Brain Spirit Desks

Brain Spirit Desks in the Ketu South District, VR, Ghana

What social, environmental, or public problem are we passionate about addressing? Why do we care?

About 10% of each country’s population, according to the WHO, is affected by a mental illness. This number is accurate for the case of Ghana, where I work with my NGO since 2010. 2.6 million Ghanaians are affected by a psychiatric disorder, some of them display mild symptoms, others moderate symptoms and about 30% suffer from a severe mental illness. Despite this high number of mentally challenged constituents, Ghana only has three government mental health hospitals, which are all in urban areas and in the South. Furthermore, Ghana only less than 30 psychiatrist and the treatment gap (people who need treatment minus patients who are on treatment) is 98%. Despite many efforts, the Ghanaian government has still not adopted the legislative instrument for the Mental Health Act 846, which was passed in 2012. As a consequence, the Mental Health Act cannot be implemented as there are no financial resources allocated. Additionally, the consequences of stigma towards mental health cannot be overestimated. The lack of adequate mental health resources as well as the lack of knowledge contribute to the status quo of mental health patients in Ghana: patients are stigmatized and their human rights violated as they are locked away, chained, and tortured to death. It was through one of my medical internships that I first got in contact with mental health patients in Ghana and witnessed these human rights violations, which set me on a mission to improve the mental health infrastructure in Ghana. The mental health activities on the ground are guided by my German NGO “On The Move e.V.”. Outside of the NGO sector, we partner with the local and the national governments as well as with traditional political authorities such as kings, queens, and councils of the elderly. Through their support, we have been able to work in and with the communities for many years now. Over time we came to realize that a large majority of those suffering from mental illness first visit religious centers (especially prayer camps) before reporting in the hospitals or the few mental health facilities within the country. While some patients benefit from the consultations in religious institutions, for the majority of the cases it delays the diagnosis and hence the begin of adequate treatment. A delay in treatment contributes to the deterioration of symptoms and facilitates chronification of mental disorders. Additionally, some of the mentally challenged patients are evidently treated inhumanely (dry fasting, beating the devil out of the patients, chaining, poor personal hygiene, drinking of unhygienic/contaminated herbal preparations, etc.), e.g., in prayer camps. We asked us if and how these two phenomena (centralized and inadequate mental health care and resources on one hand and preferences for religious institutions rather than for mental health facilities on the other hand) are connected. We then hypothesized that we might be able to offer more quality mental health care through trained religious leaders.

How will our innovation effort address the social problem described?

In short, we want to offer decentralized mental health care through religious institutions. Our approach connects mental health care and spiritual wellbeing in form of so-called “Brain Spirit Desks” (BSD). As part of the BSD project, we train spiritual leaders from different religious institutions and focal persons (community members) in each spiritual center to help in early identification of cases, provide humane modern care and timely referral to mental health professionals, boost the mental health resilience as well as support and empower victims and reduce discrimination and stigmatization – in a spiritual/community-based setting. The vast majority of Ghanaians is spiritual or religious inclined (about 95%). This high number of people who attend religious services gives us the unique opportunity to regularly interact with patients (apart from those with severe symptoms) and community members at risk for mental illness. If we cannot bring the patients to mental health facilities, we can bring mental health care to the patients. This approach is especially attractive because religious institutions are, in comparison to mental health facilities, not stigmatized. Research data suggest that in mental health trained laymen can improve the status quo of mentally challenged patients. Research further suggests that integrating spiritual believe systems and culturally appropriate laymen interventions may yield to better and more meaningful treatment outcomes (for those who are already affected as well as for those who are at risk for mental illness). In general, one can constitute that people who are more religious or spiritual can use their spirituality to cope with life and experience many benefits to their health and well-being. Spirituality and religious activities have been a source of comfort and relief from stress for multitudes of people and have been linked to better somatic and mental health outcomes as well as an increased mental health resilience. In many Ghanaian villages, spiritual leaders (i.e., TFBH) are key figures of the public life. With a training in mental health, they will be able to identify community members at risk for mental illness and/or initiate the primary medical contact with a mental health facility for patients who would benefit from medical treatment. Our initiative also places the work in religious institutions - we give the work back to where it belongs. Instead of imposing potential “solutions”, the religious leaders will stimulate community members to come up with their own solutions of how to destigmatize mental illness and improve the access to mental health care. Lastly, all religious institutions will help us to collect data which will help us to understand more about the perception of mental health or the pain related to mental health felt by community members.

In one sentence, what is our social innovation idea and the problem it will tackle?

With our Brain Spirit Desks, we can increase the access to mental health care in the Ketu South District by training religious leaders in counseling.