Paper short abstract:

This paper explores the processes through which attempts to mobilise a globalised vision of human rights in mental health care are translated, adapted and resisted in the situated practices and reflections of health workers in Ghana.

Paper long abstract:

This paper explores the processes through which attempts to mobilise a globalised vision of human rights in mental health care are translated, adapted and resisted in the situated practices and reflections of health workers in Ghana. The WHO, UN and key actors in 'global mental health' have given increasing impetus to the mobilisation of human rights in the treatment of people with mental illness, promoting the adoption of rights-based legislation and policies to combat abuse and ensure access to treatment. In Ghana the discourse of human rights has been enacted within the reform of mental health legislation and the expansion of community-based mental health care and self-advocacy groups, driven by the resources and influence of international agencies, donors and NGOs. At the same time public sector spending has been curtailed and health services receive no dedicated funding for mental health, resulting in severe challenges in delivering quality care. While workers express an overt rhetoric of people with mental illness as 'just like us', in practice there are fears that the enactment of mental health legislation prioritises patients' over workers' rights, particularly since constrained resources jeopardise worker safety. In addition, the moral imperative to maintain relationships and social harmony and the economic and social necessity to retain the family as care provider is mobilised against the prioritisation of individual rights and the use of legal compulsion. Through such debates health workers expose the political, economic, social and ethical concerns which trouble the smooth translation of human rights in mental health care.