Progress and challenges in implementation of the WHO  special initiative on mental health in Ghana (2019 - 2023):  A narrative review:

Mawuko SETORDZI; Cheryl  FORCHUK; Glorieuse  UWIZEYE

Mawuko SETORDZI Arthur Labatt Family School of Nursing, Western University, London, Ontario, Canada; Department of Nursing, Presbyterian Nursing and Midwifery Training College, Dormaa Ahenkro, Bono Region, Ghana; Parkwood Research Institute, London, ON, Canada
Cheryl FORCHUK Arthur Labatt Family School of Nursing, Western University, London, Ontario, Canada; Lawson Research Institute, London, ON, Canada; Parkwood Research Institute, London, ON, Canada
Glorieuse UWIZEYE Arthur Labatt Family School of Nursing, Western University, London, Ontario, Canada

Keywords: Mental Health Policy, Universal Mental Health Coverage, Implementation, WHO special initiative

Abstract

Background: The WHO Special Initiative for Universal Mental Health (2019 - 2023) seeks to expand access to affordable, high-quality mental health services for 100 million people across 12 priority countries, including Ghana. Despite the ongoing efforts, Ghana continues to face a substantial treatment gap of approximately 98%, with limited service coverage.
Objective: This review article aims to synthesise the literature on the implementation of the WHO Special Initiative in Ghana, evaluating its progress, highlighting challenges, and offering recommendations to strengthen the country’s mental health system.
Methods: This review analysed peer-reviewed and grey literature, policy documents, and reports on the WHO’s Special Initiative for Universal Mental Health. Sources published in English up to 2023 were retrieved from major databases and key institutional websites. Data were synthesised thematically, guided by the WHO Health System Building Blocks Framework.
Results: Ghana has made notable progress under the WHO’s Special Initiative for Universal Mental Health. Key achievements include the Ministry of Health approval of a comprehensive essential health services package which includes mental health, the establishment of the Mental Health Board for service delivery, and the inclusion of selected mental health conditions in the National Health Insurance Scheme (NHIS) benefits. Despite these significant gains, critical challenges remain, including a limited workforce, low accessibility and treatment coverage, persistent stigma and discrimination, limited funding, shortages and non-adherence to psychotropic medications, limited availability
of psychosocial therapies, and ongoing human rights violations.
Conclusion: Despite Ghana’s notable advancements in strengthening its mental health system, the targets of the WHO’s Special Initiative remain unmet due to complex systemic and structural challenges. Achievement of these remaining targets requires multifaceted interventions, including expanding the workforce, improving access and coverage, addressing stigma and discrimination, securing sustainable funding, ensuring availability and adherence to psychotropic medications, scaling up psychosocial services, and addressing sociocultural, religious, and human rights concerns. These findings outline actionable steps toward universal mental health coverage.

Progress and challenges in implementation of the WHO special initiative on mental health in Ghana (2019 - 2023): A narrative review

WHO Mental Health Initiative in Ghana: Progress and Challenges

Abstract