Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Jan 25;8(1):e31.
doi: 10.1192/bjo.2021.1080.

Quality of care and respect of human rights in mental health services in four West African countries: collaboration between the mental health leadership and advocacy programme and the World Health Organization QualityRights initiative

Maria Francesca Moro  1 , Lola Kola  2 , Olawoye Fadahunsi  2 , Edward Munda Jah  3 , Humphrey Kofie  4 , Dawda Samba  5 , Sametta Thomas  6 , Natalie Drew  7 , Emeka Nwefoh  8 , Soumitra Pathare  9 , Julian Eaton  10 , Michelle Funk  7 , Oye Gureje  2
Affiliations

Quality of care and respect of human rights in mental health services in four West African countries: collaboration between the mental health leadership and advocacy programme and the World Health Organization QualityRights initiative

Maria Francesca Moro et al. BJPsych Open. .

Abstract

Background: Although recent reports suggest that service users in West African psychiatric facilities are exposed to poor quality of care and human rights violations, evidence is lacking on the extent and profile of specific deficits in the services provided to persons with mental health conditions.

Aims: To evaluate the quality of care and respect of human rights in psychiatric facilities in four West African countries, The Gambia, Ghana, Liberia and Sierra Leone, using the World Health Organization QualityRights Toolkit.

Method: Trained research workers collected information through observation, review of records and interviews with service users, caregivers and staff. Independent panels of assessors used the information to assign scores to the criteria, standards and themes of the QualityRights Toolkit.

Results: The study revealed significant gaps in these facilities. The rights to an adequate standard of living and to enjoyment of the highest attainable standard of health were poorly promoted. Adherence to the right to exercise legal capacity and the right to personal liberty and security was almost absent. Severe shortcomings in the promotion of the right to live independently and be included in the community were reported.

Conclusions: Inadequate appreciation of service users' rights, lack of basic approaches to protect them and the non-promotion of rights-based services in these facilities are major problems that need to be addressed. Although it recognises the resource constraints and need for more human and financial resources, the study also identifies critical areas and challenges that require significant changes at the facility level.

Keywords: United Nations Convention on the Rights of Persons with Disabilities; West Africa; World Health Organization QualityRights; human rights; psychiatric services.

PubMed Disclaimer

Conflict of interest statement

S.P. reports receiving grants from Grand Challenges Canada during the conduct of the study. All other authors have nothing to disclose.

ICMJE forms are in the supplementary material, available online at http://dx.doi.org/10.1192/bjo.2021.1080.

Figures

Fig. 1
Fig. 1
Example of the World Health Organization QualityRights Toolkit's organisation, with the division of themes into standards and criteria.
Fig. 2
Fig. 2
Adherence to the World Health Organization QualityRights Toolkit's themes (i.e. degree to which the rights of the CRPD are met) in the psychiatric facilities evaluated in the different countries. CRPD, United Nations Convention on the Rights of Persons with Disabilities.
See this image and copyright information in PMC

References

    1. Vigo D, Thornicroft G, Atun R. Estimating the true global burden of mental illness. Lancet Psychiatry 2016; 3(2): 171–8. - PubMed
    1. Henderson C, Evans-Lacko S, Thornicroft G. Mental illness stigma, help seeking, and public health programs. Am J Public Health 2013; 103(5): 777–80. - PMC - PubMed
    1. Gureje O, Chisholm D, Kola L, Lasebikan V, Saxena S. Cost-effectiveness of an essential mental health intervention package in Nigeria. World Psychiatry 2007; 6(1): 42–8. - PMC - PubMed
    1. Sipsma H, Ofori-Atta A, Canavan M, Osei-Akoto I, Udry C, Bradley EH. Poor mental health in Ghana: who is at risk? BMC Public Health 2013; 13: 288. - PMC - PubMed
    1. Asare J, Jones L. Tackling mental health in Sierra Leone. BMJ 2005; 331(7519): 720. - PMC - PubMed