Managing mental illness in Ghana: The state of commonly prescribed psychotropic medicines

Background: In Ghana, about 13% of the adult population is estimated to be affected by mental health disorders of varying forms. In managing these patients, psychotropic medications are mostly employed. Since most of these conditions are chronic cases, the medications are consumed for prolonged periods of time. However, there exists an absence of information on efficacy, side effects, accessibility and prescription practices of psychotropic medication utilization from the viewpoint of the practitioners who are primarily involved in prescribing, dispensing and administering these medications. Method: Qualitative study composed of semi-structured interviews were conducted with twenty three (23) participants from Accra psychiatry, Pantang and Ankaful hospitals. These were fifteen (15) nurses, six (6) clinicians and two (2) pharmacists. All interviews were recorded digitally and analyzed thematically. Results: The commonly prescribed psychotropic medications were grouped into four classes. These were antipsychotics, antidepressants, anticonvulsants and hypnosedatives. Although each facility had at least one drug belonging to each class, there were frequent shortages recorded across the board. Also, drugs were free when supplied by government, and expensive when obtained from outside. When subsidized, the average cost of a day's supply of the most common antipsychotic was 4% of the daily minimum wage. The procurement system for the medications was fraught with challenges such as inadequate financing, poor procurement practices and bureaucracies with the process which affected the availability and quality of medications. Conclusion: The commonly prescribed psychotropic medications are in conformity with the recommendations of the WHO guidelines and the standard treatment guidelines of Ghana. However, the accessibility and quality of medications in the sector are inadequate. To improve mental health services in the country, it is important to ensure the adequate and regular provision of quality medicines in the mental health sector.