Stigma plays a critical part in the want for mental health services in Ghana. I did not realize just how much of a role stigma plays until I was able to see it firsthand.
A Bit of Backstory:
I’m all about adding interesting experiences to my life. This means I love doing things that create memorable stories to share with my friends, family, and future children about the fun and crazy adventures I embark on. One thing you might not know about me is that I don’t enjoy going on dates. However, my friends convinced me to go on a date with a bartender who had asked for my number here in Ghana. Initially, I wasn’t planning to go, but I decided to take the plunge—for the plot.
The bartender picked me up, promising to teach me how to make jollof, a traditional Ghanaian dish. He mentioned that he was from Ga, about a 20-minute drive from where I was staying. I made sure to share my location with friends and headed to the city of Ga. As we got closer, I started feeling nervous. I rarely go on dates; in fact, I’ve only said yes to maybe two in my entire life, so going on one in a foreign country was quite daunting. My palms were sweaty, and I felt uneasy since I had never been in this area before. The bartender assured me that everything would be okay and that I was safe, but his words didn’t completely soothe my anxiety.
When we arrived in his town, he mentioned that I was going to meet someone very special to him. This unexpected twist made me even more nervous, as I hadn’t anticipated meeting new people. He led me into a small house where I met Granny, his grandmother. She was in her 80s or 90s and only spoke Ga, the traditional language of the Ga people. Unfortunately, I didn’t know any words in Ga, having only learned a bit of Twi, the language of the Akan people. I felt anxious. Granny was kind and tried to communicate with me, complimenting me as the most beautiful girl she’d ever seen (in a mix of English and Ga).
As we were talking, Granny suddenly started rocking back and forth and praying. I’d never seen anything like it; it was almost as if she were speaking in tongues. The bartender looked at me intently and said, “Don’t worry, it’s the Holy Spirit.” Knowing how deeply religion is intertwined with culture here, I was curious about his explanation, though a bit unsettled because I thought we were just going to make jollof, haha.
He explained that Granny was a prophetess and a type of medicine woman. While we have medicine men and women in Native cultures, this was different from what I was accustomed to. He told me she had healed many people and then started talking about how one of his friends had attempted to sacrifice him a few years ago using black magic, but his granny put a curse on the friend, leaving him “crazy and naked on the streets.”
What. Does. That. Even. Mean??
At this point, I began to dissociate. More and more people came into the house to greet Granny and thank her for helping them, some of whom she hadn’t seen in over 13 years. They all spoke about how she had cured them of mental illnesses and credited her as the reason they were alive today. I told the bartender I had a 9 p.m. curfew, so Granny prayed for me, and I headed back home.
The next day, when I went to work at the Alliance for Reproductive Health Rights, I shared the story of my “date” with my coworkers Isaac and Dorris. I love talking with them, and over the past few weeks, we’ve had many unique and engaging conversations. When I described my “date,” which felt more like a fever dream, they began explaining the connections between black magic and the influence of Christianity on the Ghanaian people. Everything started to make more sense to me.
Role of Education
Isaac explained how education plays a crucial role in understanding healthcare, which makes perfect sense. As people become more educated about the importance of healthcare and how it functions, they tend to rely less on prayer alone. This shift leads to a greater demand for assistance beyond traditional and spiritual methods. However, due to the lack of education about healthcare and the limited resources available in Ghana, many people turn to prayer as their primary option. It is the only easily available and accessible option for many Ghanaians.
Health education is not well integrated into schools in Ghana. As a result, generations of families are not teaching children about different health needs. While families are the most significant protective factor in an individual’s life, there is sometimes limited room for growth in understanding modern medicine and the need for various types of assistance.
Christianity and Black Magic
Religion is an integral part of culture, and the key to providing mental health care in Ghana is connecting traditional and spiritual medicine with modern practices. This is important to consider, especially considering how beliefs in African black magic directly impact communities. When someone has a mental health issue, people often attribute it to a curse from a “Juju man.” A Juju specialist (also known commonly as a Juju-man) is someone who uses black magic to help individuals achieve their desires: fame, money, gifts, or love. Juju itself is used within West African countries, such as Ghana, Nigeria, Benin, and Togo. Click here to read the Cambridge University Press’s article “The Superstition that Dismembers the African Child: An Exploration of the Scale and Features of Juju-Driven Paedicide in Ghana,” which goes into depth on why Juju is practiced.
According to my coworkers, in Africa, those who engage in black magic often use sacrifices to achieve those desires. However, it’s important to remember that black magic always comes with consequences and that when you interfere with a spirit, whether human or animal, there will be consequences. These consequences vary from person to person, but typically, people get what they want, even though it is temporary. I was confused when I first heard about this, but then I thought about my experience at Granny’s house when the bartender said she had saved him from being sacrificed years ago.
My coworker, Dorris, is deeply connected to Christianity and has extensive knowledge of the Bible. I appreciate how much she has taught me and how she explains things when I have questions. She shared that one reason people in Ghana devote their lives to Christ is the protection it offers from black magic—by following God, they can avoid being deceived by the Juju man’s illusions. Dorris also mentioned that some Juju men use Christianity as a cover, posing as priests in churches. She even knew some by name, and Isaac agreed. They both explained that someone truly devoted to God could discern between a Juju man and a genuine priest because of their personal connection to the Bible and God.
