Original Research

Mental illness in Bwindi, Uganda: Understanding stakeholder perceptions of benefits and barriers to developing a community-based mental health programme

Kristen L. Sessions, Lydia Wheeler, Arya Shah, Deenah Farrell, Edwin Agaba, Yusufu Kuule, Stephen P. Merry
African Journal of Primary Health Care & Family Medicine | Vol 9, No 1 | a1462 | DOI: https://doi.org/10.4102/phcfm.v9i1.1462 | © 2017 Kristen L. Sessions, Lydia Wheeler, Arya Shah, Deenah Farrell, Edwin Agaba, Yusufu Kuule, Stephen P. Merry | This work is licensed under CC Attribution 4.0
Submitted: 02 April 2017 | Published: 30 November 2017

About the author(s)

Kristen L. Sessions, Mayo Clinic School of Medicine, Rochester, United States
Lydia Wheeler, Mayo Clinic School of Medicine, Rochester, United States
Arya Shah, Mayo Clinic School of Medicine, Rochester, United States
Deenah Farrell, Mayo Clinic School of Medicine, Rochester, United States
Edwin Agaba, Bwindi Community Hospital, Kanungu, Uganda
Yusufu Kuule, Bwindi Community Hospital, Kanungu, Uganda
Stephen P. Merry, Department of Family Medicine, Mayo Clinic, Rochester, United States


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Abstract

Background: Mental illness has been increasingly recognised as a source of morbidity in low- and middle-income countries and significant treatment gaps exist worldwide. Studies have demonstrated the effectiveness of task sharing through community-based treatment models for addressing international mental health issues.
Aim: This paper aims to evaluate the perceptions of a wide range of mental health stakeholders in a Ugandan community regarding the benefits and barriers to developing a community-based mental health programme.
Setting: Bwindi Community Hospital (BCH) in south-west Uganda provides services through a team of community health workers to people in the Kanungu District.
Methods: Thematic analysis of 13 semi-structured interviews and 6 focus group discussions involving 54 community members and 13 mental health stakeholders within the BCH catchment area.
Results: Stakeholders perceived benefits to a community-based compared to a hospital-based programme, including improved patient care, lower costs to patients and improved community understanding of mental illness. They also cited barriers including cost, insufficient workforce and a lack of community readiness.Conclusions: Stakeholders express interest in developing community-based mental health programmes, as they feel that it will address mental health needs in the community and improve community awareness of mental illness. However, they also report that cost is a significant barrier to programme development that will have to be addressed prior to being able to successfully establish such programming. Additionally, many community members expressed unique sociocultural beliefs regarding the nature of mental illness and those suffering from a psychiatric disease.

Keywords

mental health; community mental health; psychiatry; primary care

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