Rights as Relationships: Collaborating with Faith Healers in Community Mental Health in Ghana

Ursula M. Read

doi:10.1007/s11013-019-09648-3

Abstract

This paper explores the ways in which mental health workers think through the ethics of working with traditional and faith healers in Ghana. Despite reforms along the lines advocated by global mental health, including rights-based legislation and the expansion of community-based mental health care, such healers remain popular resources for treatment and mechanical restraint and other forms of coercion commonplace. As recommended in global mental health policy, mental health workers are urged to form collaborations with healers to prevent human rights abuses and promote psychiatric alternatives for treatment. However, precisely how such collaborations might be established is seldom described. This paper draws on ethnographic research to investigate how mental health workers approach working with healers and the moral imagination which informs their relationship. Through an analysis of trainee mental health workers’ encounters with a Prophet and his patients, the paper reveals how mental health workers attempt to negotiate the tensions between their professional duty of care, their Christian faith, and the authority of healers. I argue that, rather than enforcing legal prohibitions, mental health workers seek to avoid confrontation and manouver within existing hierarchies, thereby preserving sentiments of obligation and reciprocity within a shared moral landscape and established forms of sociality.

Highlights

In December 2016 I accompanied a group of trainee community mental health workers and their tutor, Jacob1, to visit the church of a local Prophet in the rural market town of Kintampo, Ghana
This paper explores the ways in which mental health workers think through the ethics of working with traditional and faith healers in Ghana
A letter inviting him to a regional meeting he had attended funded by the UK Department for International Development (DFID) outlined the intention to educate him on “stigma, discrimination and prejudice against persons suffering from mental illness” and “sensitize you on the need to work with Mental Health Practitioners”

Summary

Human Rights and Social Obligations

What rendered the interaction ethically uncertain were the ambiguous lines of authority and responsibility between health workers, the healer as a professed ‘man of God’, and the families as ‘therapy managers’ (Janzen 1987). This paper technology mimics the procedure for involuntary hospital commitment under which the family and the psychiatrist assume legal responsibility for decisions around treatment should the patient be judged to lack decision-making capacity This perceived need to control dangerous behaviour has become the point of entry for mental health workers in their collaboration with traditional and faith healers. As John, one of the CMHOs, put it: “why not work in collaboration with us so that when somebody comes and you think it’s violence or whatever, we take care of that, and when the person is stable he comes to you for your prayers?” The Prophet and health workers equate injections with chains as achieving the same ends by different means This equivalence enables mental health workers to find common grounds for intervention, recognising chains, in the words of Arthur, as “cruel” but necessary, much as they ethically justify the use of coercion in their own practice. This is a real risk in Ghana where the psychiatric hospitals have been condemned on human rights grounds (Mendez 2014)

Collaboration or Censure

Conclusion

Compliance with Ethical Standards