Accra (Greater Accra), 7th May ?99 ?
Dr. J.B. Asare, Specialist in charge of Accra Psychiatric Hospital, on Thursday called for community participation in mental health delivery.
He also called for the abolition of large psychiatric hospitals, saying these large hospitals should give way to smaller units which should have some ingredients of therapeutic community programmes where patients could feel the comfort of a home environment until they recover and join their families.
Dr. Asare was speaking on psychiatric practice and the challenges in the next millennium in an interview in Accra.
He said mental health promotion and prevention of mental illness can be undertaken in a primary care setting and urged the adoption of community-based care in the West African sub-region.
"We should not encourage the promotion of large scale psychiatric hospitals again," he said.
Dr. Asare noted that institutional-based care should not and cannot be completely abolished in the sub-region because "no matter what we do, there would be some patients whose conditions would require management in institutions where they feel safe and have some level of security."
Dr. Asare, who is also the Chief Psychiatrist of the Ministry of Health, said a Community Mental Health project is soon to be piloted in the country and would involve identifying and sensitising opinion leaders to address mental health issues in their communities.
The project would cover training volunteers to identify cases, handle referrals, after care and mental health promotion activities and mobilise communities to identify and provide some level of rehabilitation for psychiatric patients in their localities.
Other objectives of the project would be to support the districts with the aim of integrating mental health into primary health care and creating a network of supporting systems of care providers in the districts.
This would include assisting psychiatric nurses in the districts to create awareness of the problem of substance abuse and mental illness.
"Our cultural beliefs have not favoured the mentally ill and institutional-based care has its share in creating and reinforcing detachment of patients from their relatives," Dr. Asare noted.
Meanwhile, he said, with the projected population increase and increase in life expectancy, mental disorders are expected to rise and this situation would be compounded by other stress-related problems brought on by socio-economic conditions.
This situation, he noted, would increase burdens on economic and social life and structures.
By the year 2000, the number of people aged 60 and over in the world would have increased and this would lead to conditions such as dementia and other psychological problems associated with ageing.
Dr. Asare said there is the need for developing practical policies to address problems such as loneliness, isolation, depressive illness, and nutritional deficits, pain and memory impairment, which are common with the aged.
