Written by: Dr Atsu Latey, Founder And Team Lead, Mindit Mental Health Service. To learn more, follow MindIT on Facebook and Twitter
Many Ghanaians are living with undiagnosed mental illness. According to a situational analysis by the World Health Organization (1), “it is estimated that of the 21.6 million people living in Ghana, 650,000 are suffering from a severe mental disorder and a further 2,166,000 are suffering from a moderate to mild mental disorder” and the treatment gap is “98% of the total population expected to have a mental disorder”. Through interactions with the personnel of the Ghana Mental Health Authority, I, the Founder and Team Lead of MindIT Mental Health Service, learned that there are approximately 38 psychiatrists to serve the entire population of Ghana, tipping the ratio of psychiatrists to the Ghanaian population to a staggering 1 psychiatrist per every 800,000 Ghanaians.
We strive at MindIT Mental Health Service to work towards closing this enormous and dangerous treatment gap. While working with MindIT Mental Health Service to improve mental healthcare in Ghana, I have identified that many Ghanaians are ignorant about mental health conditions and where they can access to affordable and accessible mental healthcare services. MindIT Mental Health Service uses innovative technology to screen Ghana’s population for mental illness and provide them with affordable and easily accessible care. To do this, we leverage on already established healthcare systems in the country. Presently, the management team of MindIT Mental Health Service comprises of a brand strategist, a computer engineer, a PRINCE2 Certified Project Manager, a doctoral candidate in counseling psychology, and a medical doctor.
With regards to the low numbers of psychiatrists available, the Ghana Health Service sought to improve this by training community nurses from the National Health Insurance Scheme to enable them to diagnose mental illnesses and prescribe medication – thereby increasing the number of trained mental health professionals in the country. Even though the Ghana Health Service has introduced this intervention, many people are still unaware of these services. MindIT Mental Health Service seeks to change this by working to screen the community free of charge and link people to the services geographically closest to them for free consultations under the country’s National Health Insurance Scheme.
There are at least 1,068 Registered Mental Nurses working in the country (2). Hence, we screen the MindIT Mental Health Service users for psychological distress and sign post them to the community psychiatry units where the nurses are stationed for further evaluation and care. At these centers, the initial cost and treatment of diagnosed mental health conditions are covered by the National Health Insurance Scheme (3). The tool used for the screening by MindIT Mental Health Service is available by dialing short code and it is free on all networks in Ghana. The short code is: * 7 1 3 * 6 6 #. The screening tool available by calling the short code comprises of the common symptoms of Depressive Disorder, Generalized Anxiety Disorder and Psychotic Disorders. When users dial the short code, they follow the text prompt and answer a four question questionnaire. Their telephone numbers and responses are automatically forwarded to the Ghana Mental Health Authority call center via an instant text message, which is also recorded on our Electronic Health Records System. The call center operators call to screen the callers further and connect them to the appropriate community psychiatric unit.
Calling the short code is absolutely free and users are contacted by the call center personnel and directed to the community psychiatry unit that is closest to them for free consultations and subsidized medication under the National Health Insurance Scheme. This is a solution to the problems of geographical and financial accessibility to mental health care in Ghana. The users are directed to the units closest to them and the high cost of psychiatric fees are avoided through this free service.
MindIT Mental Health Service has received more than 2,000 user responses since it began in October 2017. The code is operational countrywide and does not need airtime or mobile data to work, thus those without smart phones can use it. Essentially, we use the mobile phone handset to provide affordable and accessible mental healthcare at absolutely no cost to the user. This is novel and practical, and with similar barriers to mental healthcare in other Sub Saharan African countries, we hope that this service can be extended to other countries in Africa in the near future.
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Edited by Louisa Hudson, MSc, Research Assistant, Department of Global Health and Social Medicine, Harvard Medical School
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