Stakeholders’ perceptions of the main challenges facing Uganda’s mental health care system: a qualitative analysis

摘要

In Uganda, mental health has gained increased attention in recent years, with several new initiatives to improve services. The mental health system, however, still faces many shortcomings. The aim of this paper was to explore what a range of stakeholders perceive as the main challenges facing Uganda’s mental health system and the primary ways of addressing them. A total of 62 interviews and six focus groups were conducted with stakeholders drawn from national and district levels. Thematic analysis of the data was conducted using a framework analysis approach. The participants identified a number of challenges facing Uganda’s mental health system, which included an outdated mental health legislation; low priority of mental health; absence of a mental health policy; inadequate integration with primary health care; staffing shortages; stigma and discrimination; and neglect of child and adolescent mental health. Various contradictory views between stakeholders, and discrepancies between knowledge, policy and practice were revealed. Recommendations included: revising the mental health legislation; finalizing the mental health policy; training primary health care workers in mental health issues; sensitization in the community; and involvement of traditional healers. There is a need for increased attention towards closing the gap between mental health policy, knowledge and practice in Uganda.