The disturbing case of wandering mentally-ill persons in urban areas

Mahatma Gandhi once said that the measure of any society can be found in how it treats its most vulnerable members. These, among others, may include the old, the sick, those incarcerated in prison, or the handicapped and disabled.

This would include all the voiceless, marginalised and unempowered. And if we are to adjudge Uganda basing on the above scale specifically with its treatment and rehabilitation of the mentally ill, we would surely conclude that the same paints a bad picture on the country’s civilisation standings.

Without revisiting the widely published and astonishing statistics relating to Uganda’s mental health situation, there have been so many other indicators upon which the Ugandan government and relevant stakeholders ought to have acted swiftly to mitigate this escalating situation.

One of which is the visibly high numbers of presumably mentally ill persons wandering the streets of cities and towns countrywide. Uganda’s primary legislation on mental health i.e. 

The Mental Health Act of 2018 defines mental illness to mean the diagnosis of a mental health condition in terms of accepted diagnosis in a criteria made by a mental health practitioner or medical practitioner authorised to make such diagnosis.

And refers to a patient to mean; a person who receives treatment and care for mental illness. In other words, as courts of law have established that for one to be deemed mentally ill and deservingly of being a mental health patient, he or she should be afflicted by a total or partial defect of reason or a perturbation thereof to such a degree that he/she is incapable of managing himself, herself or their state of affairs.

One wouldn’t need extensive research to establish that many of these presumably mentally ill individuals on the streets are incapable of managing themselves basing on their behaviour or persona/character even before the specific mental health condition is diagnosed.

This article focuses on this specific group. Those who according to our Primary Act referred to above prima facie require treatment and care from a mental health unit but are not capable or are unwilling to receive treatment but who may upon written request be received in a mental health unit as an involuntary patient for treatment and care.

The 1995 Constitution of Uganda as Amended provides, protects and upholds a number of human rights and freedoms  which are most relevant to our current discussion include: Equality and freedom from discrimination-since the mentally ill deserve as much as other Ugandans; protection of the right to life-which expands to right of meaningful livelihood of all citizens; protection of personal liberty-where persons can be deprived of their personal liberty if they are reasonably suspected  to be of unsound mind and the same is done for purposes of treatment of that person or community protection; respect for human dignity and protection from inhuman treatment-which would be undermined if the mentally ill on the streets aren’t exposed to emergency treatment. And most importantly, the rights of persons with disabilities-where persons with disabilities have a right to respect and human dignity and that the State and society shall (should) take appropriate measures to ensure that they realise their full mental and physical potential.

And with the ever-increasing numbers of cases among Ugandans relating to conditions like depression, bipolar, schizophrenia, anxiety disorders, various alcohol and substance addictive behaviour, this mounts more pressure on government and the other relevant stakeholder to act fast and swiftly and implement the various already existing national legislations and policies.

For example, facilities like the Butabika National Referral Mental Hospital, which already exist and would have led the way in clinical research and implementation are either underfunded, understaffed, overcrowded, or in a poor infrastructural state and as such rendered highly ineffective and efficient in as far as combating the problem at hand is concerned. And we can all agree that there has never been a single account of a public epidemic being solely successfully addressed by the expensive private sector, which in our case would refer to the exclusive private rehabilitation centres (Rehabs).

So until something is a done by way of wide scale/massive progressive involuntary treatment for mental health patients as provided for by the law and Uganda’s psychiatric system takes a huge leap forward as is the case in Sweden and Japan, all will remain the same with the mentally ill, specifically the homeless ones on the street being both the most endangered vulnerable victims of street begging, hunger, disease or violent crimes like rape, harassment, exploitation and as perpetrators of crimes like affray, assault, property damage, defilement, theft, among others.

Collins Kizito, 
[email protected]