Ghanaians and Mental Health / Health Care
It’s important to note that, in Ghana, mental health is often viewed as something frightening. Many people do not include conditions like depression and anxiety within the spectrum of mental health; they associate it with more severe mental health issues, often described to me as “naked people on the streets,” which I’ve heard multiple times.
With the Ghanaian belief that “nothing happens by chance” and that “many events are the result of curses or taboos,” it’s easy to see one of the main barriers to addressing mental illnesses and chronic health care. Family members of the patient often decide where they will receive care, aiming to find the best option for both the family and the individual. When it comes to mental health, the initial assumption is often that black magic is involved. However, after speaking with a few Ghanaians, I learned that they can sometimes distinguish whether a person’s condition is due to black magic or simply how life unfolded for them.
Choosing a Facility
When it comes to mental health conditions, there are mainly two options for individuals to consider: the Psychiatric Hospital (with only three facilities in the greater region) or a Prayer Camp.
Psychiatric Hospitals
The Psychiatric Hospital is heavily stigmatized and also requires payment for services. While working at the Accra Psychiatric Hospital (APH), I’ve explored the reasons behind this stigma and the state of the facilities (more on this in next week’s blog post!). I spoke with Fati, the director of the Serenity Place at APH, who explained that many families abandon their loved ones at the facilities. Even after they recover, the families never return to pick them up, leading to overcrowding as these individuals have nowhere to go. The facilities are poorly funded, and from a glance, it can look like a scary place (as you might remember from my previous blog post, “The Culture of Care: The Accra Psychiatric Hospital and The Mental Health Authority.”)
Many families choose to leave their relatives behind due to the stigma surrounding mental health and their desire to distance themselves from the mental health issues. Even if someone recovers, people often believe that some trace of the “mental health issue” remains, which can still frighten others. Once individuals return to society after being in the hospital, there’s a belief that the mental health problem still lingers. In Twi, there is a proverb called “maxim,” which suggests that one cannot fully recover from mental health issues.
However, there are many areas in the APH where good work is done to help individuals feel and do better, often by combining spiritual and modern medicines and practices. Despite this, the stigma surrounding psychiatric hospitals and the associated costs frequently deter families from seeking help there.
Prayer Camps
A prayer camp is an alternative that many individuals trust more or can more easily afford. Although I have not yet visited a prayer camp and cannot speak from personal experience, I have discussed these camps with several of my coworkers. Isaac explained that people at these facilities often fast and pray to expel evil spirits, a practice rooted in the belief that mental health issues are solely spiritual. While prayer camps may be effective for some, they do not work for everyone. In the past (and possibly still today), some camps have resorted to chaining up their clients in an attempt to drive out spirits.
Despite these practices, many people in Ghana view prayer camps as a better alternative to psychiatric hospitals. The hospital’s medical procedures are less understood and often unaffordable, while prayer camps provide relatability with their spiritual approach. This preference stresses the importance of addressing mental health in a way that aligns with cultural beliefs and economic realities.
Personal Reflections
It has been fascinating to learn about the intersections between black magic, Christianity, and mental health care in Ghana. These connections are deeply rooted in religion, culture, and familial values, making it challenging to teach and advocate for change without effective education systems. When traditions have been practiced for generations, how do we encourage people to consider alternatives?
Photo By: Porter Levenson
I believe there can be a meaningful connection between spirituality, religion, and mental health care. Still, there is also a critical need for scientific healthcare options to ensure that treatment is both safe and effective. During my time at the Accra Psychiatric Hospital (APH), I’ve observed that many staff members recognize the importance of integrating mental health care with spirituality. They have successfully helped their clients by combining both approaches.
However, the persistent stigma surrounding mental health means there is still a need to find ways to connect individuals with accurate information and positive support. Developing comprehensive education programs and increasing awareness can help bridge the gap between traditional beliefs and modern healthcare, ultimately leading to better outcomes for those in need.
As I continue my journey in Ghana, I am inspired by the resilience and adaptability of the people I’ve met. The blending of spiritual and modern practices in mental health care offers a unique opportunity to create a more inclusive and effective system. By acknowledging and respecting cultural beliefs while also advocating for scientific approaches, we can work towards reducing stigma and improving access to quality mental health care for all.
Education and open dialogue are vital to bridging these gaps. By fostering understanding and collaboration between traditional and modern practices, we can empower communities to embrace a holistic approach to mental health that honors their values and enhances their well-being. As we move forward, I am hopeful that these efforts will lead to a future where mental health care in Ghana is accessible and respected.
The Elmina Church
Photo by: Tai Le
Love this! You seem to have found the mental health / cultural connection you set out to explore in Ghana! Although there is some progress, sounds like a huge job for those mental health professionals whom have very little resources to help the progression. Very interesting read!
Love the extra personal touch for the plot!
Xoxo
Listening and learning from any culture is integral to the advancement of one’s knowledge not only of that culture but oneself and the culture one lives. Proud of my Jorney. You have come along way in learning and understanding yourself and others.