Mental illness in Uganda has not received the same attention as HIV/Aids or malaria, but is just as serious. A consultant psychiatrist, Sarah Nalule at Butabika hospital, Uganda's national referral mental hospital, said that 35% of Ugandans, about 11.5 million people, suffer from some form of mental illness, with depression being one of the most common. But barely half of these people seek medical attention from health centers in a country where people only associate mental illness with advanced and possessed psychosis.
According to Tina Ntulo, Africa director of Basic Needs, Mental health organization, not much money has been invested in fully functioning mental health units in district hospitals. It has been undermined by planners and decision makers with just meager budget allocations.
‘Whilst there is newly constructed mental health infrastructure in Hoima district, there is no infrastructure for mental health at all in Masindi and Sembabule districts and only a very small unit in Masaka district and this is the same with the Eastern region,” she added.
Ntulo stressed the point that there are only thirteen practicing psychiatrists in the country. Twelve of them are practicing in Butabika hospital in the capital, Kampala. This means that it is virtually impossible for people living in rural areas to easily access a psychiatrist and get the help they need unless they travel long distances, which can be very expensive.
Some drugs are only allowed to be dispensed at major Health Centers. If there is demand for such drugs at lower levels, these patients should be referred to bigger hospitals for better management. However, the distances and access to these major hospitals coupled with the poverty that mentally ill people face makes referral difficult.
What is mental health?
Mental health is how we think, feel and act as we cope with life. It also helps determine how we handle stress, relate to others and make choices. Like physical health, mental health is important at every stage of life, says
Mental health is how we think, feel and act as we cope with life. It also helps determine how we handle stress, relate to others and make choices. Like physical health, mental health is important at every stage of life, says
Dr. Sheila Ndyanabangi, principal medical officer at the Ministry of Health said that mental illness is an illness that affects or is manifested in a person's brain. It may impact on the way a person thinks, behaves, and interacts with other people.
“The term "mental illness" actually encompasses numerous psychiatric disorders, and just like illnesses that affect other parts of the body, they can vary in severity. Many people suffering from mental illness may not look as though they are ill or that something is wrong, while others may appear to be confused, agitated, or withdrawn,” she added.
Warning signs of Mental Illness
A person with one or more of the following symptoms should be evaluated by a psychiatrist or other physician immediately: Marked personality change, inability to cope with problems and daily activities, strange ideas and excessive anxiety, prolonged depression, change in eating or sleeping patterns, extreme highs and lows, abuse of alcohol or drugs, excessive anger, hostility, or violent behavior, suicidal tendencies
A person with one or more of the following symptoms should be evaluated by a psychiatrist or other physician immediately: Marked personality change, inability to cope with problems and daily activities, strange ideas and excessive anxiety, prolonged depression, change in eating or sleeping patterns, extreme highs and lows, abuse of alcohol or drugs, excessive anger, hostility, or violent behavior, suicidal tendencies
Post Traumatic Stress Disorder (PTSD), the most common mental ailment in war affected areas like the northern Uganda; it is a result of events that cause horror. These include war, accidents, loss of loved ones and sexual abuse like rape.
Dr. Seggane Musisi, a lecturer of psychiatry at the Faculty of Medicine, Makerere University says that mental illnesses are common but many times, the patients do not get treatment. Disorders which include depression and irrational fear should not be ignored. Fortunately, they are often treatable. Prescriptions and therapy can improve the life of most people with mental illnesses.
He also noted that more than a third of the individuals surveyed (67%) had signs of depression. A person who is depressed feels irritable, persistently sad, unnecessarily tired, anxious, guilty, lack of sleep and worthless.
“One also loses interest in pleasurable activities like sex or may fail to concentrate on tasks and usually has problems remembering details. One’s appetite may also rise or decline,” he added.
“One also loses interest in pleasurable activities like sex or may fail to concentrate on tasks and usually has problems remembering details. One’s appetite may also rise or decline,” he added.
Link between mental health and poverty
Uganda has come a long way in its recognition and treatment of mental health problems, but stigma and a misunderstanding about conditions remain unsolved.
Lukwago Godfrey, a Programme Officer at Mental Health Uganda says that in Uganda there is a close association between mental illness and chronic poverty. Although statistics on mental health are scanty, there is an increase in cases of mental disorder.
Lukwago Godfrey, a Programme Officer at Mental Health Uganda says that in Uganda there is a close association between mental illness and chronic poverty. Although statistics on mental health are scanty, there is an increase in cases of mental disorder.
“Many people in rural areas turn to traditional healers or faith healers to cure their illnesses. Whilst these healers are successful in treating some mental illnesses by using counseling methods in their treatments, often their methods are inappropriate and ineffective,” he added.
He stressed that there is a massive dearth in trained staff, which is why Mental Health Organisations rely a lot on local volunteers from within the communities we work in to help us reach out to people with mental health problems.
Lack of adequate treatment
Lukwago also stressed that effective treatment is a vital first step in giving mentally ill people the chance at a new life. Through effective treatment we show that mentally ill people can return to a normal state and this is an essential part removing the stigma from family and community that mentally ill people face.
“The most important thing that mentally ill people need is care that they can access in their communities however the little health care available is often found in psychiatric hospitals in cities. That means that people who live in very remote rural areas have to travel long journeys to get treatment. The transport is not free and many people cannot afford it,” Lukwago added.
