Op-ed – Where are the undocumented mentally-ill Ugandans?

By Harriet Anena

A few months ago, a friend I will call Ann, confided in another that for the past three months, she had been growing increasingly forgetful. Ann’s friend advised her to use sticky notes. “Write all your tasks for the day on the sticky notes and place them in strategic places – the bathroom, the bedroom, kitchen on your desktop computer, etc.; that way, you will be reminded about the next task,” the friend advised.

Unknown to her, Ann had already been using sticky notes and even bought a diary. Still, she forgot stuff, like that time she forgot about a presentation she was supposed to make at work, forgot to close the windows when she went to bed, and another time left the lights on as she went to work.

The turning point for Ann was when she parked her car at Garden City one day and left her keys in the ignition and windows down. She was horrified when she returned, 20 minutes later, and realised what had happened. In Kampala where it takes seconds for theft to happen, Ann was lucky her car was safe.

She decided to see a doctor after that incident. Surprisingly, the doctor didn’t take her worries seriously. He wondered why a 30-year-old was having memory loss problems. The doctor insisted that Ann could just be having a lot on her plate at work. He advised her to take it easy.

I’m not a doctor so I will not attempt to throw around any medical jargon, but the little I have read and been told is that forgetfulness can be triggered by a number of factors such as depression, stress and anxiety, alcohol, lack of sleep, etc.

While there seems to be growing interest and awareness around mental health recently, the message doesn’t seem to have sunk in as deep as it should. On any typical day, you will meet a mentally-ill person lying on the streets or eating from a garbage dump.

Forgetfulness, especially the long-term cases, is just one example of mental health concerns that many people are battling with, most times, silently.  Mental health is an issue that many shy away from talking about. Some think it’s not a big deal as those who suffer from it portray, others do not have sufficient knowledge about the many forms in which it manifests, while some will simply brush it aside as a disease for the rich (especially when it comes to depression).

In Uganda, cases of mental illness have always been cited as common in northern Uganda, especially in the recent past. In 2008, for instance, research by a team of British and Ugandan psychiatrists showed that northern Uganda led, globally, in cases of post-traumatic stress disorder. That was mainly attributed to the Lord’s Resistance Army war in the region.  In 2014, northern Uganda was said to have the highest cases of suicides, a problem attributed to the huge burden of mental illness in the region.

Just this week, Daily Monitor published a story showing that Butabika National Mental Hospital, has since 2010, registered increasing number of patients with mental illness. While the health workers credit better health seeking behaviour and growing population, as reasons for the increase in the number of mentally ill patients at the hospital, the situation is not as comforting.

The Daily Monitor story, for instance notes that from November to January every year, an average of 22,000 patients check in at Butabika hospital “…for conditions ranging from alcohol and or drug abuse, bipolar disorder, depression, dementia, schizophrenia, epilepsy, bipolar, childhood and mental health and post-traumatic stress disorders”. That number becomes definitely higher if figures from the rest of the country are considered.

While there seems to be growing interest and awareness around mental health recently, the message doesn’t seem to have sunk in as deep as it should. On any typical day, you will meet a mentally-ill person lying on the streets or eating from a garbage dump. You will read about cases of parents disowning, chaining, locking up or abandoning children who have mental health ailments.

While some families may not have the capacity to take care of mentally-ill children or loved ones, the dearth of information about the problem, makes it more difficult for help to come forth. In 2012, for instance, the World Health Organisation reported that 35 per cent of Ugandans have mental disorder of one form or another. The percentage could even be higher if one considers the cases that go unreported or cases where the patients don’t even know they have a mental health problem.

Where are these 35 per cent mentally-ill Ugandans? Who is taking care of them (if at all)?

We should start by paying attention to the people around us, and being understanding of any mentally-ill person. It starts with each of us.

While NGOs like Heart Sounds Uganda are offering peer support to mentally-ill Ugandans, government can boost its intervention in the area by creating further awareness about mental health, dealing with the stigma that surrounds the issue, and breaking down the various forms in which mental illness manifests.

Establishing and encouraging support structures that allow for family members, friends, workmates and health workers to detect and support (rather than ridicule or shun) a person with mental illness, will go a long way, considering the country has only 30 psychiatrists.

A person with mental illness may not present physical symptoms. However, what goes on in their minds can be as debilitating as only a person suffering from it can know. Like Dr David Basangwa, the executive director of Butabika hospital said in the special report by Daily Monitor, “mental illness does not discriminate”.  It therefore doesn’t matter whether someone is “successful” or “happy”.

How about we all start being each other’s keeper as we confront this ailment?

Ms. Anena is ACME’s Online Content Producer.

Twitter: @ahpetite

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Editor’s Note: Do you have strong and informed opinions on current affairs in Uganda and beyond? Send your 800-word opinion to info [at] acme-ug [dot] org and let your views be read.