Mental health or psychological well-being makes up an integral part of an individual’s capacity to lead a fulfilling life, including the ability to form and maintain relationships, to study, work or pursue leisure interests and to make day-to-day decisions about educational, employment, housing or other choices.
The opening paragraph depicts the relevance of mental health care to the economy and the need for duty bearers to prioritise this area and treat it as a development issue.
The World Health Organization (WHO) estimates that one in four people will experience a mental health condition in their lifetime. While there has been growing recognition that neurological health and mental wellness, or lack thereof, is both a cause of and solution to global issues like violence, poverty and overall health.
Experts say it makes economic sense to invest more in mental health. This is so because when cost- effective community level treatment is available there is substantial improvement in workforce productivity. The WHO & World Economic Forum (WEF) estimate that the global impact of mental disorders will amount to loss of economic output of $16 billion.
In discussing funding for mental health, it is relevant to point out that, as a country, a tremendous amount of visionary thinking, scientific research, governmental leadership and public readiness has led us to where we are today. And now there is a need to focus on concrete solutions and steps to integrating a mental health budget line into the work of achieving the Sustainable Development Goals (SDGs).
Why gov’t should focus on Mental Health
Despite the obvious importance of mental health, it continues to occupy the back seat when it comes to the allocation of resources. This is due to the burden of infectious and non-communicable diseases which are given priority over mental health.
There are fundamental reasons why mental health needs to be a greater priority in development. First is that copious reference can be made to studies which show that of people with disability, people with psychosocial disability are the poorest and the most unemployed. The rates of unemployment among people with mental illness who have stabilized in their conditions remain unacceptably high in many countries including Ghana.
Employers do not trust people with mental illness to work. They are not accepted to work because they are thought to be possessed or contagious. It’s partly the social justice issue of not employing people with a disability.
but also it is not good for development.
If one in four people in their lifetime have a mental health problem and if that is not dealt with properly, quickly, effectively, then it is likely to even affect their family’s income catastrophically. And it will also impact the capacity of a country’s economy to grow. In a nutshell, the development of this country has been held back by the level of cases of untreated mental illness. Meanwhile, pathetically, budget or funding allocations for mental health remain scandalous and it is broadly encapsulated by stigma and ignorance. We continue to still witness pitiful contribution of money to mental health care — less than one percent of health budgets. That needs to urgently change!
Justification for improving mental health financing
Financing is a fundamental building block on which the other critical aspects of any system rests. Similarly, adequate and sustained financing is a critical factor for the translation of plans into action, towards realization of a viable mental health system.
It is imperative that funding or financial systems for mental health care be aligned so that they maximize quality and do not become an obstacle to quality improvement; noting that the goal of quality improvement is ultimately to respect the rights of people with mental disorders ensuring that they are provided with the best available care, increase self-reliance and improve the quality of life.
Under the Millennium Development Goals, mental health was overlooked. But under the Sustainable Development Goals, goals for health include well-being. For advocates of better mental health support systems in developing countries, the SDG goals are opening the doors to build awareness on the diverse needs of people with mental health and the discrimination they face.
The need for mental health budget?
Budgeting for mental health service ensures transparency and accountability into the utilization of scarce resources, and ensures that the provision of mental health service remains a priority and is sustainable. Budgetary allocations to mental health will honour the various perspectives in the field, while inspiring a united vision of a person’s right to dignity and right to care and facilitate effective development of policies, strategic plans and programmes. A good mental health budget will bring forward those marginalized by psychosocial disability and those who have worked beside them to share their own unique experiences and insights on the intersection between mental health and poverty, health and peace.
However, the immense benefits that adequate funding resources holds for the effective delivery of mental health service in the country appears to have eluded political leadership in Ghana, except to say that in recent years there have been some good focus on mental health in terms of legislation (the legislative instrument for the Mental Health Act,846, 2012, has just been approved) and some commendable commitment to release of funds to address some of the age-long challenges of the psychiatric hospitals, but resources remain severely inadequate as relatively insignificant levels of total heath budget are provided mental health.
Supporting the mental health advocacy
It is important to note that it takes some advocacy and policy-influencing actions on the part of stakeholders to achieve a specific change objective. It is within this context that reference can be made to a currently on-going project titled “Accessible and Quality Mental Healthcare for Poor and Marginalized Persons with Mental Disorders.[T1] ” The project, funded by STAR-Ghana Foundation, is being implemented by the Mental Health Society of Ghana in collaboration with BasicNeeds [T2] [PA3] Ghana. As part of implementing this project the National Executive Committee of the Mental Health Society of Ghana (MEHSOG), met in Accra on Wednesday, 23rd of August, 2019. The purpose of that meeting was for the National Executive Committee of MEHSOG to deliberate, develop and implement a user/carer-led advocacy on financing community mental health. The meeting considered wide-ranging issues that ensure quality mental health services, focusing particularly on the relevance of funding to achieve the desired quality in mental health.
The Government, through the Ministry of Health, Departments and Agencies in collaboration with development partners is working towards attaining the universal health coverage by implementing the various sections of the Sustainable Development Goals. However, it is extremely important to stress that universal health coverage which is health for all, can only be attained when the mental health of the people are well catered for, per the WHO definition of health.
As we, in Ghana, strive to meet the April 2001 Abuja declaration that enjoins countries in the sub-region to commit at least 15% allocation of national budget to health, it would be most laudable if the allocation of mental health is revised upwards from the current 1% to support in meeting the mental health needs of the people. when looked at from whatever angle, there is a solid case for investing in mental health, whether on the grounds of enhancing individual and population health and well-being, reducing social inequalities, protecting human rights, or improving economic efficiency. Arguably, the wealth of every nation is dependent on the sound mind in body and soul of the people. As has been alluded to, mental health is the bedrock of all health interventions and should therefore be given the highest priority it deserves.
By Fatawu Iddrisu
The Author is the Chairman of National Executive Committee (NEC) and President of MEHSOG