Uganda on track towards achieving universal mental health care

HEALTH

KAMPALA - Uganda is on the right track towards achieving universal mental health care following the passing of the Mental Health Act 2018, according to Hafsa Lukwata, the senior medical officer in charge of mental health division at the Ministry of Health.

During the Uganda National Health Research Symposium held at Hotel Africana in Kampala on Wednesday, Lukwata revealed that the new law that was passed in September last year has facilitated the integration of mental health services to lower health facilities.

"One of the challenges towards the treatment of mental illness has been accessing to health services but now mental health services can now be accessed at all lower health facilities and we have been training people on how to handle and manage mental health people with mental illnesses," he says.

The symposium was held under the theme; Achieving universal coverage for quality mental health care in Uganda.

Uganda has been ranked among the top six countries in Africa with the highest cases of mental disorder- according to the World Health Organization (WHO).

According to the law, mental services at all levels are to be integrated into general health care starting with Village Health Teams.

"The ministry plans integration of mental health treatment and care into the community to reduce dependency on primary health centers. We also provide first-line treatment medicines for at all levels of care and this medicine is very efficacious. General and Regional Hospitals provide more highly skilled professional treatment and other psychosocial interventions," Lukwata says.

He encouraged the community to be part of ending the stigma against persons with mental health illnesses.

"If you see someone who has a mental illness, do not beat or harm the person. This person can be helped by anyone and be taken to the nearest health facility for treatment," Lukwata says.

The ministry has also embarked on training Village Health Teams (VHTs) about mental health including identification, referral and follow up after discharge from a health facility.

Prof. Seggane Musisi from the Department of Psychiatry, School of Medicine at Makerere University called for a rebranding of ways in which mental health is handled.

"If we are to achieve universal coverage, we need to change how we handle mental health. We need to change the words we use so that we don't stigmatise people and we should also sensitise the masses on mental health," Musisi says.

He said the integration of mental health services in general health services will go a long way in ensuring universal access.

"If I go to any health facility, I should be able to get mental health services without being referred to another facility or get tied on ropes because there is no nearest facility to treat me," Musisi says.

He said attention should be paid on mental health as it is with diseases like malaria, dental and eye diseases, among others.

"I have never heard of a mobile mental health camp yet there are very many people grappling with mental health. We shouldn't wait for people to show extreme signs before helping them," Musisi says.

Dr. David Basangwa, the Executive Director of Butabika Hospital noted that fact that Uganda has a good law is a big step towards ensuring quality health services despite the low funding and little research done on mental health in Uganda.

"The old law was hostile to us. I'm glad that the new law is in place, which clearly observes the human rights of the patients," Basangwa says.

Mental Illness is a condition that affects a person's thinking, feeling or mood. Such conditions may affect someone's ability to relate with others and functionality.

In Uganda persons with these disorders are too often subjected to discrimination and stigmatization, which can reduce their willingness to seek care.

"We also need to end stigma and encourage people to seek treatment since some individuals may be unaware of their condition and not seek or know about appropriate treatment. Mental illness can be treated and prevented," Basangwa said.

The current law which repealed the Mental Health Treatment Act 1964 prohibits tying the legs and arms of mental patients to restrict their movement and allows restriction of movement through medical means.

However, physical restriction of the movement of mental patients can only be used when a psychiatrist authorises and for emergency treatment by a senior health worker.

According to the law, it is an offence to use mechanical bodily restraint or bodily restraint and one is liable on conviction to a fine not exceeding sh600,000 or imprisonment not exceeding 15 months or both.