The stigma of mental illness in Southern Ghana: attitudes of the urban population and patients’ views

PURPOSE: Stigma is a frequent accompaniment of mental illness leading to a number of detrimental consequences. Most research into the stigma connected to mental illness was conducted in the developed world. So far, few data exist on countries in sub-Saharan Africa and no data have been published on population attitudes towards mental illness in Ghana. Even less is known about the stigma actually perceived by the mentally ill persons themselves. METHOD: A convenience sample of 403 participants (210 men, mean age 32.4 ± 12.3 years) from urban regions in Accra, Cape Coast and Pantang filled in the Community Attitudes towards the Mentally Ill (CAMI) questionnaire. In addition, 105 patients (75 men, mean age 35.9 ± 11.0 years) of Ghana's three psychiatric hospitals (Accra Psychiatry Hospital, Ankaful Hospital, Pantang Hospital) answered the Perceived Stigma and Discrimination Scale. RESULTS: High levels of stigma prevailed in the population as shown by high proportions of assent to items expressing authoritarian and socially restrictive views, coexisting with agreement with more benevolent attitudes. A higher level of education was associated with more positive attitudes on all subscales (Authoritarianism, Social Restrictiveness, Benevolence and Acceptance of Community Based Mental Health Services). The patients reported a high degree of experienced stigma with secrecy concerning the illness as a widespread coping strategy. Perceived stigma was not associated with sex or age. DISCUSSION: The extent of stigmatising attitudes within the urban population of Southern Ghana is in line with the scant research in other countries in sub-Saharan Africa and mirrored by the experienced stigma reported by the patients. These results have to be seen in the context of the extreme scarcity of resources within the Ghanaian psychiatric system. Anti-stigma efforts should include interventions for mentally ill persons themselves and not exclusively focus on public attitudes

Tertiary prevention in mental health care: Effects of group meetings for family caregivers

Several series of discussion groups were conducted for people caring for relatives who suffer from chronic schizophrenia. Groups aimed to provide information from both experts and fellow caregivers about the illness and about coping techniques, and to foster emotional support within the peer group. Owing to the small number of subjects, statistical power was inadequate to test effects quantitatively; however, the responses of the family caregivers to structured follow-up questions indicated many gains from group attendance. Attendance and participation rates were high once subjects were engaged; positive outcomes were reported by the carers, and they actively sought feedback of their dissatisfactions with mental health services to the relevant decision-makers. The results are relevant both in the area of preventive mental health care for carers, and in promoting collaboration between carers and professionals

Family matters: compensable injury and the effect on family

Purpose: It is well acknowledged that involvement in injury compensation processes can have a substantial impact on the recovery of the injured person. However, little attention has been given to the social or family consequences of compensable injury. The aims of this study were to better understand both the impact of compensable injury on the family and the role that families play after an injury, throughout the compensation process, and during return to work. Methods: Eighteen injured persons and nine family members recruited through three compensation authorities in Victoria (Australia) were interviewed. A thematic analysis was used to identify the role that family played after injury and how family members were affected during the recovery and compensation process. Results: The results highlight the important role family members play following a compensable injury, in addition to factors that impact family members’ daily living, health, and well-being. The study suggests that compensation processes can have an impact on family members, despite compensation systems not formally acknowledging the family in policy or procedure. Conclusions: Compensation authorities should formally consider the role of family in recovery from injury, not only as one means of addressing the overall burden of injury but as a conduit for improving health and function among injured people.Implications for Rehabilitation Family members play an important role after compensable injury that includes providing administrative, instrumental, and emotional support. The recovery and injury compensation process can also have a major impact on family members, particularly in the case of prolonged and complex injuries and illnesses Compensation authorities should formally consider the role of family in the recovery from injury, not only as one means of addressing the overall burden of injury but, as a conduit for improving health and function among injured people.</p