A Study of the Diagnostic Practices for Mental Disorders in Ghana

Introduction: A lack of awareness of the diagnosis of mental disorders exists in the Ghanaian community due to the general misconceptions about mental health. One major challenge in diagnosing mental disorders is that no blood test or scan can be performed to confirm a particular mental disorder, unlike other medical conditions such as cancer, malaria, diabetes, and hepatitis. A stepwise progressive observation and assessment to rule out all possible medical conditions that might be associated with a mental disorder is essential to enhance the quality of diagnosis and treatment. This study focuses on describing the diagnostic practices of mental disorders to educate the public, create awareness, and to improve diagnosis in Ghana. Objective: This paper aims to describe the current diagnostic practices used to diagnose mental disorders to understand the impact of the diagnosis of mental disorders and to provide evidence for mental health policy and planning to improve diagnostic practice in psychiatry in Ghana. Methods: We collected and described data on the diagnosis of mental disorders from 30 mental health professionals aged 20 years and above who were purposively selected from six hospitals. We carried out in-person structured interviews with all participants at their various hospital premises. Results: Stages of diagnosing mental disorders can be single, dual, or multiple. Proportions representing the patterns of diagnosis of the most common types of mental disorders in the population included 73.3% for mania without psychotic syndrome, and 63.3% for hebephrenic schizophrenia. Moderate depressive episodes, bipolar affective disorder with mild or moderate depression, and organic delusion (schizophrenia-like) disorder achieved the same results (56.7%). Phobic anxiety disorder and schizoid personality disorder were also reported by the same proportions (46.7%). Also, symptomatic epilepsy and epileptic syndrome was reported by (43.3%) and 40% for mood disorder due to known physiological condition with manic symptoms. Persistent delusional disorder as well as dementia with behavioral disturbance and dementia with depression and anxiety were reported by the same proportions (36.7%), and 33.3% for psychoactive substance abuse with psychoactive sub-induced anxiety disorder. The level of diagnostic quality in the psychiatric hospitals was higher than in the primary health centers (83.3% vs 63.3%). The most suitable intervention to improve diagnostic quality (40%) was associated with diagnostic education. Most participants (56.7%) assigned a moderate rating to the effectiveness of the interventions to improve diagnostic practices. Conclusion: We plan to use our findings to solicit support from mental health stakeholders to provide comprehensive public education involving basic and specific knowledge on the diagnosis of mental disorders. We recommend that any national programme would need to have sustainable long-term policies to encourage and motivate mental health professionals to participate in diagnostic activities and to pay more attention to patients. Incorporating mental health education into the school curriculum is also important.