A/HRC/31/57/Add.2 60. The Children’s Act 1998 prohibits “cruel, inhuman or degrading treatment or punishment including any cultural practice which dehumanises or is injurious to the physical and mental well-being of a child,” but allows for a degree of “reasonable” and “justifiable” punishment of children in the home and in alternative care settings, as does the Education Act (1961), the Ghana Education Code of Discipline in school settings. In 2014, the Government confirmed the widespread and ‘lawful’ use of corporal punishment. The Special Rapporteur calls on the Government to amend the relevant provisions as a matter of urgency and explicitly prohibit all forms of corporal punishment in all settings, and educate the authorities and the public so that the practice of caning, in particular, is eradicated. 61. The Rapporteur congratulates the Government for ratifying the Optional Protocol on the Involvement of Children in Armed Conflict in December 2014, and urges the expedited ratification of the Optional Protocol on the Sale of Children, Child Prostitution and Child Pornography. Although the Government has undertaken welcome legislative reforms to broaden the scope of persons responsible for female genital mutilation (FGM), which increases sanctions for those who commit the harmful practice, in 2015 the CRC reported its prevalence in rural communities, despite its criminalization. IV. Mental Healthcare Practices and Services 62. The Special Rapporteur found that challenges facing the mental healthcare system and conditions in psychiatric institutions and prayer camps remain the same as during the last visit. Lack of capacity, whether in terms of budgetary support, infrastructure, mental health professionals, medication, and even food, result in either dreadfully inadequate or nonexistent provision of services, with an estimated 98% treatment gap. At the same time, human rights abuses against persons with psychosocial disabilities – particularly in the private or “informal” sector of prayer camps or other traditional healing centers – continues, along with public stigmatization and discrimination, and the continued low priority assigned to mental healthcare by the Government. The Special Rapporteur was nevertheless impressed by the commitment displayed by the leadership of the Mental Health Authority Board (Board) and by its ambitious plans in the face of difficult constraints. However, ongoing efforts to regulate, control, and supervise health-care practices, including monitoring the prayer camps and other privately-run institutions; to recruit and train more mental healthcare professionals; and to improve the quality of care provided, including in terms of food and shelter, must be dramatically intensified and backed-up by adequate funding, resourcing, and capacity-building, if they are to result in meaningful changes. 63. In its 2015 annual report, the Board noted the troubling deterioration of services against the increasing number of patients. Capacity for mental healthcare services remains vastly reduced, with only 14 reported practicing psychiatrists and 1,600 psychiatric nurses serving a population of nearly 26 million. The country’s three psychiatric hospitals are all located in the coastal belt in the south of the country, and few options for care exist outside these facilities. The Special Rapporteur welcomes information that the Board has begun collaborating with mental health training institutions, notably Nurses Training Colleges, to facilitate the training of psychiatric nurses and community mental health workers, and that 400 individuals have been trained to date. Nevertheless, their numbers remain very low, and regional distribution is skewed, with the Board warning that the constraints posed by inadequate funding and human resources make it impossible to extend mental health services to all districts for the short- to medium-term future. It reported that there is only one psychiatrist serving the Northern, Upper East, and Upper West regions. 17

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