Despite the large number of people with disabilities in Ghana, less than one per cent of the national health budget is spent on mental health services. People with mental disabilities living in the community also reported that there are few support services, including medical care, aimed at helping them integrate into community life. As a result, they lack medication and other basic necessities such as food and shelter. The World Health Organization estimates that close to 3 million Ghanaians live with mental disabilities and 600,000 of these have very severe mental conditions. Ghana has only three public psychiatric hospitals (all of them in the south), 12 practising psychiatrists, and 600 psychiatric nurses.
Human Rights Watch accuses the Ghanaian government of doing little to combat abuses of people with mental disabilities. The report alleges that they face overcrowding and unsanitary conditions in psychiatric hospitals, and are often chained to trees at spiritual healing centers.
Ghana's three public psychiatric hospitals - in Accra, Pantang, and Ankaful - house an estimated 1,000 people with mental disabilities. In all three institutions, Human Rights Watch found filthy conditions, with foul odors in some wards or even feces on the floors due to broken sewage systems. The hospital in Accra was severely overcrowded and many people spent all day outside the hospital building in the hot sun, with little or no shade. In one ward of Accra Psychiatric Hospital in the capital, there are just 26 functional beds for 205 in-patients, according to HRW. Nurses, lacking cleaning equipment, "instructed patients to clean the wards and toilets, including removing other patients' faeces without gloves", said the researchers. Without enough staff to properly restrain aggressive patients, staff routinely turn to violence, patients told HRW. Patients reported physical abuse in the form of beatings, forced seclusion and involuntary electro-shock therapy.
Mental disability in Ghana is widely considered to be caused by evil spirits or demons. When "orthodox" psychiatric treatment does not work, some resort to prayer camps which enact so-called spiritual healing. The report found even worse conditions in prayer camps than in psychiatric institutions. Human Rights Watch found that at least hundreds - and possibly thousands - of people with mental disabilities are institutionalized in prayer camps associated with Pentecostal churches. Managed by self-proclaimed prophets, these camps operate completely outside of government control. People with mental disabilities at these camps do not receive any medical treatment - in some, such treatment is prohibited even when prescribed by a medical doctor. Instead, the prophets seek to "cure" residents through miracles, consultation with "angels," and spiritual healing. At the eight prayer camps inspected, nearly all residents were chained by their ankles to trees in open compounds, where they slept, urinated, and defecated and bathed. Some had been at the prayer camps for as long as five months. As part of the "healing process," people with mental disabilities in these camps - including children under age 10 - are routinely forced to fast for weeks, usually starting with 36 hours of so-called dry-fasting, denied even water.