Ghana: chaining of people with mental health problems persists

(Abuja) – The Government of Ghana has taken inadequate steps to end the shackles and inhumane treatment of people with actual or perceived mental health conditions – psychosocial disabilities – in faith-based and traditional healing centers despite a 2017 ban of such treatment, Human Rights Watch said today.

A decade after the adoption of the Mental Health Act of 2012, establishing a framework for the delivery and monitoring of health care in Ghana, the government has only recently established regional visitation committees and a Mental Health Tribunal, charged with monitoring law enforcement and investigating complaints.

“Shacking people with psychosocial disabilities in prayer camps and healing centers is a form of torture,” said Shantha Rau Barriga, disability rights director at Human Rights Watch. “The newly formed visitation committees and mental health tribunal in Ghana must ensure that shackles come off and that people have access to local services that respect the rights of people with mental health conditions.”

From November 28 to 30, 2022, Human Rights Watch visited five prayer camps and traditional healing centers in the eastern and central region and interviewed more than 50 people. These included people with psychosocial disabilities, mental health professionals, staff at prayer camps and traditional healing centres, mental health advocates, religious leaders and two senior government officials.

In all five of the camps and treatment centers it visited, Human Rights Watch found people were chained or held in small cages, in some cases for more than seven months. During the visits, Human Rights Watch identified more than 60 chained or caged people, including some children.

At Senya Beraku’s Edwuma Wo Wo Ho herbal center, Human Rights Watch found 22 men tightly held in a dark, stuffy room, all with chains, no more than two feet long, around their ankles. They are forced to urinate and defecate in a small bucket passed around the room. Despite the muggy conditions, they are only allowed to bathe every two weeks.

Many of them called Human Rights Watch researchers, begging to be released. “Please help us,” said one man, “we have a human right to freedom.”

As many as 30 other men are being held in another ward, which the traditional healer has forbidden Human Rights Watch researchers from visiting. The herbalist said they were undergoing special spiritual treatment.

In all five camps, people were held against their will in what amounted to indefinite detention. A 40-year-old man detained for more than two months at the Mt. Horeb Prayer Center said, “We spend 24 hours locked up in this room. Can you imagine it? Another man said: “We are not going home this Christmas. We want to go home and be with our family. Help us. Please help us.”

Hearing that the practice of chaining continues, Ghana’s Deputy Minister of Health Tina Mensah said, “With all this education, are they still chaining?”

Caroline Amissah, acting chief executive of the Mental Health Authority, said: “People with mental health problems are human beings just like you and me. They are entitled to their rights. A mental health diagnosis is not a death sentence. We should invest in community services.”

In all five camps visited, Human Rights Watch witnessed serious human rights violations, including: lack of adequate food, unsanitary conditions, lack of hygiene, lack of freedom of movement, and one case of repeated sexual assault. A 41-year-old woman in a field said: “A man [living here] he came to rape me here five months ago, in this room. He raped me three times. It is improper for such a thing to take place in the House of God.” The woman said she received no post-rape assistance.

Human Rights Watch also documented the chaining of several people with psychosocial disabilities at the Jesus Divine Temple Prayer Camp in Nyankumasi, a reversal of practice that had been halted since 2017 when the Ghana Mental Health Authority freed 16 residents there from the chains.

At the Heavenly Ministry Prayer Camp in Edumfa, eight men, five women and two girls with actual or suspected mental health conditions were locked in cages. Men are forced to urinate and defecate in small buckets placed outside their cells. The cages in which the men are held are so cramped that the people inside cannot even stretch their arms.

Ghana’s Mental Health Act of 2012 states that people with psychosocial disabilities “shall not be subjected to torture, cruelty, forced labor or any other inhumane treatment”, including shackles. The act establishes visitation committees and a mental health court to monitor compliance with the law at prayer camps and traditional healing centers. The government says it took 10 years to comply with the law due to lack of resources. The Mental Health Tribunal should uphold international human rights standards, especially the United Nations Convention on the Rights of Persons with Disabilities, which Ghana ratified in 2012.

Based on its research from 2011, Human Rights Watch has found that families often take people with real or suspected mental health conditions to faith-based or traditional healers because of the widespread belief that such disabilities are caused by a curse or evil spirits, and because their communities have limited, if any, mental health services. In some cases, the family member may have used drugs such as marijuana; in others, they were marginalized due to so-called deviant behavior.

Local NGOs, especially those led by people with psychosocial disabilities, have been active in promoting improvements in mental health services and monitoring existing facilities in Ghana. The Mental Health Society of Ghana supports training for visiting committees and the mental health tribunal and supports increased investment in community mental health. MindFreedom Ghana is building community support networks in 6 of Ghana’s 16 regions. Another organization, Basic Needs Ghana, has facilitated peer support groups.

The Government of Ghana should take immediate steps to end the shackles by ensuring that visiting committees and the mental health tribunal are adequately resourced to carry out their responsibilities and by investing in community mental health services that respect human rights, said Human Rights Watch.

The government should also ensure that people with psychosocial disabilities receive adequate support for housing, independent living and vocational training. Government should continue efforts to raise awareness among faith-based and traditional healers as well as the general public to combat the stigma associated with mental health conditions. Finally, the government should prioritize the levy under the Mental Health Act 2012 to fund mental health services.

“Despite Ghana’s ban on shackles, the government has failed to ensure that people with psychosocial disabilities no longer live in such inhumane conditions,” Barriga said. “Visiting committees and the tribunal have an important role to play in ensuring that these long-standing abuses are ended.”

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