Ghana – Chaining People With Mental Health Conditions Persists

Abuja — Ghana’s government has taken inadequate steps to end the chaining and inhumane treatment of people with real or perceived mental health conditions – psychosocial disabilities – in faith-based and traditional healing centers despite a 2017 ban on such treatment, Human Rights Watch said today.

A decade after the adoption of the 2012 Mental Health Act, which establishes a structure to provide and monitor health care in Ghana, the government has only recently established regional Visiting Committees and a Mental Health Tribunal, mandated to monitor implementation of the law and investigate complaints.

“Chaining 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. “Ghana’s newly formed Visiting Committees and Mental Health Tribunal need to ensure that the chains 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 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 centers, mental health advocates, religious leaders, and two senior government officials.

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

At Edwuma Wo Wo Ho Herbal Center in Senya Beraku, Human Rights Watch found 22 men closely detained in a dark, stifling room, all of them with chains, no longer than half a meter, around their ankles. They are forced to urinate and defecate in a small bucket passed around the room. Despite the sweltering conditions, they are only allowed to bathe every two weeks.

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

As many as 30 more men are detained in another section, which the traditional healer prohibited Human Rights Watch researchers from visiting. The herbalist said that they were undergoing special spiritual treatment.

In all five camps, people were held against their will in what amounts to indefinite detention. A 40-year-old man held for more than two months at Mt. Horeb Prayer Centre said, “We spend 24/7 locked up in this room. Can you imagine that?” Another man said, “This Christmas we won’t be going home. We want to go home and be with our family. Help us. Please help us.”

On hearing that the practice of chaining continues, Ghana’s deputy health minister, Tina Mensah, said, “With all this education, they’re still chaining?”

Caroline Amissah, acting chief executive of the Mental Health Authority, said, “People with mental health conditions 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 services in the community.”

In all five camps visited, Human Rights Watch witnessed serious human rights abuses, including: lack of adequate food, unsanitary conditions, lack of hygiene, lack of freedom of movement, and one case of repeated sexual violence. A 41-year-old woman in one camp said, “A man [living here] came to rape me here five months ago, in this room. He raped me three times. It is improper for such a thing to happen in the House of God.” The woman said she did not receive any post-rape care.

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

At Heavenly Ministry Prayer Camp in Edumfa, eight men, five women and two girls with real or perceived mental health conditions were confined in cages. The men are forced to urinate and defecate in small buckets placed outside their cells. The cages where the men are detained are so narrow that the people inside cannot even stretch out their arms.

Ghana’s 2012 Mental Health Act provides that people with psychosocial disabilities “shall not be subjected to torture, cruelty, forced labour and any other inhuman treatment,” including shackling. The act establishes Visiting Committees and a Mental Health Tribunal to monitor prayer camps and traditional healing centers on compliance with the law. The government claims that it took 10 years to comply with the act because of a lack of resources. The Mental Health Tribunal should uphold international human rights standards, particularly the United Nations Convention on the Rights of Persons with Disabilities, which Ghana ratified in 2012.

Based on its research since 2011, Human Rights Watch found that families often take people with real or perceived mental health conditions to faith-based or traditional healers because of widely held beliefs 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 been using drugs such as marijuana; in others, they were outcasts because of so-called deviant behavior.

Local nongovernmental organizations, especially those led by people with psychosocial disabilities, have been active in pushing for improvements in mental health services and monitoring of existing facilities in Ghana. The Mental Health Society of Ghana is supporting training for the Visiting Committees and Mental Health Tribunal and advocating for increased investments in community mental health. MindFreedom Ghana is establishing community support networks in 6 out of the 16 regions of Ghana. Another organization, Basic Needs Ghana, has been facilitating peer support groups.

The government of Ghana should take immediate steps to end shackling by ensuring that the Visiting Committees and Mental Health Tribunal have adequate resources to carry out their responsibilities and by investing in community mental health services that respect human rights, Human Rights Watch said.

The government should also ensure that people with psychosocial disabilities get adequate support for housing, independent living, and job training. The government should follow through on commitments to sensitize traditional and faith-based healers as well as the general public to combat the stigma associated with mental health conditions. Finally, the government should set up the levy envisaged under the 2012 Mental Health Act to fund mental health services as a matter of priority.

“Despite Ghana’s ban on chaining, the government has failed to ensure that people with psychosocial disabilities no longer live under such inhumane conditions,” Barriga said. “The Visiting Committees and Tribunal have an important role to play in ensuring an end to these longstanding abuses.”

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