Saturday, July 26, 2014

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Ghana Elections: A Victory for Mental Health?

For the first time, mentally disabled citizens in Ghana cast votes for their president. But is formal enfranchisement enough?
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A billboard campaign in Tamale, Ghana, regarding the treatment of people with mental illnesses. Photograph by Rachel Strohm.

Last month, for the first time in Ghana’s history, people with mental disabilities living in public psychiatric hospitals were able to cast a vote for their president. But amidst the initial praise surrounding the peaceful election, and the furore around opposition allegations of electoral fraud, this significant step in Ghanaian democracy has been largely overlooked.

Furthermore, while the move has been rightly lauded, the implementation of these new rights and the general treatment of Ghana’s mentally disabled require much more attention.

Polling progress for the people?

The enfranchisement of Ghanaians with mental disabilities came in two stages. Firstly, in June, parliament passed a new Mental Health Act that secures the right of people with mental disabilities to vote and otherwise participate in civil and political activities. Then, in July, Ghana became the 26th African country to ratify the UN’s Convention on the Rights of Persons with Disabilities which establishes the right of people with disabilities to “enjoy legal capacity on an equal basis with others in all aspects of life”. Furthermore, the convention asserts that law and government policy should ensure that those with disabilities have the support they need to exercise these rights.

While current mental health laws need some reform, Ghana deserves credit for passing and ratifying the UN convention this year. For people with mental disabilities, who are often among the most marginalised in society, guaranteeing the right to political participation is an important step towards ensuring full inclusion in their communities, and empowering them to hold elected officials accountable for their interests.

Failures of the system

Unfortunately, however, the new legislation did not immediately translate into new opportunities on the ground. While residents of psychiatric hospitals had the chance to vote for their president, most were not offered the same opportunity to vote for their regional member of parliament. This was largely due to the location of voter registration. For purposes of presidential elections, voters can exercise their democratic rights from wherever they happen to be. However, for parliamentary elections voters are required to cast their votes in the constituency in which they are registered.

As a result, people with mental disabilities who registered in a constituency where the psychiatric hospital is located but have been discharged and returned home to a different constituency could not vote for a member of parliament. The same applied to those residing in psychiatric hospitals who were registered in a different home constituency.

The government also failed to provide information or trained polling staff to support those with mental disabilities who may have needed assistance to vote. Considering people in psychiatric hospitals have limited access to television or radio, this lack of assistance further impaired their ability to make informed decisions.

Shortcomings were also apparent in the provision of transportation between hospitals and polling stations. Generally, those with mental disabilities needed to be transported by bus, but staff shortages in psychiatric hospitals meant suitable transportation was often not forthcoming.

Additionally the thousands of patients resident in private facilities, including the numerous unregulated prayer camps (private religious institutions where people are taken for spiritual healing), were not included in this year’s vote. Institutions such as the prayer camps are not formally registered or monitored by the government.

And finally, it is of note that there remain some legal provisions which continue to disenfranchise some with mental disabilities. Of primary concern is article 42 of the constitution, which bars the right to vote for people deemed of “unsound mind”, and section 55 of the Mental Health Act, which allows limitations on the enjoyment of rights on grounds of “assessment of capacity”.

Much more to be done

For Ghana’s enfranchisement to be fully meaningful, these weaknesses must be addressed. But at the same time, it must be recognised that the right to vote is one of many and one could even argue that the move to enfranchise citizens with mental disabilities is somewhat superficial when considered against the wider plight of these groups within Ghanaian society.

In October, Human Rights Watch released a report documenting the treatment of people with mental disabilities. During five weeks of research, hundreds of people with mental disabilities were witnessed locked in prayer camps and other private facilities. They lived in unhygienic conditions and nearly all of them were chained to trees or walls. Those kept in the camps – usually against their will – were forced to fast. It is crucial the state ensures these prayer camps are regulated and monitored.

Ghana clearly has a long way to go in fully addressing the plight of its citizens with mental disabilities and in fully respecting their rights. But if Ghana is to reform its treatment of a long-marginalised group, it could set an example for other African countries struggling to achieve stability and electoral equality. Ghana may currently be lauded as a shining example of peaceful African democracy, but on the issue of mental health there is still a lot more to be done.

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