The Mental Health Authority (MHA) is pushing for the establishment of a Mental Health Levy that will ensure that mental health services become free for all, in accordance with law.

The authority expressed concern that, although per the law mental services were to be free, patrons still paid at facility levels due to some operational challenges.

Presenting the 2020 performance review of the sector in Accra yesterday, the Deputy Chief Executive Officer (CEO) of the MHA, Dr Caroline Amissah, attributed the inability of the law to take effect to delays in the release of medicines and funds, insufficient operational funds, among others.

Assessment

The annual performance review was held to assess the impact of the COVID-19 pandemic on mental health service delivery in 2020, as well as the overall performance of the sector and challenges, and map out strategies to ensure quality and accessible mental health care for all.

Dr Amissah said the MHA was discussing and collaborating with major stakeholders, such as the government and other health agencies, to ensure an enabling environment for the implementation of the free mental health provision in the national statutes.

She said a survey would be conducted to ascertain public perception and readiness to support the mental health levy.

“The worrying part is that, because the law has made mental health services already free, it cannot be captured adequately under the National Health Insurance Scheme,” she said.

Targets

Dr Amissah said the mental health levy was just one of the MHA’s 2020 targets aimed at improving mental health care.

She said in the year under review, the MHA prioritised integration and the expansion of access to quality mental health services.

The deputy CEO mentioned other objectives set for the year as ensuring sustainable financing for mental health service delivery, improving efficiency in the governance and management of resources for mental health services and building partnerships with all stakeholder sectors to harness more resources for mental health services.

She said the authority was also keen on reducing stigma and discrimination against persons with mental health conditions.

Achievements

Dr Amissah mentioned some of the authority’s achievements as drafting policies on risk management, clearing the streets of people and the Mental Health Authority Fund Management.

Additionally, she said, the MHA was still in the process of assisting the Ministry of Health (MoH) to identify and process transfer of ownership of parcels of land for the construction of mental health hospitals in the middle and the northern belts of the country.

Challenges

Dr Amissah mentioned major challenges the sector faced in the year under review to include a reduction in the human resource capacity from 2,166, as of December 2020, to 1,948 currently.

She attributed the reduction to a number of factors, including vacation of post, retirement, death, people going on leave without pay and transfers to other facilities within the health sector.

Other challenges included the concentration of mental health facilities in the southern part of the country, the erratic supply of medicines, particularly psychotropic medicines, and insufficient support and resources for mental health policy in the country, she added.

2021 outlook

Dr Amissah said the MHA’s outlook for this year included the recruitment of the appropriate cadre of staff, such as clinical psychologists, counsellors and male nurses.

“We have also prioritised the strengthening of monitoring and evaluation of services at all levels to facilitate transparency and accountability, among many other projections,” she said.

Priority

In a speech read on his behalf, the Minister of Health, Mr Kwaku Agyemang-Manu, said mental health had been given priority in the review of the non-communicable diseases policy to ensure quality and accessible mental health services for all.

Referring to the importance of a centralised mental health infrastructure, he said the ministry was vigorously pursuing the decentralisation of the sector in relation to the national Universal Health Coverage agenda.

That development, he explained, informed the decision to put up two additional mental health facilities in the northern and the middle belts of the country.

Integration

Furthermore, Mr Agyemang-Manu said, the government was pursuing integration of mental health services into the general healthcare delivery system to increase accessibility.

“Incentive packages for mental healthcare delivery staff and other deprived healthcare specialties are under discussion to encourage more personnel to venture and stay in these sectors,” he said.

The Country Director of the World Health Organisation (WHO), Dr Francis Kasolo, applauded the country for the fact that regardless of the challenges posed by COVID-19, health services did not halt.

However, he said, more remained to be done to ensure the delivery of quality, affordable and accessible healthcare services for all.

He expressed the WHO’s continuing support to the health sector.