Adusei Abena Boahemaa, Ayiku Roberta Naa Barkey, Amarteyfio Kezia Akosua Naa Amerley, Bondzie Eugene Paa Kofi, Adjei-Banuah Nhyira Yaw, Abdul-Samed Abdul-Basit, Mirzoev Tolib, Agyepong Irene Akua
Ghana College of Physicians and Surgeons, Accra, Ghana.
London School of Hygiene and Tropical Medicine, London, United Kingdom.
Front Public Health. 2025 May 9;13:1537955. doi: 10.3389/fpubh.2025.1537955. eCollection 2025.
Mental illness can be as debilitating as physical ailments, yet many mental health patients lack access to quality mental health care in low- and middle-income countries. This study aimed to identify and characterize disparities in access to mental health care, as well as challenges in service provision, in the Ga-South district of Ghana. A qualitative case study design was used, employing purposive and snowball sampling to recruit participants. Sixteen in-depth interviews were conducted with 17 participants, which included one interview with 2 participants. The participants were mental health patients, caregivers of mental health patients, mental health advocates, health promotion officers, and psychiatric nurses in the Ga-South district of Ghana. The findings reveal that stigma, inadequate support, deficiencies in diagnosis and referral, and high treatment costs create substantial disparities in mental health care access. Stigma around mental health constrains both the provision of mental health care by nurses and healthcare-seeking efforts by patients. Diagnosis and referrals of mental health cases are sometimes deficient in the district, with some medical officers and midwives diagnosing mental health conditions inadequately before referrals to psychiatrists. Nurses on the wards also struggle to manage mental health cases, even after receiving mental health training from their facilities. Findings also reveal that some healthcare professionals sometimes exhibit apathy toward mental health issues. The cost of services and medications for patients is also high which prevents patients from seeking care. Additionally, a critical shortage of psychiatrists results in inadequate patient follow-up. The study underscores the urgent need for comprehensive reforms in mental health care delivery to promote inclusion and address disparity issues. It is necessary to ensure equitable access to quality mental health services by addressing workforce shortages and financial barriers, as well as enhancing awareness, training, and efforts to reduce stigma. Prioritizing these reforms will help to create a healthcare system that effectively supports mental health, promoting healthier communities and improving overall health outcomes.
精神疾病可能像身体疾病一样使人衰弱，但在低收入和中等收入国家，许多精神健康患者无法获得优质的精神卫生保健服务。本研究旨在确定并描述加纳加南区在获得精神卫生保健服务方面的差异以及服务提供方面的挑战。采用了定性案例研究设计，运用目的抽样和滚雪球抽样来招募参与者。对17名参与者进行了16次深入访谈，其中包括一次对2名参与者的访谈。参与者包括加纳加南区的精神健康患者、精神健康患者的照料者、精神健康倡导者、健康促进官员以及精神科护士。研究结果表明，耻辱感、支持不足、诊断和转诊缺陷以及高昂的治疗费用在精神卫生保健服务的可及性方面造成了巨大差异。围绕精神健康的耻辱感既限制了护士提供精神卫生保健服务，也限制了患者寻求医疗服务的努力。该地区精神健康病例的诊断和转诊有时存在缺陷，一些医务人员和助产士在将患者转诊给精神科医生之前对精神健康状况的诊断不足。病房里的护士即使在接受了所在机构的精神健康培训后，在处理精神健康病例时仍面临困难。研究结果还表明，一些医疗专业人员有时对精神健康问题表现出冷漠。患者的服务和药物费用也很高，这使得患者无法寻求治疗。此外，精神科医生严重短缺导致对患者的随访不足。该研究强调迫切需要对精神卫生保健服务进行全面改革，以促进包容性并解决差异问题。有必要通过解决劳动力短缺和经济障碍，以及提高认识、加强培训和努力减少耻辱感，来确保公平获得优质的精神卫生服务。优先进行这些改革将有助于建立一个有效支持精神健康的医疗系统，促进社区更健康并改善整体健康结果。
