‘The anxious rich, the depressed poor’
While the report shows Ugandans suffer more from depression than anxiety, Tugumisirize says it’s common for patients to suffer from both depression and anxiety at the same time.
People from the post war districts of northern Uganda are increasingly reporting with post-traumatic stress disorders and studies done in country show that up to 35% of Ugandans in those areas are suicidal.
But Tugumisirize says the uncertain and tough economic situation prevailing in the country is putting many people at risk of anxiety. He said some of the few rich people and the middle class could be living in constant fear of losing their sources of income and property. Some have many economic dependents and are under constant pressure to pay bills. Some have loans and, in order to service them, can no longer consume what they used to.
“As a result you could see some of them start failing to sleep at night, they will soon resort to alcohol and any other case of addiction will set in,” says Tugumisirize.
Although depression can affect people of all ages especially if one has a history of traumatic experience, family history of any mental disorder and painful physical illness, the elderly are at the most risk. It also affects more women than men. But many young people are suffering from depression, according to Mary Butamanya, the President of Uganda Professional Counselors Association. Without giving numbers, she told The Independent in an earlier interview that they are increasingly receiving young people with problems related to stress and hopelessness.
“Because the majority of the youths can’t find jobs, they have resorted to betting and other businesses of chances. When they clear bills for this month, they start to gamble on how they can clear the next bill. In the end they get mental problems”, she says.
Butamanya points out that those not trained well enough to face the realities of the world and failure to get what one wants end up living in regret which eventually drives them into early depression.
Prof. Emilio Ovuga who is an expert in psychiatry and mental health says a lack of basic needs such as ability to put food on the table, afford clothes and shelter, and have a say in the home and community can lead to feelings of sadness and hopelessness. He says humans need to feel free, secure, respected and not harassed and in need of justice.
“It’s understandable that mental illness is increasing,” he says, “Many Ugandans can only afford second hand products like clothes and vehicles. Though health care is free, health facilities work at less than a third of the expected quality. Crime rates are high and the rights of ordinary Ugandans are trampled upon without recourse to effective justice.”
He says parents; especially in the rural countryside, are overwhelmed by their experiences of powerlessness and helplessness and therefore resort to heavy consumption of alcohol that gives rise to domestic violence.
But even as cases of mental illness are going up, Uganda lacks health facilities and personnel to tackle the problem. Apart from the 13 mental health clinics at the regional hospitals which were recently established, the Butabika Mental Health and Training Hospital has been the only national referral hospital for the mentally ill since the 1960s.
According to the hospital Executive Director, Dr. David Basangwa, the hospital has an overwhelming number of 750 patients admitted at any one time.
In an earlier interview, Basagwa told the Independent that while the number of patients is increasing, funding does not increase at the same rate and most of the time they find themselves getting such challenges as drug stock outs, limited staff, and overcrowding.
In fact less than 1% of health spending is dedicated to mental health and this Financial Year if we go by the Budget Framework paper; money that goes to Butabika is set to reduce to Shs10.88billion from Shs11.04billion last year.
Faced with this reality, experts like Prof. Ovuga need to be protected from succumbing to depression by improving the economy and reducing cost of living. He says, although medical care in facilities like Butabika is important for treating the biological component of the disorders, other forms of therapy like counseling and having a good social life are very important for full recovery.
He says, because of the way mental disorders manifest themselves; they are largely neglected and not treated with the urgency they deserve even as depression is the most dilapidating form of mental illness that affects humanity.
For instance experts like Tugumisirize point to a need to invest in awareness for he says the first step into treatment is to make people aware that what they are suffering from is a medical condition.
“If people have this problem and they accept that they have it, then it means addressing it will be simple but many in Uganda never even get to know what they are suffering from.”
What’s happening in Uganda may not be very different from other developing countries where it is estimated that 75% of the people affected receive no care at all. Globally it’s estimated that only 30% of people affected by mental disorders get help.
Source: World Health Organisation.