What is escalating depression among the youth and adolescents?

Members of the Parliamentary Forum on Mental Health together with commissioners from the Ministry of Health, education ministry and ministry of gender, labour and social welfare recently concluded their fact finding mission on the state of mental health in Uganda. 

Julius Peter Emigu, the Member of Parliament for Kaberamaido District and a member of the Parliamentary Forum on Mental Health (PFMH), says the exercise was meant to help in collection of factual data that would not only enable them debate from an informed point of view, but also help enrich the existing interventions and policies. 

Family 

While in the eastern region of the country, the delegation discovered that there was an increase in mental illness and a lack of adequate facilities to support the need. 

Dr Moses Mugonyi, the Jinja City health officer, noted that most children are grappling with depression that is a spillover effect from their parents and caregivers. 

“We receive about 20 patients from various stages of mental illness at the regional referral hospital every week. Most of these are a result of depression that has led to chronic substance abuse,” says Dr Mugonyi, adding that the city has treatment and psychosocial support although it is not enough. 

“To supplement our services, we are working with national and regional partners who have been helpful in this effort,” says Dr Mugonyi. 

The district education officer also noted that the increase in school dropouts is linked to untreated depression among the learners. 

“Children escape from their homes because of domestic violence, neglect and abandonment. They end up on the streets where they abuse drugs as a coping mechanism,” he says.

Incest

 In Iganga, the district chairperson pledged to move a motion during council seatings to adopt the ministry of education mental health hour in all schools and make sure the district has a focal person for mental health as provided for by the 2019 Mental Health Act.  

Ideli Bateganya, the district’s assistant chief administrative officer, revealed that the district is facing increasing cases of incest. 

“Many men are molesting their daughters to the extent that it is now becoming the norm. Some of these girls have been brainwashed to think what they are doing is normal. Recently, a mother asked us to intervene after her daughter told her she was giving her father what she (her mother) had failed to. Interventions to rehabilitate such children and protect others from such vices are needed,” Bateganya shared. 

Lack of facilities

The district health officer, Dr Patrick Kitimbo, said the district mental health unit has only two staff to serve the region. 

“We need more human resource to be able to effectively serve the community,” Dr Kitimbo says.

The Iganga Resident District Commissioner Sadala Wandera urged the relevant authorities to organise outreaches in prisons because a good number of inmates are young people that end up in criminality because of mental illnesses. 

Wakiso was identified as the district with the biggest burden of depression among young people because it has the highest number of schools in the country and more than 50 percent of Uganda’s population is in school. The district has so far registered four cases of suicide among learners since January. 

In Butambala District, the area woman Member of Parliament, Aisha Kabanda, who is also the sponsor of the bill said the area is experiencing a strange phenomenon where children are influencing their parents to use drugs. 

“Although the district is predominantly Muslim, there is a worryingly high rate use of alcohol. There are particular areas where residents have been consumed by alcoholism and drug abuse. Most of these are young people in urban centres who call themselves the ghetto youth. We also grow and consume a lot of mairungi and since the pandemic, it is now consumed in homes as a beverage,” Kabanda outlined the scope of the problem.

Domestic violence

Moses Aruho, the Resident City Commissioner for Mbarara City's South Division said he has noticed a growing number of mentally ill young children who have flooded Mbarara City. Ariho blames the rising crisis to family disintegration caused by domestic and gender based violence. 

“In areas such as Kijungu and Kisenyi, you will find many children who have run away from their homes and are now involved in criminal activities such as substance abuse and prostitution. I have received reports of a flesh market right here in the city where about 400 young girls converge every evening to ‘sell themselves’. The few I have been able to talk to say they ran away from their homes to escape physical and emotional abuse,” Aruho says.

Interventions

The most notable intervention in all districts was interpersonal therapy provided by StrongMinds Uganda (SMU). Founded by Sean Mayberry in 2014, the social enterprise is now operating in 10 districts and has trained school staff to conduct eight-week counselling sessions. Mayberry reveals that in 2013, he came across a Johns Hopkins University study that showed remarkable success in treating depression in individuals in Uganda using Group Interpersonal Psychotherapy (IPT-G) facilitated by lay community health workers. 

Immaculate Agedo, the advocacy manager at SMU, says from the interactions they carried in communities, they found out that depression and mental illnesses are as a result of domestic violence, poverty and substance abuse. SMU is also working with the Ministry of Education and Sports (MoES) to implement at least one hour of basic counselling and psychosocial support each week. The ministry also recommends teletherapy to tackle depression among staff and students that will be provided by StrongMinds Uganda through a toll-free service.

Dr Nicholas Thadeus Kamara, the Member of Parliament for Kabale Municipality and a member of PFMH compared mental health to a blind man feeling an elephant, whereby wherever the blind man touches that is the image he has of the elephant. 

“Mental health is a complicated topic. Most of these children’s problems are not medical and should not be solved by medicine. Rather, we as a community need to listen to them and try as much as possible to address the issues that cause their depression. For example, I have noticed that most of the young people affected are those from broken homes. Therefore, if we strengthen the family unit, that will be one less challenge for them,” he says.

Dr Allan Kasozi from the Ministry of Health said there is a burden in schools yet schools are not health provision entities. To solve this challenge, he recommended a linkage between schools and the Ministry of Health. 

“What is being done right now is not enough as seen by the growing substance abuse. We need to encourage conversations in communities to help them understand mental health. The children too need to be encouraged to seek professional help because they are not able to do it on their own,” he says.