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The Royal College of Psychiatrists Improving the lives of people with mental illness

Southampton - George Kunyangna

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27/08/2013 11:11:54

My longest journey

The weather was unusually warm as I walked down the winding street just before my residence in Lygon on a huge patch of land not far from the Isle of White, I felt some aches in my ankles and then I suddenly realized that I have been walking for the past few hours, I mean rather for the past few days or even weeks.  No! It must have been some months. I decided to take a rest under that big tree which has virtually lost all of its branches due to the many seasons it has seen standing like a royal guard on duty except this notorious branch pointing southwards along the Greenwich. I suddenly heard a sound and looking up, I saw a multi coloured little bird which soon started singing a sort of lullaby that my weary eyes could not resist.

In my sleep I recalled how I embarked on a team journey of discovery, with mental health in my mind because I knew there was some missing information I needed. I was not exactly sure of the nature of this information though that made no difference. I knew I had what it takes to go on this journey; willingness to follow the spirit within without hesitation, desire to make an impact by partnering in creating a better world. With this mind set my trip has been magical in every way. I have been guided in every way possible. I have been to the right place at the right time meet the perfect people who gave me exactly the right potion I needed to challenge the challenges of mental ill health. I am still struggling to find words to express my profound gratitude to all the wonderful and beautiful people that offered me and my colleagues this potion and the necessary incantations. I was just about to say that I was looking forward to my next visit when I heard a voice saying ‘it’s time to go!!’. In an attempt to see who was speaking I woke up from the dream and to my surprise the little bird had grown huge. Taking off from the branch it started singing ‘’follow me, follow me……..’’ and flew southwards along Greenwich meridian into the clouds beyond the horizon.

Thank you Southern Health Trust, thank you The Kintampo Project, thank you The United Kingdom. Our country and people will forever be grateful to you. Long live our commonwealth!!  

 

30/07/2013 10:31:05

Epilepsy, the need for a pardigm shift

 

The diagnosis and management of epilepsy probably with the exception of grandmal, continue to pose a challenge in most parts of the world especially in my country where the condition is classified as a mental disorder. I do not intend to bore you, but it might be interesting to remind myself and probably some of you that there are around 40 different types of epilepsy though the spectrum can be narrowed by classification, widely ranging in complexity, seizure type and the potential for complications. Yes, this is the condition in my opinion that is being underestimated in its impact on individuals and communities, the risks of injury and death, and the terrible stigma that epileptics have to live with every day.

The effects of epilepsy on fecundity, pregnancy, the potential teratogenicity of some anti-epileptics, the lack of EEG machines, MRI scanners and low quality of perinatal services in some parts of Ghana is even more alarming considering the rustic nature of our communities and slow pace of road development. There is the need to take a decisive decision if we are to break the stranglehold this condition has on sufferers.  I strongly believe that the classification of epilepsy under mental disorders in Ghana is misleading and stigmatizing and any belief that epileptics will end up with mental disorders is proven to be untrue if timely diagnosed and properly managed.

We might not have the money and the resources we need yet, but we should begin to think of neurology and neuropsychiatry as specialty / special interest areas for Physician Assistants and Clinical Psychiatric Officers in Ghana as is the case in the UK where some complex epileptic presentations are picked up early and managed by specialist medics. This will help provide for the huge numbers of people suffering from epilepsy and other neuropsychiatric disorders from infections, trauma etc.  I think the time for change is now, especially during this period of transition of mental health services from institutional to community based practice.

 

03/07/2013 11:56:30

Informed Consent: UK experience

Informed Consent: UK experience, my contextual practice.

 

Informed Consent is a legal and ethical consideration in psychiatric practice, which aims at empowering the patient to make informed decisions, about a particular treatment and what the treatment entails.


In the UK, low practitioner client ratios, the availability of wide range of alternatives, patient’s awareness of their rights, access to legal redress, vibrant media and functioning social support systems have given meaning to this doctrine of consent to a large extent.

