The economy and Uganda’s mental health crisis
We cannot speak of resilience without asking what people are being forced to endure. We cannot encourage young people to hope while refusing to confront the realities that make hope increasingly difficult to sustain, writes Moses Mukasa Bwesige
Moses Mukasa Bwesige. (Courtesy)
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OPINION
By Moses Mukasa Bwesige
Over time, I have become increasingly troubled by what appears to be a growing mental health crisis in Uganda. I have witnessed the growing concern over suicides, while reports attributed to the country’s national mental health referral hospital have highlighted concerns about substance use and depression. I have participated in media interviews, written newspaper columns and engaged with policymakers, trying to understand what is happening to the mental health of my fellow Ugandans.
What is pushing many of our people to the edge? What is happening in the lives of our compatriots that makes simply surviving feel increasingly unbearable?
Yet, the more I engage with these questions, the more elusive the answers sometimes seem. We discuss depression, substance use, suicide and mental illness as though they exist in isolation, as though they can be understood entirely through clinical diagnoses, individual choices or awareness campaigns. We hold conferences, conduct interviews, develop policy recommendations and call for greater access to mental health services. All these efforts matter. But I sometimes wonder whether we are looking deeply enough at the conditions in which people are expected to live, struggle, raise families and somehow remain mentally well.
And what happens when people lose faith that their circumstances can change, that their institutions will protect them or that anyone with the power to make a difference is listening?
The problem beneath the problem
I do not pretend to have all the answers. Indeed, despite the interviews, the written columns and conversations with policymakers, I sometimes find myself confronting the uncomfortable possibility that we are trying to treat the wounds without adequately examining what keeps inflicting them. Mental health is complex, and no single political or economic explanation can account for every suicide, every experience of depression or every struggle with substance use. But neither should we ignore the social, economic and political environments in which these struggles unfold.
A country cannot endlessly demand endurance from its people while remaining indifferent to the conditions that exhaust them. We cannot speak of resilience without asking what people are being forced to endure. We cannot encourage young people to hope while refusing to confront the realities that make hope increasingly difficult to sustain.
Perhaps this is where my frustration lies. We seem increasingly able to name the mental health problems affecting our people, yet far less willing or able to confront the deeper conditions contributing to their suffering. We can count cases, describe symptoms and recommend interventions, but can we honestly say that we are confronting the full human reality behind the numbers?
Meanwhile, Uganda continues to struggle with the rising cost of living, limited opportunities for many young people, concerns about corruption and accountability and widespread anxieties about the future. These realities deserve serious scrutiny, not because they explain every mental health outcome, but because the psychological consequences of prolonged hardship cannot simply be separated from the circumstances in which people live.
Our suffering rarely commands the sustained international attention given to crises that threaten powerful nations or disrupt strategic interests. The lives of ordinary Ugandans should not need to become geopolitically important before their pain is treated as urgent. Our humanity should be enough.
I keep returning to one difficult question: What if the deterioration of our collective mental health is not only a health-system challenge, but also a warning about the conditions under which our people are being asked to live? If that question makes us uncomfortable, perhaps it is precisely the question we need to confront. Uganda’s people deserve more than instructions to cope.
They deserve conditions that make living with dignity possible, institutions that respond to their needs, opportunities that give young people a reason to believe in tomorrow, and a society in which seeking help does not mean suffering in shame or silence.
Because behind every statistic is a human being. Behind every suicide is a life and a story that cannot be reduced to a number. Behind every struggle with depression or substance use is a person whose circumstances, experiences, and needs deserve to be understood.
And behind the growing concern about our nation’s mental health is a question we can no longer afford to avoid: Are we prepared to confront not only what is happening to our people, but also the conditions that may be contributing to their pain?
The writer is a suicide behavioural scientist and mental health expert