Background: Mental, neurological and substance use disorders are poorly resourced and prevalence of these disorders is 10–13% in Ghana with only 10% of those affected seeking formal psychiatric treatment. The NHIS coverage gap for mental health has consistently been a cost burden on households, with high out-of-pocket expenses. But it was a turning point in November 2024 when four mental health conditions joined the NHIS benefits package, reflecting a positive step towards improved financial protection and treatment opportunities. Objective: This review aimed to examine, through secondary data, the prospects and challenges of mental health insurance in Ghana, in order to identify policy options for strengthening the mental health financing system. Method: The peer-reviewed literature, government publications, national statistics and international literature were used to conduct this secondary-data review, which was completed between 2012 and July 2026. Relevance and credibility of the evidence were evaluated, and the evidence was presented in a narrative form thematically. Results: There was a rise in NHIS coverage from about 40% in 2014-2015 to 68.6% for the 2021 census period. Progress also includes digital enrolment reform and promises to increase the provision of integrated mental health care. However, challenges still exist, such as payment delays by NHIS, a lack of psychiatric professionals, poor psychotropic medicine supply chains, and stigma linked to spiritual interpretation of mental illness. Conclusion: The growth of NHIS coverage for mental disorders is a significant progress towards achieving equity in healthcare coverage. But deeper strides will take place if claims are processed better, medicines are available, workers are distributed more effectively, and stigma and misconceptions about mental illness are addressed.