I have observed the length of time spent with each patient in the UK, on discussions covering virtually every step of a treatment, and procedures, and occasionally making references to text  and literature, with practitioners sometimes locked in a debate with a client.  Sometimes there are threats of legal action by the clients and this really amazes me. 

All this has tasked my understanding of informed consent and the call for tact and professionalism in my own practice and my role as a teacher in Ghana.

The experience here in the UK has amplified my practical difficulties in applying this ‘ideal’ concept back home in Ghana.  At home we have large numbers of clients, erratic flow of medications and nearly the opposite of the UK context though we also have some strengths.  There are some signs that our mental health situation will improve soon, but until then, I wonder if there is a practitioner who will become excited if his client refuses his treatment because of associated challenges with no alternative.

If I may ask … ‘informed consent, is it really a standardised tool of practice with regards to the relativity of impairment or is it a contextually relative term of psychiatry practice?’ The UK has seen it all over the past 150 years and it is a great feeling to be here at this time to understand how it unfolded and the way forwards for my country

 

15/07/2013 10:08:05

Culture of compassion – a Ghanaian perspective

As part of my learning experience in the UK I am seeing so much and I’m looking forward to still more, but I was forced to stop and look back when I was introduced to the 2012 NHS drive towards a Culture of Compassion. In sharing my thoughts with you now, I must tread cautiously to avoid disrespecting the norms, sensitivities and sensibilities of my society in Ghana and the pundits of my profession at home, but as the Ashantis  say; ‘ yedi abotre ena edwa aboa ntetia ehu ne sono eni ni breboo ( literally “it is with patience that we dissect an ant to see its entrails”) so with patience much can be achieved !   

Compassion is often regarded as emotional in nature, and there seems to be a quantitative dimension too, such that compassion can be given a property of "depth" or "vigour" The etymology of "compassion" is Latin, meaning "co-suffering." More involved than simple empathy, it often gives rise to an active desire to alleviate another's suffering.  A defining feature of Hospitals and health professionals down the ages has been their ‘compassionate’ consistent care for the sick to improve their health and that of their community.

At no time are we more vulnerable than when we’re ill, and more so, perhaps when mentally ill. The vulnerability of patients must not lead to abuse or exploitation, but rather a clarion call for professional expertise, predicated by scientifically grounded knowledge and for effective and compassion based treatments to be at the very core of our practice.

 

So, what’s niggling me? The running of some health institutions back home …..Like business entities (in the disguise of clinic/hospitals ?) and some health professionals paid for who they are and not how they do what they are mandated do, evidenced by a gradually growing public concern that core professional values are waning among health professionals, is what’s eating me.   It poses a threat to the very foundation of what we are as social beings in the first place and is an insult to the Golden Rule: Do to others what you would have them do to you. I fret over the psyche of the youth and professionals in the making who need to be insulated from this risky canker.  I hope was can feed them with scientific and rational knowledge that emphasize our existence and wellbeing in the cosmos to compassion within the therapeutic milieu of our clinical practice.

 

I see and appreciate the re-invigoration of the Culture of Compassion in the care of patients in the UK as a ‘germ’ concept with potential for interrogation and replication in my country. The teaming up of compassion driven professionals of different disciplines to generate blazing patient focussed ideas in an environment void of derision and the hospital at home concept where clients are provided with the care they need in their home environment is  a challenge I relish and would wish to strive to  subdue with determination and commitment.

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        About this blog


George Kunyangna


George Kunyangna is a Clinical Psychiatric Officer from Kintampo.  He is one of the first specialists of his kind in Ghana and is providing services at the level of a psychiatrist to support his few medical psychiatrist colleagues for his nation of 24 million people.  George is a product of Kintampo Project programmes and is now becoming a teacher to ensure the long term sustainability of The Kintampo programme. He is undertaking 8 weeks of professional development in Southern Health NHS Foundation Trust, UK. His visit has been arranged via The Kintampo Project and is funded by a Professional Fellowship from the Commonwealth Scholarship Commission which is one of the largest and most prestigious scholarships schemes for international study in the world. This is George’s first time in the UK and he shares his observations of UK practice with you.