At Butabika National Referral Hospital, wards meant for a few hundred patients are now filled far beyond capacity, with some patients sharing space as demand for mental health care surges.
Doctors and nurses move quickly between patients, many of them young, as the country faces a growing mental health crisis.
Juliet Nakku says the number of mental health cases in Uganda has risen sharply, increasing by more than 70 percent over the past four years. Children and adolescents now account for nearly a quarter of those affected. “Those numbers are huge,” she told Parliament’s Public Accounts Committee.
The pressure is evident across the hospital. Built to accommodate 550 patients, Butabika often holds between 1,000 and 1,200—and at times up to 1,400. “Our occupancy rate has gone as high as 230 percent,” Nakku said. “We must either expand capacity or find ways to manage patients at community level.”
Behind the numbers are families struggling to cope, and a health system stretched beyond its limits. Lawmakers say the rise in mental illness among children is particularly worrying. Asuman Basalirwa called for urgent action to understand the causes and support families.
“With a 70 percent increase, we need to understand what is driving this, especially among children,” he said. PAC Vice Chairperson Gorreth Namugga described the situation as alarming, urging experts to guide parents on how to respond.
Nakku pointed to gaps in early detection and care, stressing the need to integrate mental health services into schools and primary healthcare “Schools should provide mental health support—not just for learners, but for teachers as well,” she said.
But resources remain limited. The hospital has only 14 psychiatrists, with each doctor handling far more patients than recommended. Nurses face similar pressure, caring for up to 60 patients at a time. Even as funding for medicines has increased, it is still not enough to meet demand. Meanwhile, overcrowding is putting additional strain on infrastructure.
For many families, access to care remains a challenge, and without stronger investment and community-based support, experts warn the situation could worsen.
