Uganda:14% increase in patients seeking mental health services - govt

There has been a 14 percent increase in the number of patients seeking mental health services in outpatient departments in facilities across the country, a new report shows.

This information is contained in the Annual Health Sector Performance report for 2022/2023 financial year, released on Wednesday, a day after another study in four districts from four regions found high prevalence of mental disorders.

“An increase of 14 percent is observed in the number of outpatient attendances due to mental health conditions in 2022/2023 financial year, [from 455,153 in 2021/2022 financial year to 520,614 financial year],” the report read.

“Epilepsy remains the most common mental health condition constituting 50.7 percent of attendances followed by bipolar disorder at 9.7 percent and unipolar depressive disorders at 8.6 percent,” the report further read.

Unipolar depression is a term used interchangeably with major depressive disorder. It is characterised by continuous feelings of sadness, worthlessness, lack of interest in activities you used to enjoy, low mood as well as suicidal ideation. The condition, according to mental health experts, can be hereditary and it is also linked to a history of childhood abuse, including physical, sexual, and mental abuse, having relationship issues, being divorced, and a history of substance abuse.

Bipolar disorder on the other hand, the World Health Organisation (WHO) states, is characterised by experience of alternating depressive episodes with periods of manic symptoms.

“During a depressive episode, the person experiences depressed mood (feeling sad, irritable, empty) or a loss of pleasure or interest in activities, for most of the day, nearly every day,” the WHO explained.

Back to the report, the number of attendances due to unipolar depressive order significantly increased by 144 percent from 18,378 in FY2021/2022 to 44,824 in FY2022/2023.

“Anxiety disorder due to gender based violence also increased by 47.4 percent. Almost all regions reported an increase in Outpatient Department (OPD) attendances due to epilepsy. West Nile regions still has the highest number of OPD attendances due to epilepsy followed by south, north, and central regions,” the report said.

According to the report, also the number of people who went to health facilities because of internet addiction, more than doubled, from 971 in FY2021/2022 to 2,097 in FY2022/2023.

Internet addiction, scientists define, is when a person has a compulsive need to spend more of their time on the Internet, to the detriment of their relationships, work or health.

Cases of intellectual disability –a term used when there are limits to a person’s ability to learn at an expected level and function in daily life, more than tripled from 805 in FY2021/2022 to 3,776 in the FY2022/2023.

These figures are coming amid reports from Butabika Hospital and Health ministry that mental health units are overwhelmed. The Ministry has also opened up mental health units in 13 regional referral hospitals, meaning more people are accessing care, in a country where some studies and official records put prevalence of mental disorders in the population at between 18 percent to 35 percent.

Dr Raymond Odokonyero, a psychiatrist and lecturer at Makerere University College of Health Sciences, said the report that 35 percent of Ugandans have mental health problems is an underestimation.

“In the morning you may wake up when you are in the green zone, that is before your loan shark calls you at 1pm and now, whenever your phone rings, your heart starts racing and by evening you are completely well seated in the red zone. It is not fixed position that you are in the red or green zone,” he said.

Dr Diana Atwine, the permanent secretary of the Health ministry, said : “The Covid-19 pandemic made it so evident that there is no health without mental health...Stigma and discrimination experienced by people with mental illnesses not only affect that person physically and psychologically, but it also affects their educational opportunities, current and future earning and job prospects, and also affects their families and loved ones.”

Top mental health conditions in 2022/23

Condition Number Percentage

Epilepsy 263,843 50.7%

Bipolar disorder 50,657 9.7%

Unipolar depressive disorder 44,824 8.6%

Anxiety disorders 40,764 7.8%

Other adult mental health conditions 27,744 5.3%

Schizophrenia 26,471 5.1

Post-traumatic stress disorder 13,293 2.6%

Anxiety disorder due to GBV 11,078 2.1%

Alcohol use disorder 11,038 2.1%

HIV-related psychosis 9,150 1.8%

Substance (Drug) use disorder 7,096 1.4%

Intellectual disability 3,776 0.7%

Other form of dementia 3,355 0.6%

Internet addiction 2,097 0.4%

Dementia due to stroke (diabetes, hypertension) 1,325 0.3%

Autism spectrum disorders 1,110 0.2%

Delirium 1,012 0.2%

Alcohol-related dementia 980 0.2%

Alzheimer’s disease 589 0.1%

HIV-related dementia 412 0.1%

Total 520,614 100%