Coronavirus and persons with mental illness, Who cares?

Initially referred to as “2019-nCoV” or the 2019 novel Coronavirus, COVID-19 an acronym denoted by “CO” for Corona, “VI” for Virus and “D” for Disease.
COVID-19 is a new viral disease linked to the same family of viruses as Severe Acute Respiratory Syndromme (SARS) and some types of common colds.

Currently, available data suggest that the COVID-19 affects different people in different ways. According to the World Health Organization when one is infected, it takes a minimum of 5 days to a maximum of 14 days to show some signs and symptoms with the majority of infected people demonstrating mild to moderate illness and recovery without being hospitalized.

The symptoms experienced by infected people ranges from very common fevers, dry coughs and general weakness to less common symptoms like headaches, loss of taste or smell, diarrhea, sore throats, aches and pains, discoloration of fingers to very severe symptoms like difficulty and shortness of breath, chest pains, loss of speech and movement.

Characterized by its disturbing intensity and severity of transmission, the COVID-19 was initially identified on December 2019 in Wuhan, China. It was declared as a global pandemic on the 11th of March, 2020 by the World Health Organization (WHO). States and governments were called to duty in order to stop the spread of the virus.

Ghana’s case count of the COVID-19 pandemic has risen exponentially since it was first confirmed on the 11th of March, 2020. As at the time of writing this paper, Ghana had confirmed Seven Thousand, Eight Hundred and Eighty-One (7,881) cases of the COVID-19 (www.ghanahealthservices.org.Accessed on 31/05/2020).

There have been international calls to ensure that human rights influence all decisions with regard to fighting this pandemic. In the midst of the novel COVID-19, the right to the highest attainable standard of health and the prevention of threats to public health and the provision of medical care to those in need is safeguarded as per International human rights law (Human Rights Watch, 2020).

Ghana as a signatory to the “International Covenant on the Economic, Social and Cultural Rights (ICESCR)” is expected to respect, protect and fulfil aspects of the right to health. Specifically, Article 12 of the ICESCR guarantees “the right of everyone to the enjoyment of the highest attainable standard of physical and mental health”, including steps to be taken necessary for the “prevention, treatment and control of epidemic, endemic, occupational and other diseases”.

It is therefore the responsibility of the country to anticipate the severe impact of the COVID-19 virus on persons with mental illness who roam on the streets so as to design appropriate rights-based strategies to fully deal with the situation.

Consequently, it means that in this COVID-19 pandemic era all Ghana’s activities and actions for prevention, preparation, containment and treatment from the beginning to the end should be aimed at enhancing public health and supporting the most vulnerable groups and people who are most at risk (mentally ill persons).

In this COVID era, has Ghana risen to the occasion of protecting the rights of mentally ill persons?

Ghana has an estimated population of 30 million people. Per the World Health Organization (2007) estimates, using the same rate of growth, todays’ population of Ghanaians with moderate to mild forms of mental disorder could be projected around 3,000,000 persons whilst 900,000 persons representing 3% of the entire population live with severe mental disorder (Ghana Health Services, Annual Report 2005).

Only a minority (2%) seek care, where services are provided at the various levels, especially at the specialized government psychiatric hospitals and private facilities which are characterized by reduced investment funding hence poor services delivery (Ghana Health Services, Annual Report 2005). Lack of care, stigmatization and poverty are among the key reasons why a lot of persons with mental illness are found on the streets.

The Mental Health Authority reports that an estimated 20,000 persons with mental illness roam the streets and public places in Ghana. About 2,000 out of the total estimate, representing 10% of these persons with mental illness are located in Accra and Tema cities alone.

To a large extent, Ghana’s partial lockdowns of the Greater Accra and Greater Kumasi Metropolitan Assemblies and some contiguous Districts rarely met the globally accepted rights-based approach criteria and also failed to enhance the protection of especially the at-risk population of persons with mental disability.

Interventions

There have been some interventions from governmental agencies and non-governmental organizations during this COVID-19 pandemic in Ghana. During the period of the lockdown, some national televisions were seen telecasting occasions where sections of the vulnerable population were being provided with food, temporary shelter, health screening and sanitary wares by some governmental and non-governmental agencies.

Again, the Gender ministry through the Livelihood Empowerment Against Poverty (LEAP) secretariat released two payment cycles to the vulnerable beneficiaries during the period of the lockdown.

Moreover, the government in a national televised broadcast on April 5th 2020, announced a three month tax holiday for all health workers and an increment in salaries for some health workers in order to boost their morale for work. In furtherance, the president directed for the provision of potable water at no cost for all residents in Ghana.

Additionally, the costs of electricity were fully paid for and/or subsidized (per one’s rate of consumption) for three months in order to cushion the general population on the work time lost during the partial lockdown period.

Furthermore, on the 27th of April 2020, the government launched a stimulus package worth GH? 1.2 billion to boost businesses from the shocks of the pandemic with some positive indications of prioritizing applications from the vulnerable including persons with disabilities to support their business ventures.

Generally, the above-mentioned interventions sought to provide some relief to the entire population and some vulnerable groups, however, there seems to be no specific broader strategies to cater for persons with disabilities and for that matter, persons with mental illness. This is evidenced per the chronology of events and responses observed so far.

In support of this assertion was the press briefing by the Ministry of Gender, Children and Social Protection, where it was indicated that only twenty (20) persons with mental illness were to be taken in and catered for during the lockdown period at only the Greater Accra Metropolis and its contiguous Districts due to the unavailability of facilities to cater for them.

It could be inferred that the strategies aimed at preventing persons with mental illness from contracting the COVID-19 disease were highly inadequate and non-proportional when juxtaposed with the projected 2,000 persons with mental illness roaming the streets of only Accra and Tema, not even talking about those in greater Kumasi.

Moving forward, after the removal of the restrictions on movement, the governments’policy of the three “Ts” strategy of Testing, Tracing, and Treatingwhich are periodically reported on by the relevant government agencies have been silent on records of mentally ill persons. This has been so because not a single test is known to have been conducted on them (unless evidence to the contrary is provided).

In conclusion, the Constitution of the Republic of Ghanain chapter five and six respectively together with International human rights laws, notably the International Covenant on Civil and Political Rights (ICCPR) and the International Covenant on Economic, Social and Cultural Rights (ICESCR) imposes a duty on Ghana to respect, fulfill, promote and protect the rights of all persons including persons with mental illness.

Notwithstanding these obligations to all persons including persons with mental illness, the current state of affairs concerning Ghana’s response to the COVID-19 pandemic, does not make concrete provisions for mentally ill persons.

This is in sharp contradiction to the saying by the world-renowned Sir James Munby, who posited that civilized societies don’t fail the vulnerable.

Recommendations

• We call out on government for a holistic policy to address the needs of vulnerable groups especially persons with mental illness in Ghana in the fight against the COVID-19 pandemic.

• We recommend to government to prioritize the acquisition of data on vulnerable groups so as to ease decision making concerning same.