The economics of mental health

Raimah Amevor

The economy and mental health are two words you hardly ever see in the same sentence. Raimah Amevor, Founder of Mindfully African, explains why if Ghana is truly going to move ‘beyond aid’ we need to change that.

In a few weeks’ time it is your boss’ birthday party at La Palm hotel in Accra and you have been asked to make a speech. Although a little nervous, you are thankful for the opportunity to show your gratitude to someone who over the last few years has trained and supported you in your career ambitions. On the morning of the party, you wake up in another room as an argument with your spouse left you both angry and frustrated that the same issues in your marriage continue to rear their ugly head. You are worried that you may be on the verge of divorce.

Unbeknown to anyone outside your immediate family, your mother was diagnosed with breast-cancer and the financial pressure of her treatment and supporting/maintaining your family while working 50+ hours a week have long taken its toll. Your sleep patterns have been disrupted, you are irritable and you are often walking on eggshells within a home once filled with love.

You were looking forward to a ‘night off’, when you could have a drink and celebrate your boss – yet with the looming pressure of the speech, you are physically and emotionally drained, ruminating in negativity, wondering why life often feels like a constant struggle. You decide that you will cancel going to the party and take the time to give yourself some long overdue rest, and maybe even communicate to your spouse the pressure you are feeling. Thank God, the kids are with the in-laws.

 

In this scenario, would you rather call your boss to let him/her know you cannot come because:

 

  1. A) you are having a mental breakdown and have realised you cannot cope with another social outing where you have to pretend to be happy; or
  2. B) because you have food-poisoning from something you ate last night and have been throwing-up all night?

If you would feel more comfortable using the latter as your reasoning, you are affected by the stigma of mental illness. Let’s continue with our scenario.

After you work up the courage to cancel, your spouse comes home and realises that you are having a mental breakdown. They are worried but don’t want to call any of your family members, fearing whispers that they knew you were suffering in the marriage ever since.  Your spouse drives you to the local hospital. Once there, things are not looking good; you are told that the unit dealing with mental health is unavailable, live wires hang from the ceiling in the treatment rooms – and one of the few mental health nurses in the hospital is not due in until Monday. You are able to see a general doctor in a few hours, but due to years of lack of funding for operating mental health services in Accra, you are denied basic essential care to get you out of the mental and physical rut you find yourself in.

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Ghana has an impeccable international reputation, hailed as one of the fastest-growing African economies this new decade; there is no shortage of FDI from agriculture to fintech. Fortune 500 companies like Google have wasted no time setting up shop in Accra, and our shiny new airport is a symbol to the world that we have arrived. Luxury apartments, brunch spots and pool-side lounges that would raise the eyebrows of even the most discerning foodies are peppered across hotspots like Airport Residential and East Legon.

Yet, healthcare, particularly mental health services, are severely lacking. Considering that 1 in 5 people suffer from a mental illness at any given time, our 98% treatment gap is not only shocking but demonstrates a deep-rooted aversion to an issue that threatens our social and economic development.

 

We don’t like to talk about it, but our mental health is central to everything we do. From our ability to form close relationships and lead fulfilling lives to our ability to make sound decisions and be productive at work. Neglecting mental health is like having fufu and light soup with no meat; you know something is wrong but you just can’t put your foot on it until you are mindlessly snacking just one hour later. You are unsatisfied, and it shows.

 

The economic cost of mental health is an unnecessary burden that the future of our economy does not need to bare. We may not be able to wholly control our marginalisation in the world trade system and unfair international trade policies, but what is in our hands we must use to our advantage. Up to 7% of GDP reduction is attributed to mental health issues; and when people suffer from mental health issues they are less likely to participate in the labour market, have higher unemployment rates, and diminished productivity when they do participate.

People with mild to moderate mental illness, such as anxiety or depression, are twice as likely to be unemployed. It is no wonder that the Organisation for Economic Cooperation & Development (OECD) has prioritised mental health as a pressing labour market challenge; half of the overall cost of depression is attributed to the reduced productivity of work. Considering that over 50% of the population in Ghana are under 25, these statistics demonstrate a direct threat to the country’s economic future.

Living in Africa is no easy feat; even within the formal sector, people take on multiple ‘hustles’ to live comfortably, transportation costs and taxes continue to rise, while the slow growth of higher earning wages are juxtaposed against a fast-growing vulnerable and informal sector of employment. Ghana cannot afford to play Russian-roulette with its mental health services.

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Thankfully, we live in extraordinary times: it is not just infrastructure than can be transformed within a matter of years. With a concerted and pragmatic approach that places sustainable implementation practices at its centre, our mental health services can be revolutionised if only we have the courage to hold government accountable for it’s appalling history of not funding the mental health authority; and the wisdom to not wait for more fatal tragedies due to mental illness in our young people before we take action.

Ghana, and other Africa countries, face a distinctive problem when it comes to mental health services; the treatment gap in mental health services is filled by the vibrant community of traditional and faith healers who can and do abuse people physically, sexually and financially.

Because of the stigma attached to mental health and outdated belief systems, such as mental illness being a punishment from God, misunderstandings about mental health are widespread – as is the lack of trust between the general public and healthcare professionals when it comes to mental health.

But this doesn’t have to be a barrier; in the early 1980s being diagnosed with HIV/AIDS was a death sentence; most people who contracted the disease would pass within a year. In 1991 Magic Johnson contracted HIV; it’s now 2020 and he just turned 60. He continues to be a wildly successful entrepreneur and advocate for HIV/AIDS. What changed in the decade leading up to Magic’s diagnosis? Million-dollar investments into finding a cure, technology and a bullish public awareness and education campaign.

Thankfully for us, half the work has already been done. The treatments are available, the research has been done and the expertise is available.  Private practices like Supreme Healthcare in Ghana are already providing corporate bodies with mental health helplines for their employees. We have millions of young people who will graduate without a job and skills fit for the future: if the government needs a place to start, Ghana is ripe for the taking. Not only do we have a unique opportunity to continue to set the precedent for the African continent when it comes to integrated public healthcare, the ‘Ghana Beyond Aid’ mantra will live long after Akufo-Addo’s presidency. Isn’t that what we want?

If you are looking for qualified mental health professionals in Africa visit Mindfully African’s therapists’ directory https://www.mindfullyafrican.co.uk/

The writer is the  CEO and Founder of Mindfully African

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