Social integration - a challenge to psychiatric patients
“I cannot go home, I do not have any place to lay my head. Doctor, I’m homeless; please help me; please consider me,” 57-year-old Evelyn Ashiabor, a recovered patient, pleaded sorrowfully for mercy with a medical officer at the Pantang Psychiatric Hospital (PPH) in Accra.
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Ever since she was brought to that health facility in 2004 by some family members after suffering Psychosis, a mental disorder, she has been left to her fate, her dreams and aspirations now shattered.
The room that provided shelter for her and her only daughter before her illness has been rented out, forcing her daughter with no option but to perch with friends.
It was a real struggle through thick and thin for her daughter to complete her Polytechnic education, but remains jobless and cannot take care of herself and mother.
Popular hiplife artiste, Kwaw Kese, spent time with some patients at the PPH on Valentine’s Day, and had interactions with Ms Ashiabor who is healed. She, however, has no option but to remain in the hospital.
Ms Ashiabor is just one of such patients with similar tragic experiences in life, after they have recovered from mental ilnesses at the psychiatric hospital.
Challenge
The Director of the PPH, Dr Frank Baning, indicated that there were many patients who had recovered from mental conditions but were still under the care of the hospital because they were homeless.
“This issue has become a worry to the hospital because some people are homeless, others cannot go back to their families because they have been rejected by their own people,” he said.
The stigmatisation of former mental health patients even after they are well, coupled with the rejection by familes, Dr Baning said, was a tall mountain to climb as far as socially conditioning such patients to live normal lives was concerned.
The issue of cost of caring for the cured but abandoned patients is another major hurdle for the hospital. The director said plans were far advanced, however, to launch an initiative, “Setting the Captive Free,” to solicit funds to support such people.
Psychosis
Psychosis is a disorder of thinking and perception, where typically, people do not ascribe the symptoms to a mental disorder.
Most new cases, according to physicians, arise in men under 30 and women under 35, but a second peak occurs in people over 60 years.
People with a first or recurrent psychotic episode tend to present themselves late for medical attention, and many do not present at all. Presentation is often initiated by others, not by patients themselves.
Some people who become depressed (one in five persons over a lifetime) also develop hallucinations and delusions related to and “congruent with” their low mood.
According to statistics by the World Health Organisation (WHO), bipolar affective disorder has a lifetime prevalence of 1.3 -- 1.6 per cent, and it is characterised by episodes of psychosis during both high (“manic”) and low (depressive) relapses.
Also, the misuse of substances, notably cannabis, raises the prevalence of psychotic symptoms and further substance misuse partly explains the 10 times higher prevalence of psychosis in prison populations.
Psychosis occurs frequently in all forms of dementia, including Parkinson's disease. Parkinson's disease affects the nerve cells in the brain that produce dopamine.
Parkinson's disease symptoms include muscle rigidity, tremors, and changes in speech and gait. Treatments can help relieve symptoms, but there is no cure.
Other causes of organic psychoses are neurological disorders such as epilepsy, head injury, haemorrhage, infarction, infection and tumors.
Taken together, therefore, acute psychosis is one of the most common psychiatric emergencies.
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The SDGs
Some questions remained unanswered. What becomes of the lives of patients who recover from psychiatric problems? How are rehabilitating centres preparing the patients to face the real challenges in the world after they are recovered from mental disorders?
Meanwhile, Goal Three of the Sustainable Development Goals (SDGs) emphasises the need to ensure healthy lives and promotes the well-being for all at all ages. Little attention has been given to such issues.
Similar encounters could also be said of the Goal Five and Eight of the SDGs. The Goal Five addresses the achievement of gender equality and empowerment of women and girls in the society while the Goal Eight seeks to promote inclusive and sustainable economic growth, employment and decent work for all.
Way forward
The solution to the social canker can best be approached through a multi-faceted effort where the family, as well as the society will play a crucial role of gradually fitting the recovered patients back into the society.
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The Ministry of Health ought to take pragmatic steps to ensure that Parliament approves the legislative Instrument (LI) on the Mental Health Act, 2012 (Act 846), to empower the Mental Health Authority (MHA) to raise funds to support mental health care.