Caring for the mentally ill

Focused on peer support yields positive results

| MICHELLE M. SCHWAB | In many regions of Africa, traditional healers have treated all illnesses, physical and mental, for centuries. As the prevalence of mental illness continues to rise in Uganda, western influence impacts how those with a mental illness can access mental healthcare in developing countries.

In low- and medium-income countries like Uganda where disease, ignorance, and poverty are common, a demand for steadfast mental healthcare can seem a luxury. That is according to the American Psychological Association (APA). The World Health Organisation (WHO) estimates that in such regions, “between 76% and 85% of people with mental disorders receive no treatment for their disorder.” Mental healthcare is just as important as any other form of healthcare, yet it is consistently the most neglected worldwide. In the absence of mental healthcare, those who have a mental illness are less likely to prosper. This often can trap them in a cycle of poverty.

Cultural, financial, geographical and social components influence the accessibility of mental healthcare within a country or region. This leaves many with a mental illness at the mercy of what is accessible and acceptable within their communities.

In developing countries, it is common for people to seek help from traditional healers instead of evidence-based styles of medicine that are popular in the west. Many instances of mental health episodes go untreated altogether due to the stigma surrounding mental healthcare. In many different cultures, seeking help would reflect poorly on those afflicted and their family. Many believe it would affect status and reputation.

Mental health in Uganda

The effects of mental illness have been proven to reach far beyond the individual. For instance, research shows that children of depressed parents are more likely to have poor mental health. To support the fight for the prioritisation of mental healthcare in Uganda, organisations like Mental Health Uganda, Gulu have formed.

A non-profit and community-based organisation, Mental Health Uganda describes itself as the “Gulu branch of national service user organisation, focused on peer support, awareness, sustainable livelihoods and advocacy.”

The mission of the organisation is a huge help in bringing Western-influenced ideals to regions like Uganda. Staff members train through the Sheffield Gulu Mental Health Partnership to assist community members in need.

A major way the organisation does this is through peer support groups. The intention is to offer psychosocial support, foster adherence to treatment plans, and help reintegrate into the community. The organisation has also launched various income-generating activities for economic empowerment such as candle making, liquid soap production, tree planting, a local savings scheme that provides short-term loans for community members and the “Pass a Goat” scheme.

The Pass the Goat scheme provides community members with a goat to create a sustainable source of income. Mental Health Uganda, Gulu additionally aspires to create a “model mental health house” in the future to be used as a community center.

Groups like Mental Health Uganda, Gulu can help to catalyze a shift from preconceived stereotypes of mental illness and mental health treatments towards acceptance and create an environment where help is accessible to all regardless of cultural, geographical, financial and social restrictions.

Western Influence

As mental healthcare became more highly advocated in the west, developing countries began to join the mission. Western influence on mental healthcare in Uganda has had many positive effects, such as affecting policy change. Many positive reforms have been included in Uganda’s mental health policy over the years. The policy includes integrating mental health services into Primary Health Care (PHC) while also including decentralisation. While previously only about 1% of government funding went towards mental healthcare, the expenditure on mental health has risen more than 4% within the last decade.

The inclusion of western evidence-based healthcare in Uganda has also yielded positive results. StrongMinds is an organisation offering group interpersonal psychotherapy that has served nearly 90,000 women with depression in Uganda and Zambia.

After treatment, over 80% of the women are depression-free. These results last at least 6 months post-treatment, which is the accepted indication of remission. Positive mental health outcomes affect family and community members. Around 13% of women reported an increase in food security, 16% reported increased work attendance and 30% reported their children having fewer absences from school.

A growing public health concern, major psychiatric disorders account for roughly 14% of all global illnesses. Evidence-based mental health treatments often have great success in treating such disorders. The APA has conducted various studies that point to psychotherapies as extremely successful but also extremely underutilised.

Psychotropic medications can also greatly improve the quality of life for those living with psychiatric disorders. In a survey conducted by the APA, 99% of psychologists who participated “believed that psychotropic drugs can play a positive role in treating mental health disorders.” With the help of advocacy organisations and the spread of evidence-based mental health treatments and ideologies popular in the west, Uganda is well on its way to mental healthcare reform.

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Source: Borgen