Apart from that, the hospital, one of the three leading psychiatric facilities in the country which serves the Central, Western and Western North regions and even parts of Cote d’Ivoire, is also facing serious logistical constraints that are hampering effective healthcare delivery.

In addition to providing specialist services in mental health delivery, it also provides general medical care for the public.

At the moment, the hospital owes its suppliers GH¢2 million — GH¢1,003,564.07 owed to suppliers and a judgement debt of GH¢1,118,422.04 awarded in favour of a supplier who sought legal resolution.

Some of the indebtedness to suppliers date back to between 2015 and August 2018.

In an interview with the Daily Graphic, the Head of Administration of the hospital, Chireh Thomas Kuusanoo, said the hospital was facing dire financial challenges because it had been operating on its internally generated funds (IGFs), as government subvention had not been forthcoming.

The last time it received subvention was June last year and the IGFs are raised from hospital charges and affiliate fees from nursing schools for internships.

Ankaful

The Ankaful Psychiatric Hospital was built by Ghana’s first President in 1965 to host mentally ill patients from the then Akuse Asylum who had to be relocated to make way for the construction of the Akosombo Dam.

It currently has seven active wards and two others for temporary detentions, as well as an outpatients department (OPD) for general medical care. 

As of the time of the Daily Graphic’s visit, it had 121 patients, made up of 73 males and 48 females.

The hospital has different categories of patients, including vagrants, patients referred to the hospital by the courts, paupers who have traceable relatives but who cannot afford treatment and some others who can afford.

Feeding outsourced

Mr Kuusanoo said with the rising cost of food items and its inability to stock up its kitchen due to suppliers’ refusal to continue doing business with the facility, management had had to temporarily outsource the feeding of patients to caterers who charge GH¢26 for three meals a day per person.

“Up until June last year, we were running the hospital’s kitchen to feed patients. However, with the constant increases in prices and no subventions coming in from the government, the management decided to outsource patients’ feeding to outside caterers who charge GHC26, tax inclusive, for three meals a day,” he indicated.

No grain

The administrator said the decision to outsource the feeding to caterers was a necessary action to keep the hospital running.

“In fact, by the last week of May last year, we didn’t have a single grain in the stores. We were left with only a box of chicken or something like that,” he said.

He said in the past the hospital had support from benevolent groups to feed patients, but that had also not been forthcoming.

Challenges

Mr Kuusanoo listed a plethora of challenges the hospital faced, including the deplorable state of its OPD, inadequate staff and security and lack of resources to operate a forensic ward. 

Inadequate staff 

He said per the staffing requirements for a psychiatric hospital, the hospital needed to have a minimum of five specialists, a maximum of nine and an average of seven.

Presently, the hospital had two specialists, in addition to the medical director and five medical officers, he said, noting that the two specialists were due for retirement next year.

Again, he intimated that the high demand for psychiatric nurses by the United States and the United Kingdom was impacting negatively on the hospital’s staff strength, as nurses left once opportunities to travel presented themselves.

Poor facilities

From the outside, the buildings that make up the facility look relatively good, but a peep inside reveals washrooms and wards that are in deplorable conditions.

Mr Kuusanoo said with the challenges involved in adequately feeding the patients, renovating the various units, though ideal, could not be done and often members of the hospital management had to pool resources to repaint the administration block to give it a facelift.

He commended institutions, including the Enterprise Group Plc, for renovating the Sangmuah Male Ward and courtyard recently, but called for the total renovation of the hospital.

Security 

Mr Kuusanoo said the hospital’s inability to completely fuel its standby generator also put the security of the facility at risk anytime there was a power cut because it could not afford to have it running until power was restored.

“When the lights go off, the facility runs on the generator till 10 p.m. when it goes off. It is put back on at 4.30 a.m. because it ‘consumes’ a lot of fuel, he said, adding that with the state of the patients, that could be very risky and make everyone within the precincts of the hospital vulnerable,” the administrator said. 

Stigma

Mr Kuusanoo expressed concerned that not much attention was being given to the psychiatric hospital, a situation that was unfortunately feeding into the issue of stigmatisation of mental health disease and patients and which even extended to workers at the facility.

“The stigmatisation associated with working in a psychiatric hospital is having a very negative impact on the facility’s ability to attract the needed staff. Stigmatising people who work in the facility is a great disincentive to attracting the right workforce here,” he explained.

He called on the government to give adequate financial attention to mental health institutions, saying anyone could find himself or herself there.

Staff motivation

Mr Kuusanoo called for special incentives for doctors, nurses and other health professionals in psychiatric institutions to encourage younger professionals into the field.

He also called for levies on, for instance, imported alcoholic drinks to help fund the Mental Health Fund and make it operational.

He urged Ghanaians to understand that many mental illnesses were resolvable by medication and appealed to them not to over-spiritualise mental illness but seek medical attention.