Following Uganda’s independence in 1964, the nation went through devastating periods of unrest that significantly impacted its population of 42.8 million people. While Uganda has seen major improvements in recent years due to reaching their millennium development goals, such as lowering poverty from 33.8 percent in 1998 to 19.5 percent in 2012, the nation is still struggling with an epidemic of mental illness. As much as 35 percent of the population suffers from mental illness, 15 percent of which require treatment.

Changing Precedents

Major improvements have been made to Uganda’s healthcare system, raising the average life expectancy from 44 to 59-years-old. However, less then 1 percent of the 9.8 percent of GDP Uganda dedicates to healthcare goes towards mental health. The majority of this funding goes towards the national mental health hospital in Butabika, which holds 500 beds and is still almost always overcrowded.

Mental Health Still Neglected

The rest of Uganda’s mental health budget is spread out over a network of 28 out-patient facilities that specialize in follow-up care. These services are starved of the funding needed for proper medication. According to a study conducted by the World Health Organization in 2006, only 57 percent of clinics had at least one psychotropic medication in each class, meaning medication someone needs is highly unlikely to be available in Uganda.

The stigma around mental illness in the nation comes in particular from traditional beliefs that associate illnesses of the mind with spirits and witchcraft. Due to religious culture in the area, mental illness is viewed as a spiritual curse.

While mental health care in Uganda is struggling, many improvements have been made in recent years to help those who are affected by it.

5 Ways Uganda is Improving Mental Health Care

1. Ending the stigma around mental illness is the first step that must be taken to tackle the problem. According to the Community Development Officer of the rural district, “…most people think that [mental illness] is bewitching. Others associate it with disagreements with their elders.” Bringing awareness about the true cause of mental illness is allowing the healthcare system to grow and make room for mental health care. This may be the most important of the 5 ways Uganda is improving mental health care.
2. Increased aid would drastically improve the living conditions in Uganda. For every dollar invested in mental health, the economy sees a return of $4 due to an improved ability to work. In Uganda, the mentally ill often have trouble finding employment, however, increased aid would allow them to become contributing members of society. Organizations such as Basic Needs are working to tackle both poverty and mental illness by supporting locals to create small businesses. By helping the mentally ill and their families, organizations such as this are increasing peoples means and helping them afford the care that can save them.
3. The Mental Health Action Plan for 2013-2020 was released by the World Health Organization (WHO) in the spring of 2012. The plan cites its goal “is to promote mental well-being, prevent mental disorders, provide care, enhance recovery, promote human rights and reduce the mortality, morbidity and disability for persons with mental disorders.” In order to accomplish this, the WHO has set out to achieve four goals: strengthen government leadership, provide integrated mental health care in community-based areas, strategize prevention techniques, and strengthen information and research for mental illness.
4. Grand Challenges Canada, an organization that supports “Bold Ideas with Big Impact,” has trained nearly 500 faith healers, otherwise known as witch doctors, to recognize symptoms of mental illness and refer them to physiatrists. This unlikely tactic takes advantage of the abundant number of traditional healers in Uganda. While there are only 32 western-trained, psychiatrists in the country, there is a ratio of one witch doctor for every 290 Ugandans. As a result, most suffers of mental illness go to faith healers for their symptoms. This new technique is building a bridge between traditional healing and western health care.
5. New Legislation in Uganda such as the Mental Health Act of 2018 is improving health care conditions. The Act provides mental health treatment at primary health centers, along with emergency treatment and involuntary admission and treatment for those who need it.

Mental health care is a complicated system and as Uganda improves life expectancy and poverty reduction, improvements and funding for mental health will become more available. There is a long way to go for the Ugandans suffering from mental illness, but enhancements are present as indicated by these 5 ways Uganda is improving mental health care.

– Maura Byrne
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