ACCRA, Ghana -- Mentally ill patients suffer from severe abuse at psychiatric hospitals and so-called healing centers in Ghana, with many chained to trees and even denied water, a human rights group said Tuesday.

Some 1,000 residents live in squalid, overcrowded quarters in Ghana's three psychiatric hospitals, according to Human Rights Watch. Patients face physical and verbal abuse, and some are given electroshock therapy without their consent, said the group's report.

The abuse is even worse in healing centers known as "prayer camps," which lack government oversight, it said.

Thousands of mentally disabled people in the West African nation are sent to the camps, usually by their family members to be "cured" by self-proclaimed prophets through miracles, prayer and fasting. In most prayer camps, residents are only allowed to leave when the prophet deems them healed.

At the Mount Horeb Prayer Camp earlier this year, about 120 of the 135 residents there were chained either to trees or to the walls inside cell-like rooms 24 hours a day, sometimes for months at a time, Human Rights Watch said. Most of the chains measured only two yards (meters) long.

"People had to bathe, defecate, urinate, change sanitary towels, eat, and sleep on the spot where they were chained," the group reported.

Medi Ssengooba, Finberg fellow at Human Rights Watch and one of the report's authors, urged Ghana's government to end abuses against people with mental disabilities.

"The conditions in which many people with mental disabilities live in Ghana are inhuman and degrading," Ssengooba said.

Ssengooba said researchers were disappointed to find the level of human rights abuse against the mentally ill in Ghana, which is one of the most progressive countries in Africa in terms of good governance and leadership.

Ghana's 2012 Mental Health Act went into effect in June and allows people with disabilities to challenge their detention in psychiatric hospitals. But the law does not apply to the prayer camps operating outside of government control. Many families send their mentally ill family members to prayer camps because there are very few mental health providers in Ghana and almost all of them are concentrated near Accra, the capital.

Ghana ministry of health spokesman Daniel Osman said the government is making an effort to decentralize so that every regional hospital has a psychiatric unit.

Besides the three psychiatric institutions around Accra, Ssengooba said there are only four private facilities in the country and they are expensive. And in many rural areas, people equate mental illness with demonic possession, and only think there is a spiritual cure, Ssengooba said.

Yet many mentally ill people face bondage, near starvation, and an inability to challenge their confinement at the camps.

One man with a mental disability at Mount Horeb Prayer Camp told Human Rights Watch he was chained for one year without any treatment. He said: "I want to go home, but they don't discharge me and they don't give me any reason."

Doris Appiah, the treasurer of the Mental Health Society of Ghana, said advocates aren't asking the government to close the camps but instead to monitor them.

Appiah, 57, was a medical student in her early 20s when she was committed to a mental hospital with severe depression. After escaping from the hospital, her family put her in a prayer camp near the town of Kumasi, north of Accra, hoping for a quick fix.

She stayed in prayer camps for five years, and was tied to a tree with rope. She is now an advocate for mentally ill people in Ghana.

"People are sick and they are not blamed for being sick, but you are mentally ill and it's your fault. And we hear it over and over again. People say mentally ill people are a liability and we are a menace to society," she said. "When you have mental illness you are considered sub-human, and that is the truth. You are carried places and things are done to you."

She said minimum standards at prayer camps need to be set by the government, and people in Ghana need to be educated about the causes of mental illness.

"Whether you are in chains or not, being mentally ill is like being incarcerated," Appiah said.

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