Maternal Mental Health Crucial To Women | Health

In January 2010, Ghanaians woke up to the shocking news of a mother who had killed her five children and committed suicide.

Georgina Akweley Pipson, who was in her early 30s, arranged her dead children according to their ages on her bed after she had given them a poisonous substance. She then committed suicide.

The incident, which was reported in the Daily Graphic focused on her suicide note which said “My people deserted me,” “God give me hope,” and “Forgive me and my children, Nana, Kwaku, Angel, Kofi, Esi”. “What a painful world?” “God have mercy on me and my children”, “Why, Kojo, my husband,” “Kojo, I do love you and will never forget you.”

Later it emerged that Georgina was mentally ill. She had postpartum depression. The circumstances of her death served as a wake-up call to the country on the need to overhaul its mental health services.

Dr Akwasi Osei, who was then the Executive Director of the Accra Psychiatric Hospital (APH), was at the time one of the ‘lone voices’ championing the need for the country to have a mental health law.

To him, Georgina’s case at that time was evidence of inadequate mental healthcare in the country, lack of adequate and full complement of personnel, lack of modern mental health bill rooted in human rights, stigma among the populace towards mental illness, breakdown of family support and a lack of state machinery for the support of the mentally ill.

It later emerged that every time Georgina gave birth, she suffered post-partum depression which went away untreated. It was only during her fourth and fifth births that she was given treatment but it had become too late.  

According to the Ashanti Regional Director of Health, Dr Emmanuel Tenkorang, about 50 per cent of pregnant women experienced severe mental crises during pregnancy and a year after delivery.

Dr Tenkorang said if a Maternal Mental Health Policy was instituted, it would help create awareness for caregivers to identify mental health conditions associated with pregnancy, as well as to prepare caregivers to critically examine pregnant women for early detection of mental conditions and to manage them.

Awareness Month
The Mental Health Authority has set aside the month of May for awareness creation of mental health. It is known as Purple Month, with the first week used to commemorate maternal mental health.

This year’s celebration is on the theme: “Movement: moving more for our mental health”. Depression in pregnancy which is perinatal depression, includes prenatal depression that occurs during pregnancy and postpartum depression that occurs weeks after childbirth these two types of depression are said to be the commonest mental health conditions associated with pregnancy and early detection and treatment were important to save more women.

Maternal mental health
Maternal mental health refers to the state of emotional and psychological well-being of the woman during pregnancy, delivery or the period of up to one year following delivery. 

The physiology of pregnancy and the stress that accompanies pregnancy and delivery trigger the occurrence of maternal mental health disturbance. Social factors such as marital problems and financial difficulties are major predisposing factors and even though sufficient evidence exists on the adverse impact of maternal mental health disorder on the mother and the infant, and the high prevalence of the disorder in Ghana, there is little provision in the country’s current healthcare system for its screening, early detection and effective management.

Health experts are therefore using the month of May to call for the need to integrate maternal mental health interventions within health systems from the level of the community and across all levels of health care in the Ghanaian setting.

The prevailing significant challenges to providing adequate mental health care for new mothers include lack of trained staff, financial constraints, lack of affordable medications and social stigma. 

Mental Health Policy
The Ghana Mental Health Policy and Plan advocates for integrating mental health services into primary health care, with a specific focus on vulnerable populations such as women during pregnancy and postpartum.

As the commemoration of Mental Health Month comes to an end, improving maternal mental health care in the country requires national prioritisation, intentional high-level advocacy, multi-sectoral collaboration, and safeguarding of mental health of providers to guarantee the delivery of compassionate, respectful client-centred, integrated maternal mental health care routinely.

Also, there is the need to provide adequate skills mix and equitable distribution of healthcare workers with the capacity to deliver mental health services at all levels, as well as improve physical access to maternal mental health services.