In many countries around the globe, healthcare professionals have begun to fully realize the need for comprehensive mental health care along with physical care. However, in many developing countries, where access to basic needs such as clean water and vaccines can be hard to come by, mental health care is often viewed as an unnecessary addition to the already costly and (rare) healthcare systems that may be in place.
Mental Health in Uganda
Uganda is the last of the six African countries with the highest number of mental health cases reported. Of the 38 million people in Uganda, almost 5 percent experience clinical depression and almost 3 percent deal with anxiety disorders. Now, the government has taken a new look at options to address mental health care in Uganda.
The Ministry of Health has begun The Health Services Strategic Plan (HSSP), a comprehensive plan to overcome the challenges many developing countries face in providing access to good physical and mental health care. There are some crucial barriers that Uganda, and many other countries, must overcome in order to fully assist their citizens in receiving proper mental health care.
- Distance: One-third of Uganda’s population lives over 5 kilometers from the nearest health facility, and it is not guaranteed that the nearest facility will have patients’ pharmaceutical requirements or even be equipped to treat the patient’s medical needs.
- Communication: In the healthcare field, direct and effective communication is key to both the success of the program and the well-being of patients. In Uganda, 43 different languages and dialects are spoken, making communication for all involved—doctors, nurses, psychiatrists and patients—difficult when it comes to discussing diagnosis, treatment, medications and discharge information.
- Funding: In developing countries, the cost is often a large factor in the country’s ability to provide healthcare to their people. Only 9.8 percent of Uganda’s GDP is spent on healthcare, and less than 1 percent of these funding is directed towards mental health care.
- Stigmas about mental health: Mental illness has long been stigmatized by the general public around the world. The concept that people suffering from mental illness have done something to deserve or create their struggles can have a powerful effect on one’s willingness to seek the necessary treatments.
Treating Trauma for Women
Poverty and mental illness often augment each other in a negative cycle. In Uganda, and in many other countries where poverty is prevalent, women and girls have a greater risk of mental illness. In Uganda, 80 percent of women who have received care for trauma-related issues have reported experiencing sexual assault. The negative consequences to one’s mental health associated with such a traumatic incident often keep people at low levels economically, socially and mentally.
The cycle of abuse towards women along with expectations of marriage and childbearing in at a young age and the minimal educational opportunities available perpetuate the ongoing cycle of poverty as a whole. In 2012, The Uganda Ministry of Health and World Health Organization (WHO) became partners in solving the growing issue of insufficient access to treatment options for mental health care in Uganda, specifically for children, women and those living in poverty.
Focus on Children and Adolescents
One component of Uganda’s new work on mental health care is Child and Adolescent Mental Health training, or CAMH. By providing access to mental health care for children and adolescents, Uganda can promote well-being from a young age, thereby de-stigmatizing the act of seeking and receiving care and support as needed. Therefore, training more professional is integral to the success of the new mental health policies.
In order to complete this mission, the training will tackle the issues preventing access to mental health care for all in Uganda through 5 main objectives: increasing knowledge surrounding mental health care, improving availability of mental, neurological and substance abuse care, increasing research, monitoring and evaluation of mental health concerns, contributions to the development of legislation, and increasing collaboration in providing mental health care to children and adolescents.
Treating Depression With HIV/AIDS
In 2016, a program was initiated in Uganda, developed Dr. Etheldreda Nakimuli-Mpungu, that focused on mental health care in relation to HIV/AIDs. Nearly one-third of HIV/AIDs patients experience depression. While the number of facilities and healthcare professionals trained to deal with HIV/AIDs has increased, access to mental health care has remained minimal.
The new program has introduced ‘group support psychotherapy,’ targeting the management of depressive symptoms occurring in those with HIV/AIDS. It is believed that 70 percent of patients will recover substantially from depression through the group therapy, thereby positively influencing self-esteem, feelings of social support, and general functioning levels. By alleviating patient’s depression through mental health care in tandem with physical care needed, it is predicted that 20 percent of patients will experience less poverty due to higher productivity rates.
The country of Uganda began drafting legislation targeted at towards these and more mental health issues in its new Mental Health Policy, which will review and revise the 1964 Mental Health Act. The aim is to provide structure and safety for those struggling with emotional, neurological or substance abuse problems as well as create preventative measures involving communities and regional, rather than national, healthcare centers and professionals.
Through Uganda’s new efforts and policies, there is now hope that those suffering from mental health issues in the country will be able to seek the help they need. By working to provide the training, facilities and education against stigmas necessary to enact real change in the community, Uganda will be able to alleviate some of the mental health issues being faced, which will, in turn, help alleviate poverty.
– Anna Lally