Helping to improve mental health services in
Ghana
Hampshire Partnership NHS Foundation Trust
UK
Linked with
The Rural Health Training School
Kintampo
Summary report on Fieldwork Placement Development visit by
Sally Gore, Director of Organisational Development, HPFT
9th to 22nd May 2009
www.thekintampoproject.org
Acknowledgement:
This visit was generously supported by NHS Education South Central, UK
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1. Background
In March 2007 a Link was established between Hampshire Partnership NHS
Foundation Trust (HPFT) in the UK and the Rural Health Training School in Kintampo
(KRHTS). The Link was initiated by the Tropical Health Education Trust (THET). The
link is to help to improve Mental Health Services in Ghana through the development
of training curricula at KRHTS.
In November 2007 the Ministry of Health decided to create two new community
based mental health practitioners with training programmes at KRHTS. The two new
posts are;


Medical Assistant Psychiatry (MAP)
Community Mental Health Officer (CMHO)
Since November 2007 much work has been undertaken to develop the programmes.
2. Purpose of the visit
This visit, supported by NHS South Central through NESC, was primarily made to
assess library services at KRHTS in order to make recommendations on the support
needed for the curriculum development for the MAP and CMHO programmes. A
secondary aim was to assess fieldwork placements and to make recommendations
to inform the curriculum development for the programmes
Two librarians (Sarah Lewis, Clinical Librarian, Specialised Services, Hampshire
Partnership Foundation Trust [HPFT]) and (Andrew Simpson, Library Services
Manager, HPFT) and a senior manager and project member (Sally Gore, Director
Organisational Development, HPFT) undertook the visit from 9th to 22nd May 2009.
This report is concerned with the assessment of fieldwork placements
undertaken by Sally Gore. The library assessment, undertaken by Sarah Lewis and
Andrew Simpson is subject to separate report.
3. Summary of key findings
It is difficult to provide a summary from the wealth of information gathered during the
visits, however the following is a summary of the high level findings;
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1. In the field and from student responses it is evident that the MAP and CMHO
programmes are increasingly known about as well as seen as an important
and welcomed development
2. Mental health in Ghana appears to be gaining a higher profile through the (yet
to be enacted) Mental Health Bill, ministerial involvement and support
3. KRHTS is actively working with Kwame Nkrumah University of Science &
Technology (KNUST) to prepare for university status; this includes detailed
documentation of all curricula in line with KNUST. This will result in a formal
assessment from a visiting team from KNUST in the near future
4. KRHTS are in the process of appointing (at least one) additional tutor to lead
on mental health. This will be welcomed by students who reported the need
for more lecturers who are ‘experts in their field’ at KRHTS
5. There was overwhelming support in the field for more preceptor (clinical
supervisor) development and in particular for workshops to be held during
September 2009 with involvement from HPT/KRHTS staff
6. Some examples of good practice relating to fieldwork support were seen on
visits. Of particular note was the role of the in service training co-ordinator (a
trained psychiatric nurse) at Pantang Hospital and the enthusiasm of the
Principle Nursing Officer and Medical Assistant interviewed at Accra
Psychiatric Hospital both of whom had recently attended a preceptor
development workshop run by University of Ghana, Legon for nursing staff.
7. There continues to be a need to fully utilise the field work element of student
learning experience and to reinforce the connection of theory (school based
learning) with practice (learning in the field). This includes developing
processes and systems (such as the assessment of students learning and
performance in the field; collection and organisation of learning material from
the field; contact between the School and fieldwork sites; ability to run regular
preceptor development workshops). A limiting factor to develop learning in the
field is the lack of resources at KRHTS to support this.
8. ICD10 has recently been introduced for capturing mental health diagnostic
data which has the potential to improve the Ghanaian evidence base in
mental health
9. In the medium to long term (once the MAP CMHO programmes are active)
there is the potential to develop the Ghanaian evidence base through clinical
research – HPFT could perform a useful role in stimulating this potential
through partnership working between, for example, the academic University
of Southampton (Mental Health Group) and University of Ghana research
centres
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4. Summary of Recommendations
1. Stakeholder/preceptor engagement
 Continue to actively engage the 9 identified field sites
– Identify leads in each of the field sites (for communication purposes)
– KRHTS and field site leads to communicate regularly
– Invite stakeholders (including leads) to preceptor workshops in
September
– Find out their resources and interests
 Explore all options for engaging other stakeholders such as
– List of MAs who are also Psychiatric trained
– Utilise 40th anniversary celebrations to engage people
2. Student portfolio/reference file
 Create new framework for a reference file for students to collect information
on practice and to keep and use when they qualify. This should include
– Case studies including interventions
– Reflective diary
– Copies of useful resources
– Log book – record of key task and learning objectives (this part will be
in duplicate so KRHTS can keep copy)
– Log book (and if possible full reference file) to be assessed and add to
final mark
 UK will give thought to headings and structure
3. Strengthen link between field work and school learning
 Hold discussion groups when students return from fieldwork so they share
experience, clarify issues, ask questions and have opportunity to make
connection between practice and theory (tutor to facilitate?)
 Enable students to go out into practice more and intersperse this with school
learning (Post Basic Medical Assistants interviewed say this would have been
helpful)
 Wherever possible encourage experts in the field to lecture at college and
also support students on placement
4. Field work Assessment process
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 Develop material (based on current form) for MAPs and CMHOs linked with
learning objectives
 At least 15% of the final marks could be based on the students’ fieldwork
experience. Therefore it is important the fieldwork assessment process is
strengthened and robust – address this at preceptor workshops
 Create the environment that preceptors in the field begin to be seen a equal
partners and ‘faculty members’ of KRHTS
 UK to give thought to field work assessment process and forms
5. Research project topics
 Great opportunity to develop the evidence /knowledge base of Ghanaian
mental health needs
 Work with stakeholders (especially 9 field sites and MAs with Psychiatric
backgrounds) to generate research topic areas and research questions
 Tutors from KRHTS be given opportunities to undertake research in the field
of mental health
 Consider potential to develop research links between University of
Southampton Mental Health Group, KRHTS and Ghana research centres of
excellence to grow evidence base
 UK will also give thought to this
6. Ensure shared understanding of MAP and CMHO job role (by students and
preceptors)
To maximise potential for both role clarity and learning opportunities
 Prepare very clear description of job role (what they will do)
 Ensure this is understood by students before they go on fieldwork
 Ensure this is understood by preceptors and stakeholders before students go
to them for fieldwork
 This will be included at preceptor workshops to include handout
5. The assessment of fieldwork placements
During the 2 weeks the following discussions, meetings and visits were undertaken
and informed the findings and recommendations. A set of questions were used to
guide these discussions.

