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In May 2021, the Atlas Alliance partner Mental Health Uganda (MHU), launched the country`s first national phone service providing free counselling, guidance, and information on mental health issues.
The helpline is a low-threshold alternative to anyone who needs someone to talk to. The main target groups for the project are young people between 15 and 35 years of age. Callers are allowed to speak to a person who can provide advice and guidance on mental health and who, if necessary, refer them to the nearest helpline where they can receive further follow-up.
As in many other countries, people associated with mental health problems face great prejudice and social stigma in Uganda. At the same time, it is normal to have mental health problems in one or several periods of life. MHUs interactions with people through meetings and campaigns prior to the opening of the helpline showed that people in general do not have much knowledge about mental health. The media still use language that dehumanizes people with mental health challenges.
Support for people with mental health challenges in Uganda is very limited. Around 75% of Uganda’s 45 million inhabitants live in rural areas where there are few mental health services available. The COVID-19 situation has put further pressure on an a grossly abandoned sector and has triggered many relapses among people that would otherwise have stabile conditions. It has also triggered new cases. The reduced access to health facilities and medical treatment have complicated the situation for many people. In the face of a heavily deprioritized sector with few available recourses to keep up with the increasing demand in the population, the helpline became an important contribution to the country’s mental health services.
Covid 19 is changing the whole perception around mental health, not only in Uganda, but worldwide. MHU has been one of the few players in the field at a time when the demand and attention towards a previously under-communicated issue has drastically increased. The Ministry of Health (MoH) express concern about the expected increase in demand for mental health services, and MHUs activity (faces major public expectations and) has achieved broad reception in the population.
Immediately after the helpline opened, the popular interest was overwhelming. MHU recorded around 800 calls every day. By the end of August, they had received over 3,300 calls. The most common conditions or problems presented by callers relate to excessive fears and worries, severe stress due to loss of jobs and losses in business, grief from broken or lost relationships, stigma and feelings of rejection, addictions, anger management issues, sleeplessness, suicidal thoughts, among others. For many, anxiety and stress related to covid-19 has become a heavy burden.
MHUs restructuring and adaptation to the change of circumstances
The adaptability of the service was tested when the lock-down happened during the second wave of COVID-19 in June 2021, just months after launching. Due to the flexibility in the service and their ability to quickly adapt to the changes in circumstances, MHUs counselors have ensured continued counseling services by transferring the services to their homes. Their counselors have received positive feedback from MoHs quality checks through anonymous callers.
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The project has changed life situations for many people and brought attention to the importance of receiving qualified support to cope in difficult situations and detecting mental health problems early to prevent long-term complications.
The project will also train so-called peers – people who have experienced mental health challenges themselves – and enable them to establish local self-help groups in the districts. In this way, the project will continue to support people in Uganda to improve mental health.
Ensuring sustainability beyond the project period
Playing a coordinating role in the mental health sector coalition of actors, MHU has become a go-to partner for the civil society and health authorities, and MoH have suggested MHU to start thinking about a long-term perspective beyond the five-year support period. Their cooperation and mutual exchanges on information and expertise provides MHU strong hope in terms of the sustainability of the interventions.
MoH has trained MHUs agents on COVID-19 related concerns voiced by the callers and trained 300 community mental health volunteers, which is a step in the right direction in the spirit of delivering community mental health care. MHU addresses the need for coordination in the sector and for linking up activities with community structures to become more than a quick fix for the psychosocial needs related to Covid-19. MHU will continue to engage MoH to operationalize such structures, as this will be important for the sector in the coming years.