Improving Ghana's mental healthcare through task-shifting- psychiatrists and health policy directors perceptions about government's commitment and the role of community mental health workers.
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Authors
Agyapong, Vincent Israel Opoku
Farren, Conor
McAuliffe, Eilish
Issue Date
2016-10-01
Type
Journal Article
Language
en
Keywords
Community mental health workers , Health policy directors , Psychiatrists , Task-shifting
Alternative Title
Abstract
The scarcity of mental health professionals places specialist psychiatric care out of the reach of most people in low and middle income countries. There is growing interest in the effectiveness of task shifting as a strategy for targeting expanding health care demands in settings with shortages of qualified health personnel. Given this background, the aim of our study was to examine the perceptions of psychiatrists and health policy directors about the policy to expand mental health care delivery in Ghana through a system of task-shifting from psychiatrists to community mental health workers (CMHWs).
A self-administered semi-structured questionnaire was developed and administered to 11 psychiatrists and 29 health policy directors. Key informant interviews were also held with five psychiatrists and four health policy directors. Quantitative data were analysed using descriptive statistics. Qualitative data were analysed thematically.
Almost all the psychiatrists and 23 (79.3 %) health policy directors were aware of the policy of the Government of Ghana to improve on the human resource base within mental health through a system of task-shifting. Overall, about half of the psychiatrists and 9 (31 %) health policy directors perceived there is some professional resistance to the implementation of the policy of task shifting. The majority of respondents were of the view that CMHWs should be allowed to assess, diagnose and treat most of the common mental disorders. The respondents identified that CMHWs usually perform two sets of roles, namely; officially assigned roles for which they have the requisite training and assumed roles for which they usually do not have the requisite training. The stakeholders identified multiple challenges associated with current task shifting arrangements within Ghana's mental health delivery system, including inadequate training and supervision, poor awareness of the scope of their expertise on the part of the CMHWs.
Psychiatrists and health policy directors support the policy to expand mental health service coverage in Ghana through a system of task-shifting, despite their awareness of resistance from some professionals. It is important that the Government of Ghana upholds its commitment of expanding mental healthcare by maintaining and prioritizing its policy on task shifting and also providing the necessary resources to ensure its success.
A self-administered semi-structured questionnaire was developed and administered to 11 psychiatrists and 29 health policy directors. Key informant interviews were also held with five psychiatrists and four health policy directors. Quantitative data were analysed using descriptive statistics. Qualitative data were analysed thematically.
Almost all the psychiatrists and 23 (79.3 %) health policy directors were aware of the policy of the Government of Ghana to improve on the human resource base within mental health through a system of task-shifting. Overall, about half of the psychiatrists and 9 (31 %) health policy directors perceived there is some professional resistance to the implementation of the policy of task shifting. The majority of respondents were of the view that CMHWs should be allowed to assess, diagnose and treat most of the common mental disorders. The respondents identified that CMHWs usually perform two sets of roles, namely; officially assigned roles for which they have the requisite training and assumed roles for which they usually do not have the requisite training. The stakeholders identified multiple challenges associated with current task shifting arrangements within Ghana's mental health delivery system, including inadequate training and supervision, poor awareness of the scope of their expertise on the part of the CMHWs.
Psychiatrists and health policy directors support the policy to expand mental health service coverage in Ghana through a system of task-shifting, despite their awareness of resistance from some professionals. It is important that the Government of Ghana upholds its commitment of expanding mental healthcare by maintaining and prioritizing its policy on task shifting and also providing the necessary resources to ensure its success.
Description
Citation
Agyapong, V. I., Farren, C., & McAuliffe, E. (2016). Improving Ghana's mental healthcare through task-shifting- psychiatrists and health policy directors perceptions about government's commitment and the role of community mental health workers. Globalization and health, 12(1), 57. https://doi.org/10.1186/s12992-016-0199-z
Publisher
License
Journal
Globalization and health
Volume
12
Issue
1
PubMed ID
DOI
10.1186/s12992-016-0199-z
10.3390/ijerph7020353
10.1016/S0140-6736(07)61239-2
10.3109/10673229.2012.652875
10.1192/bjp.184.4.366
10.1016/S0140-6736(07)61263-X
10.1186/1748-5908-6-2
10.1192/bjp.bp.115.179556
10.1186/s12960-015-0050-2
10.1186/1472-698X-12-27
10.1016/j.trstmh.2008.09.019
10.1016/S0140-6736(08)60307-4
10.1016/S0140-6736(11)61093-3
10.1186/1478-4491-7-49
10.1056/NEJMsb071889
10.1186/1472-6963-12-61
10.1186/1478-4491-9-1
10.1111/j.1471-0528.2007.01443.x
10.1186/1478-4491-2-12
10.1016/S0140-6736(04)17229-2
10.1111/j.1365-3156.2008.02012.x
10.1186/1478-4491-12-S1-S3
10.1016/j.midw.2013.05.001
10.1002/j.2051-5545.2010.tb00305.x
10.1086/521122
10.1186/1478-4491-7-44
10.1080/17290376.2008.9724916
10.3390/ijerph7020353
10.1016/S0140-6736(07)61239-2
10.3109/10673229.2012.652875
10.1192/bjp.184.4.366
10.1016/S0140-6736(07)61263-X
10.1186/1748-5908-6-2
10.1192/bjp.bp.115.179556
10.1186/s12960-015-0050-2
10.1186/1472-698X-12-27
10.1016/j.trstmh.2008.09.019
10.1016/S0140-6736(08)60307-4
10.1016/S0140-6736(11)61093-3
10.1186/1478-4491-7-49
10.1056/NEJMsb071889
10.1186/1472-6963-12-61
10.1186/1478-4491-9-1
10.1111/j.1471-0528.2007.01443.x
10.1186/1478-4491-2-12
10.1016/S0140-6736(04)17229-2
10.1111/j.1365-3156.2008.02012.x
10.1186/1478-4491-12-S1-S3
10.1016/j.midw.2013.05.001
10.1002/j.2051-5545.2010.tb00305.x
10.1086/521122
10.1186/1478-4491-7-44
10.1080/17290376.2008.9724916
ISSN
1744-8603