Why Uganda should prioritize mental health

By Mariam Namakula

“She would shed tears… genuine tears of pain, hurt and regret. She would be sweeping the [broken glasses and plates] off the floor and saying ‘maybe this time, it’s for me to [replace them]’,” Joseph Ajal narrates as he recalls the distress of experiencing firsthand the toll mental health took on his wife and entire family.

This is a story Mr Ajal has openly shared in various media platforms, more so after he lost his beloved wife to suicide. He has been instrumental in highlighting mental health issues and its effect on families. For 17 years, the human resource practitioner, who is also a certified professional coach, lived a life he describes as nearly impossible to share at home as his wife went through several mental breakdowns.

Ajal would later find out that his wife was suffering from a mental condition called schizophrenia and it is characterized by violent episodes.

“It was a life of physical pain and trauma. When she would not sleep, I wouldn’t sleep; she would smash plates on walls and throw knives around the house, I was the victim, I was the one suffering broken bones and wounds all over my body as well,” he narrates in a discussion with Centre for Mental Health Services Uganda.

He had to mask his pain from colleagues at work, putting on a tie and a suit and yet underneath, holding onto nail marks dug into his neck the night before because his wife had gone through a violent episode.

Unlike Ajal who has chosen to be open about it, for many Ugandans mental health remains a sensitive topic that most people are not willing to discuss. As a result, interventions are not sufficient because many people battle the condition silently.

Statistics from the World Health Organisation (WHO) indicate that only 30 percent of the 8 billion people were confirmed mentally sick through diagnosis while the rest remain anonymous.

Additionally, a report by the Uganda Counseling Association (2022) revealed that every 35/100 Ugandans may be battling a mental health issue.  In 2017, WHO ranked Uganda among the six African countries with the highest rates of depression disorders, totaling 4.6%, on top of the 2.9% struggling with anxiety.

Ms Diana Nafula, a counselor, notes that it is crucial to take a break for the sake of our mental wellbeing. She adds that with self-care, stress reduction and engaging in activities that promote relaxation, one would be able to revive their energy and also start loving and taking good care of themselves.

Ms Pamela Natasha Bugembe, a mental health advocate and counselor, defines mental break as a period of time when one stops or reduces usual activities to rest, relax or recover from stress. Bugembe notes that taking a mental break would improve one’s well being in terms of mood, performance and preventing burnout.

“Some signs that you may need a mental break are anxiety, insomnia, panic attacks or difficulty in concentrating,” she says, adding that a good time to take a mental break is after a stressful event, a busy season, or a major accomplishment.

She lists proven ways for mental relief as meditating, reading, exercising, spending time in nature or doing something you enjoy.

The path to sustaining healthy mental capability does not come without challenges. As such, Nafula advises that one should try to seek help from friends, relatives and professional therapists.

Unfortunately, mental health remains one of the least resourced areas in Uganda with about 53 psychiatrists expected to treat 14 million people that are suffering from mental health related conditions, which is an uphill task.

The country, therefore, needs to prioritize mental health and increase funding, clinicians, therapists, counselors and other professionals who are in the value chain of providing support to persons with mental challenges. There is also a need to invest in research and provide more support for the patients, including the caregivers who may face as much trauma.

While there is progress, especially in workplaces that are paying more attention to mental health by putting in place counseling services for staff, stigma remains a major challenge. People still need encouragement and sensitization about the importance of seeking counseling services, especially in highly stressful workplaces.

As a solution, Bugembe recommends deliberate effort to publicize information about mental health. With sustained awareness at home and at work places, and encouraging honest conversation about mental health, we can break the stigma around mental health, which would be a significant step in curbing the problem.