Visit to two psychiatric hospitals (Accra Psychiatric and Pantang Hospitals)
and two psychiatric units in Regional Hospitals (Sunyani Regional Hospital
and Komfo Anokye Teaching Hospital Kumasi)
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



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Visits to rural health settings
o Jema District Hospital
o Fiaso CHPS and a Health Centre near Techiman
o Techiman Holy Family Hospital (CHAG)
Interviews (in small groups) with 33 students at KRHTS
Meetings with KRHTS staff in particular
o The Director, Dr Adjase
o Field work coordinator, Mr Azindow
o Curriculum leads MAP and CMHO programmes, Mr Ofori and Mr
Okyere
Visit to a prayer camp (traditional healer) Mr Kofi Kyere Pastor MDC Church
Kintampo
Discussions with Dr Ama De-Graft Aikins
----------------------------------------------------------------------------------------------------------------Readers who wish to know more about the project or request other reports should
contact either;
Dr ET Adjase, Director
Project Lead (RHTS)
The Rural Health Training School, MoH, Box 9, Kintampo, B/A, Ghana
Or
Dr Mark Roberts, Consultant Forensic Psychiatrist
Project Lead (HPT)
Ravenswood house, Hampshire Partnership NHS Trust, Knowle, Fareham,
Hampshire, UK PO17 5NA
+441329 836010
mark.roberts@hantspt-sw.nhs.uk
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