The mentally ill are often chained up in Ghana, like this woman suffering from depression

A young woman stands with her left foot chained to a tree in rural Ghana. Her wrap-around traditional cloth hangs loosely at her hips, and her breasts are exposed.

“Cover yourself,” Atete Atempon yells at the girl I’m now staring at.

The woman smiles a doped-up smile as two servants rush to unchain her. They know I’m quizzically wondering why she’s tied up and how she got there. They work hard to unshackle her so they can shoo her away before I start asking questions.

“She is not well,” says Atempon, as he orbits his hand around his ear to imply she’s lost her mind. Atempon is an herbalist at the prayer camp where the woman is being treated.

Finally, she is covered up, unchained and led away screaming.

In Ghana, schizophrenia, bipolar disorder and depression are conditions rarely diagnosed. What is diagnosed, however, is the condition of being possessed by evil spirits. The belief in witchcraft and spiritualism is very much alive here. For someone to simply be mentally ill is not. As a result, most mentally ill end up in prayer camps such as this instead of receiving psychiatric care.

As treatment on the camps, they’re often given herbal mixtures or physically beaten until the demon is believed to have left the body. Or, they’re left secluded under a mango tree for weeks, as is the case with this nameless woman.

Her family left her here because she began exhibiting strange behavior after her former boyfriend reneged on his promise to marry her. What might be cured in Canada with a vat of ice cream, a session with a shrink or an anti-anxiety pill is treated a little differently in Suhulm, Ghana, where patients are chained up or fed herbal remedies until they’re no longer possessed—or broken-hearted.

As resident herbalist, Atempon treats patients with his special concoctions. He offers to show me his workspace and I eagerly agree. We cross the threshold of his laboratory of blood-red oils, leafy soups and bottles of herb-infused moonshine, to be ingested by or smeared on patients, and I ask him if he has a background in mental health.

“I know how to cure anything,” he says, averting the question. He tells me he not only cures AIDS, but also makes the insane sane. He looks at the tree where the woman was shackled. “In two weeks, the girl that was there will be fine.” His claims are lofty, but Atempon’s Ralph Lauren shirt and stacked gold rings tell me people pay him big for his work.

Dr. Akwasi Osei, chief psychiatrist at the Accra Psychiatric Hospital, has a different approach to mental illness. He believes in mainstream psychiatry that assesses a person’s mental state and considers any contributing social factors to their condition before suggesting treatment. According to Osei, about 2.4 million Ghanaians are living with mental illness, many of whom suffer quietly on the peripheries of society, in fringe communities like Suhulm.

Spiritual churches, prayer camps and other unorthodox institutions treating the mentally ill are rampant in Ghana. It’s a cheaper option than going to the hospital, and often the only option for most families who make less than $1.50 (CDN) a day. Dr. Osei laments that he and the World Health Organization, which also supports mainstream care, face a barrage of opposing views from the public in their battle to erase the stigma attached to mental illness.

But how do you convince an entire society that someone is not possessed but instead depressed, suffers from a chemical imbalance or simply has a case of the breakup blues in a country where a belief in witchcraft is so deeply engrained?

One way might be through legislation. In 2006, the Disability Bill was passed in Ghana to prevent mistreatment of the mentally ill, but abuses still abound and proper care remains widely unavailable. As it stands, Dr. Osei says only two per cent of people suffering from mental illness have access to adequate treatment.

There are a meager nine practising psychiatrists in all of Ghana, and they are stifled when it comes to reaching even half of all cases. What’s more, many are discouraged from becoming practising psychiatrists, according to Dr. Osei, because their peers believe gods and spirits rule the psyche of a person. Chemical imbalances seems obtuse to many in a country where the mental state of the individual is often put down to sorcery, not psychiatry.

That’s why this girl is chained to a mango tree. Patients waiting to see Atempon barely blink an eye at the chained insane. There is an undercurrent of acceptance; people in the waiting area sit like an audience ready to applaud at the wonder of the herbalist — seemingly making it a Gordian-knot of a problem to solve.

As I leave the compound, I hear the girl screaming as she is doused with cold water and barked at by her two keepers.

Atempon waves goodbye as his gold rings catch the sun and blind my gaze.