Trauma-Focused Therapy Waitlist Queue Position and Mental Health Symptom Deterioration in Ghanaian District Clinics: A Regression Discontinuity Analysis of Intake Scheduling Thresholds

District clinics in Ghana allocate scarce trauma-focused therapy slots through intake scheduling thresholds that place patients into queue positions, yet the mental health consequences of queue position itself remain unexamined. The estimand is the local average treatment effect at the threshold, comparing patients immediately above and below the cut-off who are otherwise comparable. Drawing on the DHS Program indicator 'Current users most recent supply or information from a government health center' (FP_SRCM_W_GHC), 150 country-survey observations from 36 African countries between 1990 and 2025 (mean 25.261, SD 18.895, range 1.50 in Morocco to 51.89 in Zambia), the paper situates Ghanaian clinic-level scheduling within continental patterns of public-sector health facility utilisation. The design specifies running variable, bandwidth, kernel, covariate adjustment and falsification tests, and it addresses the ethical tension of withholding priority from patients just below the threshold. The contribution is a transferable identification strategy for waitlist queue effects in low-resource mental health systems, together with a set of testable propositions about symptom deterioration as a function of queue position.