Social determinants of mental health in Ghana project

Background

The treatment gap refers to the disparity between the number of people experiencing mental health difficulties and those who receive treatment. Efforts to reduce this gap have traditionally focused on increasing access to psychological and pharmacological interventions. Underpinning these efforts is the assumption that the treatment gap exists because many people lack access to effective treatment and that increasing the availability of treatment will enable more people to receive care and thereby reduce the gap.

While expanding access to treatment has been beneficial, it has become increasingly apparent that treatment alone is insufficient to reduce the burden of mental health difficulties. In many settings, people continue to experience mental health difficulties that are closely linked to poverty and other adverse socioeconomic conditions. Even when treatment is available, some individuals do not seek care because they perceive the source of their distress to lie in these adverse socioeconomic conditions and therefore do not view treatment alone as a viable solution.

There is growing recognition that improving mental health and the responsiveness of care requires attention to the social determinants of mental health. Evidence to inform action on the social determinants of mental health remains limited, particularly in low and middle income settings, including Ghana.

The project consists of a number of studies

This project responds to these knowledge gaps through four interconnected studies. The first study employed systematic review and meta-analysis to examine the prevalence of anxiety and depressive disorders and symptoms, and social determinants of mental health potentially associated with their occurrence among adults in Ghana.

The second study employed network analysis to examine the association and clustering of adverse experiences, mental health symptoms, and help-seeking behaviours among adolescents and adults in Ghana.

The third study is a qualitative study using reflexive thematic analysis to understand mental health professionals’ perspectives on the impact of social determinants of mental health on the provision of care.

The fourth study is a qualitative study employing framework analysis and the Consolidated Framework for Implementation Research to understand potential implementers’ perspectives on barriers and facilitators to implementing social determinants screening within mental healthcare in Ghana.