A call for dignified treatment of mental health patients in Uganda

By Jimmy Acellam Odoki

World Mental Health Day was celebrated on October 10, under the theme "Dignity in Mental Health." However, Uganda's celebration is on November 10 and will be held in Kampala.

Mental illness is still neglected in Uganda despite efforts by the Government over the years to integrate mental health in primary healthcare. Despite that, the extent to which mental health services have contributed to improving the condition of people suffering from mental illness is wanting. The country has less than 40 psychiatrists for a population of 35 million people.

It is estimated that by 2030 depression, a form of mental illness, will become the most common illness, overtaking by far HIV or cancer (Network for Mental Health, 2012). This is a real threat. Globally, 10-20% of children have mental or behavioural problems and many of the affected children are neglected and do not have access to appropriate resources for recognition, support and treatment (WHO report on mental health 2001).

Thousands of people with mental health conditions are deprived of their human rights. Psychiatric hospitals in Uganda systematically violate the rights of patients, Mental Disability Advocacy Center (MDAC), found in a report launched last year. Among others, the report documented cases of people with mental health illness being frequently locked in dark and cold seclusion rooms. The national referral mental hospital in Butabika was noted to widely practice this.

The United Nations Convention on the Rights of Persons with Disabilities (UNCRPD), which Uganda has ratified, prohibits all forms of torture and ill treatment including in healthcare settings.  The convention is meant to promote, protect and ensure the full and equal enjoyment of all human rights and fundamental freedoms by all persons with disabilities, and to promote respect for their inherent dignity.

Stigma, marginalization and discrimination are commonly faced by mental health service users, according to Mr. Joseph Atukunda, founder and president of Heartsounds Uganda, an organisation that raises awareness and promotes peer support for persons with mental health.

It is difficult for mental health patients to integrate into the community and live a normal life. Society looks at them as worthless yet the path to recovery involves much more than medication. How well families look after their relatives while undergoing and after treatment means a lot in the healing process.

The dignity of the mental health service users is very important because they are very sensitive to the way they handled despite the illusion that they know nothing in their state. It is not uncommon to find some people with mental illness, especially in rural areas, being tied up with ropes and being subjected to the most inhumane treatment. Others are forcefully detained and taken for treatment without their consent. 

Poor quality care due to lack of qualified healthcare workers in some of the regional mental hospitals lead to violation of rights of patients. In many instances the patients get medication without even knowing their diagnosis.

Many things can be done to help restore the dignity of persons with mental health challenges. Key among them is teaching about mental health right from families up to schools. Empowering patients who feel better, according to Eddie Nkurunungi of the Butabika Recovery College, is very important. In many cases they are productive people who can do things considered for "normal people".

Angela Nsimbi, the national Coordinator of Heartsounds Uganda emphasizes the importance of showing love and care to persons with mental illness by their families.

Locking and hiding them away from the community often leads to aggression and anger. The best thing that can be done to those with mental health challenges is to treat them with dignity.

The writer is a mental healith advocate