The problem of mental illness in Uganda needs to be tackled head on, but with the sensitivity it demands and deserves. The west embraced de-institutionalization of mental patients as the medical model of disability came under attack. Out was the medical model, in was the social model of dealing with mental illness.
The best case study which is often cited as the best model is Sweden where services for those suffering from mental illness have been integrated which is why there are hardly an individuals with mental illness who are homeless which is more or less the norm in the USA: those homeless black brothers you see on the mean streets of USA cities are most likely to be veterans of various American wars. USA abandons them the moment their contribution is done. Imagine that. Individuals with serious mental problems due to the trauma suffered in war being abandoned. And African-American brothers top the list.
Back to Uganda where I suspect those in need of mental treatment are underestimated or fear seeking help due to the stigma attached to mental illness.It may take prominent women and men coming forward to share their personal experiences with mental illness like it took the late Mr Philip Bongoley Lutaaya (RIP) to confront HIV/AIDS. The idea of having famous Ugandans embrace the cause of mental illness is great. Let the media take the lead.
In Uganda, I assume the medical model is still dominant, which needs to change towards the social model. But things should be done without ‘abandoning’ individuals with mental illness as is the case in the USA. They have been abandoned by psychiatrists who left them to PhD holders in clinical psychology. Then the state abandoned them to by closing mental institutions without doing what Sweden did: integrating service delivery which is critical under the social/community model.
Now given Uganda’s traumatic history, what is the state of mental illness in the country?
QN: does Uganda give priority to individuals with mental illness in terms of allocating them the limited social housing-if left?
For Uganda, the language ought to change from calling them ‘mad’ to people suffering from mental illness. Language matters. So let us media friends in UAH take notice and do the needful: they can help change perceptions about mental illness in Uganda. NO MORE “MAD” but mental illness. Is that asking too much from the editors? The media is supposed to be an agent of change and it can change attitudes about mental illness.
UK is way behind compared to other developed countries in dealing with mental health. The problem now is that the pendulum has swang too much towards the social model that you have individuals with mental illness who are not able to take their proper medication because there is no one to remind them or help them take it. The best place is Sweden where integration has delivered effective services. The other day I met chap from Egypt who needed help and was was in his hospital attire and was trying to tell me that he was on his way to Cairo. The fellow needed help to take his medication. But since he is not a threat to anyone or himself, he is let loose on the street. that is cruel.
I am actually surprised that in the UK, the medical model is still supreme. It was in Europe where Foucault did a lot more to expose the power imbalance in metal institutions. Actually the UK has some of the leading scholars in disability studies like Dr Oliver who have written great stuff. How can it be so behind?
Yes, Sweden is the best in the world in mental health services! Why? It has integrated services. Why is that important? Because individuals with mental illness get the housing they need within their community and the medical support to go along. They also enjoy subsidized services. Sweden has embraced the social model and put its money there.
In the USA, psychiatrists ‘abandoned’ mental patients-it is called the abandonment thesis and is controversial. Basically, the claim is that psychiatrists gave up on their most vulnerable patients once de-institutionalization took place and mental hospitals hut down. It created space for clinical psychologists and social workers to move in.
In Uganda the need is huge because of the historic trauma the country has witnessed. Many individuals need help but they cannot access services. Ugandans prefer escapism that it is ‘mayembe/voodo/juju’/misambwa’
BTW, historical trauma is generational and the sooner Ugandans dealt with it the better.