The lack of qualified psychiatrists is affecting the proper diagnosis of mental illnesses in Agago district,” states a report by Basic Needs UK in Uganda, an organization that has been providing mental health services, training, and raising awareness in Agago district since 2018. According to their statistics, “at least 2,928 clients have been treated for mental illness.”
Florence Adong, the program’s Manager at Basic Needs UK in Uganda, delves into the breakdown of these cases. She reveals, “Out of the 2,928 patients, 1,623 clients are epileptics, followed by those suffering from depression at 1,066 cases, psychosis 115 and other, 124 cases.
Furthermore, Adong identifies the sub-counties with the highest prevalence, stating that “Lokole has 626 patients, Greater Paimol has 594 clients, Adilang Sub County has 510 patients, Greater Wol has 435 clients, Kalongo Town Council has 418 patients, and Greater Lirapalwo has 346 clients.”
Adong attributes this prevalence of mental illness to a variety of factors, including “post-war trauma, poverty, excessive consumption of alcohol, gender-based violence, and cattle rustling by the Karamojong.”
“We don’t have any psychiatrists,” laments John Paul Okello, the Agago District Senior Health Educator. He adds that the district only has general medical practitioners whose services are primarily limited to “counseling, health education, and other general medical services
.” Okello is concerned about the presence of undiagnosed cases of mental health problems in the community, including among those who have already sought help at health facilities.
According to him, diagnosing mental health problems is a time-consuming process that necessitates talking sessions with the client and even family members. Unfortunately, some staff lack the necessary skills, patience, and time to conduct these extensive assessments.
An assessment conducted by the WHO in 2010 paints a bleak picture of Uganda’s mental health care system, revealing that the country only has 53 psychiatrists, with each attending to a million people.
Most of these psychiatrists are concentrated in urban areas and are typically employed as university lecturers and researchers. The scarcity of psychiatrists in community health units exacerbates the issue.
Okello also notes that the low uptake of medicine for managing mental illness further highlights the problem of improper diagnosis.
Jimmy Ocaka, a psychiatrist working with Basic Needs UK in Uganda, underscores that many people with mental illness resort to conventional medical help as a last option, after seeking divine intervention or turning to traditional healers or witch doctors.
To address this issue, Ocaka mentions that they conduct a Community mental health clinic each month in government health units to inform the community about the signs and symptoms of mental illnesses. He calls upon the community to support each other in improving their health-seeking behaviors, as some individuals may be unaware of their mental health condition, while others may be in denial.
Ocaka outlines some common signs and symptoms of mental illness, including “social isolation, suicidal ideation, stripping naked, paranoia, hallucinations, and the commonest being depression, which involves losing interest in activities that were enjoyed in the past and loss of appetite and insomnia among others.”
A report by the Ministry of Health and the Uganda Counseling Association in May 2022 reveals that by 2019, “14 million out of 43 million Ugandans had been diagnosed with mental illnesses.
Experts in the field of mental health believe that this number may have increased since 2019, due to societal stigma that discourages many from seeking medical help for mental health issues and the taboos associated with accessing mental health services.