Community Mental Health Service Psychotropic Medication Borrowing Between Household Members and Treatment Disruption in Ghanaian Catchments: A Social-Network Estimation of Informal Redistribution Exposure

Psychotropic medication borrowing between household members is a recognised but poorly quantified feature of community mental health care in low-resource settings, where supply interruptions and out-of-pocket costs push families toward informal redistribution. The framework formalises borrowing as a directed dyadic transfer within households, specifies the conditions under which a borrower's own treatment episode is disrupted, and derives catchment-level exposure as a function of household composition, network degree, and the supply reliability of the index patient. Using published DHS Program survey indicators on household age structure across 36 African countries (135 country-survey observations, 1994–2025), the analysis characterises the demographic conditions that make cross-generational borrowing plausible, with a mean age difference between co-resident men and women of 32.358 years (SD 15.598). Informal redistribution is not a marginal deviation from formal dispensing but a structurally predictable consequence of household composition and supply fragility, and that catchment-level exposure can be estimated from routinely available demographic and service data. The contribution is a transferable estimation strategy that reframes medication borrowing as a network phenomenon amenable to community mental health service planning rather than an individual-level compliance failure.