Ghana: End Chain for Mental Illness

(Accra) – Ghana’s 2017 ban on shackling people with psychosocial disabilities – or mental illness – has not stopped the practice, Human Rights Watch said today. The government has not provided sufficient funds for enforcement mechanisms to monitor compliance at religious centers where people are kept in chains and to assist those currently illegally detained.

Human Rights Watch visited two spiritual healing centers – known as “prayer camps” – from October 19 to 23, 2023 in the Eastern region of Ghana and interviewed more than 30 people. They included people with psychosocial disabilities, prayer camp workers, mental health advocates, a mental health professional and a senior civil servant. Human Rights Watch found ten people in the two camps being held in chains against their will, amounting to indefinite detention and other ill-treatment.

“The Ghanaian government’s 2017 ban on shackling and promises to address this abuse have not ended the shackling of people with psychosocial disabilities,” said Elizabeth Kamundia, deputy disability rights director at Human Rights Watch. “The government should enforce the ban so that the chains come down and help people improve their lives. One chained man is too many.”

A Human Rights Watch researcher arriving at the Mount Horeb prayer center in Mamfi heard a staff member telling colleagues to “clean things up.” When Human Rights Watch later gained access to the facility, they found chains lying on the ground, but only one person was still chained, a 19-year-old woman who had been chained for two weeks in a rundown and poorly ventilated room. Another person at the restaurant said the woman was chained up because the staff did not want to eat. Staff members told Human Rights Watch that fasting was the prescribed treatment for her condition and was necessary for her “deliverance.”

One man at the facility, who was shackled two months after arriving, said: “This environment is not conducive to healing.”

Another man said: “I want to go back to work and I want to get married. I want to live my life.”

People detained in the camp spoke of constant, ravenous hunger from inadequate food; some looked emaciated. A few were kept in cramped cubicles, while others had some freedom of movement in what was billed as a “VIP” room. Others, who were thought to be in a more acute condition, were particularly emaciated and confined to a small windowless room called the “convicted” room. Prophet Paul Kweku Nii Okai, the leader of the camp, told Human Rights Watch that prayer and fasting were his interventions for mental illness.

At the Pure Power prayer camp in Adeso, Human Rights Watch found nine people, including a woman, shackled with chains no longer than half a meter around their ankles. They were forced to urinate and defecate in a shared small bucket. A man was chained under a tree.

The UN Special Rapporteur on Torture specifically noted after his visit to Ghana in 2015 that shackling “unequivocally means[s] of torture, even if committed by non-state actors under conditions where the state knows or should know about them.’

Dr. Pinaman Apau, chief executive officer of the government’s mental health authority, said: “We have trained the leaders of the prayer camps, but we also need to strengthen the mental health system at the community level.” She said the main challenge facing the government in dealing with the abuses of the prayer camps is the lack of funding.

According to Ghana’s Mental Health Act 2012, people with psychosocial disabilities “shall not be subjected to torture, cruelty, forced labor or any other inhuman treatment”, including shackling. The law calls for the creation of visiting commissions in all 16 regions to carry out inspections and ensure that the rights of people with mental illness are protected, as well as a mental health tribunal to offer recourse.

Ten years later, only five regions have committees; two of which made only one observation visit. The government claims it has taken so long because of a lack of funds, even though the law requires the finance minister to prescribe an appropriate levy or levy to fund mental health care through parliament. Such a levy should be urgently introduced.

Human Rights Watch witnessed a number of serious human rights violations in both camps, including denial of adequate food, unsanitary conditions and lack of hygiene, lack of access to health care, imprisonment, and denial of freedom of movement.

Families in Ghana often bring people with real or suspected mental illness to religious or traditional healers because of widespread beliefs that curses or witchcraft cause such disabilities and because their communities have limited, if any, mental health services.

Kweku Nii Okai of Mount Horeb Camp said he believes people have psychosocial disabilities for several reasons, including ancestral curses, evil spirits or a family member who is or was a fetish priest or priestess, people who serve as mediators between spirits and men.

One man who has been in and out of Mount Horeb for over a decade said, “You can be brought here for many reasons. Smoking weed, having illicit sex with other men.

Local NGOs, particularly those led by people with psychosocial disabilities, have actively advocated for improved rights-based mental health services and facility monitoring in Ghana. The Mental Health Society of Ghana provides training for the Association of Traditional Medicine Practitioners of the Federation of Ghana on a rights-based approach to mental health at the national level so that the association can disseminate this information to its members.

MindFreedom Ghana led a coalition of mental health groups in writing a report sent to countries participating in the UN Human Rights Council’s Universal Periodic Review of the State of Human Rights in Ghana, which made recommendations on the need to provide services for mental health in Ghana.

The government must take immediate steps to end shackling and other abuses in the prayer camps, Human Rights Watch said. This includes providing Visiting Committees and Mental Health Tribunals with adequate resources to carry out their responsibilities and investing in rights-respecting community mental health services.

The Government must also ensure that people with psychosocial disabilities receive adequate support for housing, independent living and job training. The government should provide training to traditional and religious healers and the general public to combat stigma and ensure that people can live with dignity in the community. Finally, the Government should establish the fee required under the Mental Health Act 2012.

“The Government of Ghana allows these camps to operate with minimal regulation and no consequences for violating the rights of people with psychosocial disabilities,” Kamundia said. “Boards of Visitation and the Tribunal must be fully operational and adequately funded to ensure that people are released and can live freely.”

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