Mental health: The silent pandemic

Don Zane Muwanguzi is the founder of Awesome Mind Speaks, a youth-led and youth-focused non-profit organization focused on mental health advocacy for young people in Uganda. He is passionate about Human Rights advocacy, inclusion, gender equality, and creating awareness on young people's mental health in Uganda.

He spoke to us about the current state of mental health in Uganda.

Thank you for honoring our invitation to speak about the mental health situation in Uganda. First of all, how big is the problem?

Mental health is not a common conversation yet it’s very important. For instance, there’s the inaccessibility to affordable and accurate youth-friendly mental health information and services for young people throughout the country. Uganda is a low-income country with a population of 38 million and unlike previous years, there is steady recognition that mental health is an important public health and development issue. Statistics show that close to 20%, which is about 7 million out of the 34 million people in Uganda, have some degree of mental illness, ranging from anxiety and depression to severe mental health illness. Ugandan mental health services have been characterized as inadequate, with little or no community care and in-patient services able to meet demand. The World Health Organization estimates that 9 out of 10 people with mental illness receive no treatment. The situation is exacerbated by many skilled healthcare workers leaving Uganda to work in high-income countries, reducing the already thin workforce.

For long, mental health has been sidelined to the periphery of diseases by many, and yet the World Health Organisation recognizes mental wellbeing as a core component of health. Ultimately many do not understand the dimensions of mental illness. What are the common forms of mental illness in Uganda?

There are number of mental health illnesses and it’s important to understand that mental illness is not one until diagnosed by a professional and licensed mental health service provider.  Some of the feelings we occasionally have like sadness are not illnesses. However, some of the common mental illnesses especially among adolescents include depression, anxiety disorders; including panic disorder, obsessive-compulsive disorder, phobias, and bipolar disorder is also rife. Others include eating disorders, personality disorders, post-traumatic stress disorder, and psychotic disorders, including schizophrenia. Additionally, suicide is the fourth leading cause of death among 15–19-year-olds.

Thanks for the distinction, how then do we identify someone who needs help?

With Mental health, you might never know someone going through Mental health challenges because very many people respond differently. Being happy might not necessarily mean someone is okay and neither does being sad mean one is not okay. However, we need to pay attention to the people and their behavioural patterns. Consistent and inconsistent moods, feelings could be indicators. Also, if a behaviour lasts for more than 2 weeks and it’s affecting how they think, act and respond to things calls for concern. Furthermore is having normal and honest conversations about mental health so that someone feels the courage to say hey I am not okay.

You mentioned having honest conversations about mental health. And this has probably been one of the main constraints to addressing this issue especially with the stigma that society metes upon mental health patients. I believe Awesome Mind Speaks is probably already doing something around this. How exactly are you letting the masses know that It’s Okay not to be okay?

We use a human-centred and integral approach to reach different young people with mental health information. We design and assess the program with a sample of the targeted beneficiaries to understand their needs in mental health which we embed into our mental health response. In addition, we use creative and socially considerate approaches that engage without breaking their social and cultural values.

Speaking at the Generational Perspective Dialogue 2020

Ultimately multi-faceted integration is the way for any meaningful social intervention. How much headway has Awesome Mind Speaks made with this approach and what’s the reaction to the intervention? Do you see people opening up more about issues mental health?

We see tremendous improvement in the area of mental health due to our intervention. More young people are opening up to conversations on mental health and seeking help. Organizations and institutions too are starting to come on board to do mental health programming and inviting Awesome Mind Speaks to do capacity building and strengthening on mental health. We also involve key players in the country like Ministry of health, CSOs, universities, and policymakers to talk about mental health. Recently, we carried out a one-of-a-kind mental health dialogue in Uganda that reached over 3 million people.

Uganda is one of the countries where, among numerous challenges, the number of mental health practitioners is stretched thin. For instance, we have one psychiatrist attending to over 100,000 people, and just one national referral hospital for mental related issues. With the Covid19 pandemic in context, what have been the biggest challenges in extending mental health services to those that need them?

Awesome Mind Speaks is mainly an advocacy and awareness creation organisation and we do not provide direct mental health services. One of the biggest challenges is Mental health service providers are few and the available ones are very expensive. That means even when we create awareness and people are ready to embrace mental health, those who need therapy and counselling are going to be left hanging. However, we are mobilizing mental health service providers that we shall work with to ensure adequate access to mental health services among young people in Uganda.

Now, the cost of mental illness treatment is still steep for the average Ugandan. As a key stakeholder in this, what exactly should be done especially from government to address the high costs of mental related treatment and ensure more Ugandans access therapy?

 I normally say that first, we as individuals need to normalise mental health conversations. Secondly, the governing bodies should ensure a convenient and support environment on mental health, favourable policies and laws that protect service providers. However as Awesome Mind Speaks, we have come up with a mental health innovation that we shall soon put to market that aims at ensuring increased access to mental health services by linking young people to licensed mental health service provider. This will be key in increasing mental health service providers through the mental health professionals on the app.

 Finally, how can one benefit from the services of Awesome Mind Speaks currently.

We have programs that are running from time to time that many people can take advantage of and also be part. We also have social media platforms where people can follow us and learn more from the different mental health information that we share.

 Thank you Zane!