Innovations in mental health training: the Kintampo Project, Ghana

Mark Roberts,1 Emmanuel Teye Adjase2 and Jim Crabb3

Background Until recently only 2% of people with a mental illness in Ghana, West Africa, received treatment or assessment by health services, as there were only around 18 psychiatrists and 1177 other trained mental health workers for the whole country of 24 million people (Roberts et al, 2013). A high-income country (e.g. the UK) would expect nearer 24000 such workers for 24 million people. Ghana now has a growing health budget but has nevertheless experienced a doctor and nurse ‘brain drain’. Concerns about human rights abuses and the emergence of increasingly Western disease profiles have focused the country on improving mental health services. In 2007 the Ghana government resolved to strengthen community services by developing two new types of middle-level mental health worker, the clinical psychiatric officer (CPO) (initially called the medical assistant psychiatry, MAP) and the community mental health officer (CMHO). The CPO performs a similar role to district-level psychiatrists and the CMHO works with community psychiatric nurses (CPNs) and acts as a bridge with primary care. They cost less to train than doctors and nurses. The new roles also provide specialist career opportunities to improve workforce retention. Those trained in the new roles should be less likely than doctors and nurses to leave for work abroad, as their knowledge and skills are specifically designed for best practice in their own country. For full article access, become a member for free.