Kampala, Uganda | URN | Psychiatrists from across the country gathered in Kampala Wednesday to celebrate a milestone that has taken Uganda decades to achieve; the country now has 100 psychiatrists actively in service.
Dr Emmanuel Kiiza Mwesiga, President of the Uganda Association of Psychiatrists, says Uganda operated for years with barely 50 psychiatrists. Reaching 100 now puts the country among the few in Africa with such a number of specialists, even as the entire continent has only about 2,500 psychiatrists.
However, despite doubling the number of psychiatrists, Uganda remains far below the level required to provide adequate mental health services.
The World Health Organisation recommends a ratio of one psychiatrist for every 10,000 people. With Uganda’s population estimated at 46 million, the country currently has roughly one psychiatrist for every 460,000 people.
Mental health specialists attending the meeting acknowledged that, for many Ugandans, accessing a trained psychiatrist remains a matter of chance.
Ministry of Health statistics show that only seven of the country’s regional referral hospitals have a psychiatrist. Fourteen psychiatrists are employed at Butabika National Mental Hospital, while two work at Mulago National Referral Hospital. This means that of the 100 psychiatrists now being celebrated, only about a quarter are employed in facilities providing direct clinical care.
Dr Juliet Nakku, Executive Director of Butabika National Mental Hospital, says the shortage calls for innovative approaches, including equipping all health workers, regardless of their cadre, with basic mental health skills. She says this training should begin as early as the community level, including among Community Health Extension Workers, or CHEWs.
According to Nakku, a psychiatrist stationed at a regional referral hospital should be able to oversee mental health services across the entire region. This would require psychiatrists to understand the mental health conditions most common in their areas, the interventions available, and the factors contributing to those conditions, so they can effectively guide health workers in lower-level facilities.
But the shortage is even more pronounced at regional referral hospitals. Only seven of the 17 regional referral hospitals have a psychiatrist, despite the high burden of mental illness and the need for specialised care.
When these concerns were put to Dr Hafisa Lukwata, the Assistant Commissioner in charge of Mental Health and Control of Substance Use at the Ministry of Health, she said the government plans to recruit about 50 psychiatrists as a starting point.
Lukwata says the new public service structure provides for at least three psychiatrists at each of Uganda’s 17 regional referral hospitals. However, she says implementation has been constrained by challenges with the wage bill. She adds that Uganda also needs more psychologists, occupational therapists and counsellors, who are similarly in short supply.
The need is underscored by findings from the 2024 National Census, which showed that 12 per cent of Ugandans were living with some form of mental illness. Another 20 per cent reported experiencing distress, a condition experts warn could deteriorate into mental illness if left unaddressed.
Lukwata says the figures demonstrate the urgent need to train more psychiatrists. She notes that even among the 100 currently available specialists, a significant number work in academia, private practice or policy, meaning they are not directly involved in treating patients.
For Mwesiga, however, attracting more doctors into psychiatry remains a challenge because the career can be both demanding and costly.
He says after completing the Bachelor of Medicine course, doctors pursuing psychiatry undergo at least three years of specialised training. They are also expected to gain extensive clinical experience and keep up with changes in the field, including the growing number of subspecialties.
Mwesiga adds that many of the earliest psychiatrists in Uganda benefited from training grants, but such opportunities are becoming increasingly difficult to secure.
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