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Fifty-four-year-old Asana Forson, whose son has been battling with mental health difficulties for the past three years, has been struggling to get a second dose of COVID-19 vaccine for her son for months.

Fearing that her son was vulnerable to catching the virus due his condition, she did not hesitate to get her son inoculated when the Government rolled out a mass vaccination programme for the public last year.

Sixteen months down the line, efforts to get the second dose have been futile, she says.

“After the first shot, we were told to come back in three months for the second shot. I have visited the Centre more than five times and anytime I go there, I am told there are no vaccines,” she said.

“My son normally suffers from fever, and I give him medicines. I really need to get the second shot because I do not want anything to happen to him,” Asana added.

Every week, Asana visits the Accra Psychiatric Hospital (the largest mental health facility in the capital) to procure medication for her son.

The Facility caters for an average of 80 persons with mental health disorders daily and houses 290 in-patients.

The Hospital says it has so far vaccinated all inpatients in addition to its staff, but currently, it does not have a vaccination centre dedicated to persons with mental health disorders.

“We do not have a vaccination centre at the facility. However, for all the two national vaccinations that took place, Accra Psychiatric Hospital was selected as a site,” it said in response to a written enquiry about whether or not the Hospital had a vaccination centre.

The Ghana News Agency gathered that the situation was not different at the Pantang Hospital and the Ankaful Psychiatric Hospital where inpatients and staff of the hospitals had been inoculated.

According to sources, outpatients who were interested in getting the jabs were referred to nearby health facilities accessed by the public.

However, in separate interactions with some persons who had come to the Accra Psychiatric Hospital to seek care for their relatives, they expressed concern about being stigmatised when they visit health facilities accessed by the general public.

That situation, they said, had accounted for their lack of interest in getting the jabs for their relatives.

“I will prefer if there was a vaccination centre here so we can access it directly instead of visiting a facility where we will not feel accepted,” a mother, who spoke on condition of anonymity, said.

The Government in the beginning of the year embarked on a massive vaccination campaign with the aim of vaccinating 20 million Ghanaians part of measures to combat the COVID-19 pandemic.

The mass vaccination campaign targets vulnerable groups such as healthcare workers, security personnel, students, commercial drivers, and government workers, and persons living with disabilities.

With the country said to be experiencing a fifth wave of the coronavirus, the vulnerability of persons with mental health disorders to contracting the virus appear to have intensified, in the wake of the widespread disregard to the COVID-19 preventing protocols, including wearing of nose masks.

As of June 20, 2022, Ghana’s active cases has risen to 1,255 – the highest in months.

Unlike mental health facilities who have vaccinated their inmates, thousands of mentally ill persons on the streets have been cut off from the country’s vaccination programme as there is no plan in place to target that group.

The last random rapid assessment carried out by the Mental Health Authority (MHA) about six years ago, found about 15,000 mentally ill persons on streets across the country.

According to the Alliance for Mental Health and Development, a national network of CSOs, NGOs, and CBOs engaged in mental health advocacy in Ghana, persons with mental illness are among the “worst affected by the pandemic,” and among the most vulnerable to contract COVID-19 because of their “poor income and health status.”

The BasicNeeds Ghana, a non-governmental organisation, has been advocating for the inclusion of persons with mental health disorders in the Government’s COVID-19 relief package and vaccination programme.

The Organisation says accessibility of vaccines by persons with mental illness has been a challenge particularly at the community level.

Mr Peter Yaro Badimak, Executive Director, BasicNeeds Ghana, said the population also lacked guidance and education on the vaccines, and called for more sensitisation to reduce hesitancy.

“There was so much rush for the vaccines and so the able-bodied people out-muscled persons with psychosocial conditions who because of their peculiar situation were so weak and not able to come out.

“Now that the vaccine is said to be widely available in healthcare facilities, we should bring it closer to the people especially at the community level,” he said.

When contacted, the MHA said currently, it had no plan or programme in place to specifically target persons with mental health disorders for COVID-19 vaccination.

“I do not think so far, we have identified anything that makes them (persons with mental illness) specifically disadvantaged.

“As much as possible, we want to remove stigma, so, we don’t want any differentials that might stigmatise anybody,” Professor Akwasi Osei, Chief Executive Officer of the Authority, said.

The Ghana Health Service said its attention had been drawn to the need to have a “special dispensation” for persons with mental health illness to enhance their accessibility of the vaccines and had made efforts to address the situation.

Dr Kwame Amponsa-Achiano, the Programme Manager for the Expanded Programme on Immunization (EPI), GHS, said the District Health Directorate within the Korle Klottey Municipality, where the Accra Psychiatric Hospital is sited, had been directed to make provisions for that population.

“If there is need to establish a vaccination centre at the mental hospital, that can be done, but it hasn’t come to our attention,” he said.

The World Health Organisation (WHO) estimates that 10 per cent of the population of Ghana (30.8 million) has one form of mental disorder or the other.

Access to quality healthcare (physical and mental health) is a fundamental human right as enshrined in WHO’s Constitution, adopted by member countries.

“The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition,” the preamble of the Constitution reads.

In September 2015, mental health was included in the UN Sustainable Development Goals (SDGs). The WHO recognises mental health as key to achieving social inclusion and equity, universal health coverage, access to justice and human rights, and sustainable economic development.

The negligence of persons with mental health disorders in national COVID-19 vaccination plans has become a global phenomenon.

A survey conducted by the Psychiatric Section of the European Union of Medical Specialists (EUMS) and published in Lancet Journal in February last year found out that people with severe mental illness “are not being prioritised for vaccination.”

Out of 20 European countries surveyed for a study, only the Netherlands, Britain, Germany, and Denmark were found to recognise severe mental illness as a high-risk medical condition and to have made specific provisions for vaccinating patients.

The EUMS recommended that there should be an “explicit inclusion of both inpatients and outpatients with severe mental illness in priority groups for COVID-19 vaccination, meaningful patient and family organisational participation in developing vaccination plans, and engagement of peer workers in providing vaccination education to patients.”

In September last year, India’s Supreme Court ordered states in India to make Covid-19 vaccinations available to everyone detained in a mental health facility and to the staff.

The Court expressed concern about what it described as human rights violations in mental health facilities and directed states to submit a progress report to the Ministry of Social Justice and Empowerment explaining the steps they have taken, including the number of people vaccinated within one month.