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Written by Godfrey Kagaayi
In late April 2022, I had the privilege of co-chairing the WHO Informal Consultation with People Living with NCDs (PLWNCDs) and Mental Health Conditions (MHCs) in the African Region. This gathering provided a platform for diverse perspectives, emphasizing the crucial voices of those with lived experiences. It illuminated the unique challenges faced in mental health across the region, offering insights into both the regional and local contexts, along with practical considerations for engaging PLWNCDs and MHCs inclusively.
My journey with Twogere, a not-for-profit NGO dedicated to enhancing services for young people affected by mental health conditions in Uganda, has made me acutely aware of the mental health challenges prevalent in my country and the broader African Region. Shockingly, in Uganda alone, an estimated 35% of the population suffers from mental illness, with only 1% of the healthcare budget allocated to mental health care, leaving community mental health services entirely unaddressed. Traditional beliefs attributing mental illness to spirits and witchcraft persist in Uganda, often leading individuals to seek the services of traditional healers. Astonishingly, approximately 80% of individuals in Uganda's mental hospital had previously consulted traditional healers, resulting in practices such as chaining or tying individuals during supposed spirit warding rituals.
The COVID-19 pandemic has further exacerbated the existing mental health service gaps. The few available mental health care services were repurposed into COVID-19 isolation centers, leaving the mental health impact of the pandemic, including social isolation, separation from loved ones, and financial insecurity, to potentially have long-lasting effects on the mental well-being of Ugandans.
A glaring issue is the insufficient commitment by African governments to mental health, treating it as a standalone matter rather than integrating it into mainstream healthcare. Stigma and discrimination against individuals with MHCs continue to act as formidable barriers to accessing mental healthcare, perpetuating the suffering of many in silence.
The consultation underscored the critical absence of community services, emphasizing the need for community-based initiatives. Establishing safe spaces where people can openly discuss the challenges affecting their livelihoods is crucial. It became evident that addressing mental health challenges in Uganda and the wider Africa Region requires a human rights-based approach, rooted in holistic strategies and shaped by the lived experiences of those marginalized.
Meaningful involvement of individuals with lived experiences emerged as a pivotal solution. Engaging them continuously in policy formulation, research, and project design is imperative. As a region, we must urge organizations and governments to embrace this approach, recognizing the invaluable resource that lived experience brings to the table.
The informal consultation was a unique opportunity for connection, sharing, learning, and reflection among lived experience leaders from across the continent. It underscored the urgency of improving mental health needs for all, emphasizing that true progress lies in collective efforts, inclusive policies, and the empowerment of those with lived experiences.
Godfrey Kagaayi is a Global Mental Health Leader. Founder of Twogere, a youth-led NGO working to improve services for young people affected by mental health conditions in Uganda. He is the Principal Coordinator of the Movement for Global Mental Health (MGMH), a coalition of individuals and institutions committed to collective actions that aim to close the treatment gap for people living with mental conditions worldwide. Godfrey's expertise is in Organizational Development and Leadership, Monitoring and Evaluation, and Strengthening Mental Health Systems and Structures in low resource settings
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