The Role of Mental Health Legislation and Governance in Program Delivery: An Analysis of Ghana’s Mental Health Act 846 (2012)

Abstract

Mental health legislation plays a critical role in shaping equitable and rights-based service delivery, particularly in low- and middle-income countries. In 2012, Ghana passed the Mental Health Act (Act 846) to decentralize care, protect the rights of persons with mental health conditions, and integrate mental health into general health services. This study examines the extent to which the Act has influenced mental health program delivery in Ghana, using qualitative data from 20 key stakeholders across the Western Region and national-level institutions. Data were collected through semi-structured interviews and document review and analyzed thematically. The findings reveal that although awareness of the Act exists among stakeholders, its implementation has been hindered by weak institutional coordination, inadequate funding, limited decentralization, and absence of a Legislative Instrument. Rights-based provisions and regulation of traditional healing practices remain largely unimplemented. The study concludes that Ghana’s mental health legislation, while progressive on paper, requires targeted governance reforms, operational clarity, and sustained political will to translate policy into practice. It calls for immediate passage of the supporting Legislative Instrument, improved inter-agency coordination, and culturally grounded stakeholder engagement to ensure full realization of the Act’s goals.

Keywords: Mental Health Act, Governance, Policy Implementation, Mental Health Services, Ghana