District Hospital Trauma Mental Health Screening Chaplaincy Referral Proximity and Post-Traumatic Stress Disorder Treatment Initiation Among Ghanaian Survivors: A Geospatial Accessibility Analysis of Spiritual Care Pathways

District hospitals in Ghana screen trauma survivors for post-traumatic stress disorder (PTSD), yet initiation of evidence-based treatment remains low, and the spatial relationship between screening, chaplaincy referral and treatment uptake is poorly understood. The framework treats chaplaincy referral as a spatial mediator: survivors screened at a district hospital are more likely to be referred to a chaplain when a chaplaincy facility lies within a defined travel-time threshold, and referral in turn raises the likelihood of treatment initiation through trust, stigma reduction and navigational support. Using published DHS Program survey data on knowledge of any method of contraception among married women (38 African countries, 162 country-survey observations, 1986–2024; mean 91.776, SD 11.342, range 57.80 in Chad to 99.90 in Eswatini), the paper illustrates the distributional logic that any accessibility model must accommodate: a high mean with substantial between-country dispersion. The framework specifies estimable quantities, identification assumptions and falsifiable predictions, and it distinguishes spatial mediation from confounding by facility quality and urbanicity. The contribution is a testable conceptual model that repositions chaplaincy proximity as a modifiable structural determinant of the PTSD treatment cascade, with implications for district hospital planning and for the design of spiritual care referral pathways in Ghana and comparable settings.