Implementation of the World Health Organization's QualityRights initiative in Ghana: an overview.

BACKGROUND: Globally, human rights violations experienced by persons with psychosocial, intellectual or cognitive disabilities continue to be a concern. The World Health Organization's (WHO) QualityRights initiative presents practical remedies to address these abuses. This paper presents an overview of the implementation of the initiative in Ghana. AIMS: The main objective of the QualityRights initiative in Ghana was to train and change attitudes among a wide range of stakeholders to promote recovery and respect for human rights for people with psychosocial, intellectual and cognitive disabilities. METHOD: Reports of in-person and online training, minutes of meetings and correspondence among stakeholders of the QualityRights initiative in Ghana, including activities of international collaborators, were analysed to shed light on the implementation of the project in Ghana. RESULTS: In-person and online e-training on mental health were conducted. At the time of writing, 40 443 people had registered for the training, 25 416 had started the training and 20 865 people had completed the training and obtained a certificate. The team conducted 27 in-person training sessions with 910 people. The successful implementation of the project is underpinned by a committed partnership among stakeholders, strong leadership from the coordinating agency, the acceptance of the initiative and the outcome. A few challenges, both in implementation and acceptance, are discussed. CONCLUSIONS: The exposure of the WHO QualityRights initiative to a substantial number of key stakeholders involved in mental healthcare in Ghana is critical to reducing human rights abuses for people with psychosocial, intellectual and cognitive disabilities.

Assessing quality of care and observance of human rights in residential mental health facilities in Greece through the WHO QualityRights tool kit.

In this paper, we present and reflect upon the process of evaluating two residential mental health facilities in Thessaloniki, Greece, through the WHO QualityRights tool kit. The QualityRights tool kit is a structured process for assessing quality of care and human rights in mental health and social care facilities, in accordance with the United Nations Convention on the Rights of Persons with Disabilities (CRPD), introduced by the World Health Organization in 2012. We have piloted the use of the Toolkit in two supported accommodation facilities, a hostel and a service supervising independent living in apartments, for individuals with long-term severe mental health problems in the region of Thessaloniki. In this paper, we present the methodology and process of evaluating the facilities, including the challenges posed to the evaluation process by restrictions due to the Covid-19 pandemic. We showcase the outcome of this evaluation through presenting a summary of the results and the ensuing recommendations for improvement. Finally, we reflect on the usefulness, appropriateness and relevance of the Toolkit for evaluating mental health care facilities in the particular context of contemporary Greece.

Recovery-oriented mental health principles in psychiatric hospitals: How service users, family members and staff perceive the realization of practices.

AIMS: The aim of the study was to describe and compare how recovery-oriented mental health principles have been realized in Finnish psychiatric hospitals from the viewpoint of different stakeholders (service users, family members and staff). DESIGN: A multimethod research design was adopted to combine both quantitative and qualitative descriptive methods. METHODS: A total of 24 focus group interviews were conducted with service users (n = 33), family members (n = 3) and staff (n = 53) on 12 psychiatric Finnish hospital wards (October 2017). The interview topics were based on six recovery-oriented principles (WHO QualityRights Tool Kit, 2012). A quantitative deductive analysis was conducted to describe and compare the realization of the recovery-oriented principles between three stakeholder groups. A qualitative deductive content analysis was used to describe participants' perceptions of the realization of recovery-oriented principles in practice. The GRAMMS guideline was used in reporting. RESULTS: Out of six recovery-oriented principles, 'Dignity and respect' was found to have been realized to the greatest extent on the psychiatric wards. The most discrepancy between the participant groups was seen in the 'Evaluation of recovery'. Service users and family members found the realization of the practices of all principles to be poorer than the staff members did. Wide variation was also found at the ward level between perceptions among participants, and descriptions of the realization of the principles in psychiatric hospital practice. CONCLUSION: Perceptions about the realization of recovery-oriented principles in practice in Finnish psychiatric hospitals vary between different stakeholder groups. This variation is linked to differing ward environments. IMPACT: More research is needed to understand the factors associated with variation in perceptions of recovery principles. PATIENT OR PUBLIC CONTRIBUTION: Service users and family members participated in this study.

A nationwide evaluation study of the quality of care and respect of human rights in mental health facilities in Ghana: results from the World Health Organization QualityRights initiative.

BACKGROUND: In 2012, Ghana ratified the United Nations Convention on the Rights of Persons with Disabilities and enacted a Mental Health Act to improve the quality of mental health care and stop human rights violations against people with mental health conditions. In line with these objectives, Ghanaian stakeholders collected data on the quality of mental health services and respect for human rights in psychiatric facilities to identify challenges and gather useful information for the development of plans aimed to improve the quality of the services offered. This study aimed to assess psychiatric facilities from different Ghanaian regions and provide evidence on the quality of care and respect of human rights in mental health services. METHODS: Assessments were conducted by independent visiting committees that collected data through observation, review of documentation, and interviews with service users, staff, and carers, and provided scores using the World Health Organization QualityRights Toolkit methodology. RESULTS: This study revealed significant key challenges in the implementation of the United Nations Convention on the Rights of Persons with Disabilities principles in Ghanaian psychiatric services. The rights to an adequate standard of living and enjoyment of the highest attainable standard of health were not fully promoted. Only initial steps had been taken to guarantee the right to exercise legal capacity and the right to personal liberty and security. Significant gaps in the promotion of the right to live independently and be included in the community were identified. CONCLUSIONS: This study identifies shortcomings and critical areas that the Ghanaian government and facilities need to target for implementing a human rights-based approach in mental health and improve the quality of mental health care throughout the country.