospitals and spiritual healing centers known as "prayer camps." He documented cases of shackling and denial of food and water to people with mental disabilities, including children as young as 7. Human Rights Watch issued a report in 2012 with similar findings.

"The UN expert's report shows the urgent need for Ghanaian government oversight of prayer camps and mental hospitals where people with mental disabilities are suffering horrific abuse," said Shantha Rau Barriga, disability rights director at Human Rights Watch. "The government needs to bring shackling, forced treatment, and other abuses of people with mental disabilities to an end."

Mendez commended Ghana's adoption of the 2012 Mental Health Act and its ratification of the Convention on the Rights of Persons with Disabilities, but he expressed concern that few steps have been taken to carry out the requirements of the legislation. Mendez reported observing people with mental disabilities who had been shackled for prolonged periods to prevent them from escaping or exhibiting aggressive behavior. As he noted, international law does not permit restraining people with mental disabilities on these grounds.

Human Rights Watch documented abuses against people with mental disabilities in Ghana in its 2012 report, "Like a Death Sentence: Abuses against Persons with Mental Disabilities in Ghana." Human Rights Watch found that thousands of people with mental disabilities are forced to live in psychiatric hospitals and prayer camps, often against their will and with little possibility of challenging their confinement.

In psychiatric hospitals, people with mental disabilities face overcrowding and unsanitary conditions. People with mental disabilities in the prayer camps do not receive adequate medical treatment, are often forced to take herbal concoctions against their will, and are deprived of food or water for days. At the eight prayer camps Human Rights Watch visited, nearly all residents were chained by their ankles to trees in open compounds or in prison-like cells, where they slept, urinated, defecated, and bathed.

Ghana's Mental Health Authority was inaugurated in November 2013. Although the government recently nominated members to the authority, it has yet to begin monitoring mental health facilities across the country. Local mental disability advocates have expressed concern that the authority does not include members from nongovernmental organizations, as required by the Mental Health Act.

Echoing key Human Rights Watch recommendations, Mendez called for an absolute ban on the use of electroshock therapy without consent, and a prohibition on chaining and other forms of prolonged restraint. He also highlighted the need for additional mental health professionals, as there is currently one psychiatrist for every two million people in Ghana.

The report should have repeated the call of the special rapporteur's 2013 report on torture in health care settings, Human Rights Watch said. That report stated that "an absolute ban on all coercive and non-consensual measures, including restraint and solitary confinement of people with psychological or intellectual disabilities, should apply in all places of deprivation of liberty, including in psychiatric and social care institutions."

The Ghanaian government should provide community-based services, including housing and proper mental health care, as an alternative to prayer camps and forced psychiatric institutionalization, Human Rights Watch said.

"Ghana needs to closely monitor its mental healthcare facilities as a crucial step in fixing its system," Barriga said. "People with mental disabilities need support and adequate, voluntary medical care, not shackling and forced electroshock therapy."