Medics say Uganda is sitting on a silent mental health crisis-one fuelled not only by rising cases of depression, drug abuse, and suicide, but by a chronic shortage of funding. Sources told Daily Monitor that while thousands of Ugandans are battling mental illness, government budget allocations to mental health remain alarmingly low, leaving hospitals without drugs, districts without psychiatric units, and families without hope.
Mental health experts now want Uganda to uphold its commitment to the Abuja Declaration of 2001, which recommends a 15 percent allocation in the national budget for health so that mental health can be given a reasonable allocation. Uganda currently allocates about 6 percent of the budget to the health sector.
Ms Sarah Mbabazi, a mental health counsellor, said low budget allocation emerges is one of the biggest challenges to effective management of mental health.
She observed the urgent need to support the mental health and psychosocial needs of people.
‘Poor mental health is not inevitable, and together with adequate support from the government, we can help everyone have better mental health,’ she said.
During this year’s World Mental Health Day, celebrated every October 10, the campaign focused on the urgent need to support the mental health and psychosocial needs of people affected by humanitarian emergencies. At the national level, only a tiny fraction of the health budget goes to psychiatric services, leaving hospitals and health centres with inadequate drugs, limited infrastructure, and an acute shortage of trained mental health workers.
For instance, Butabika National Referral Mental Hospital-the country’s main referral facility for psychiatric cases-remains overcrowded and under-resourced, struggling to cope with the growing number of patients from across the country. In rural areas, the situation is even worse. Several districts lack psychiatric units, forcing patients to travel long distances for treatment. Others go untreated, often ending up in communities without proper care, where stigma and discrimination make matters worse.
Mental health advocates warn that unless the government increases investment in this area, Uganda risks a hidden crisis that undermines productivity, education, and family life. Ms Vivian Olgah Kudda, a clinical psychologist at Minders Wellness and Psychological Centre in Ntinda, Kampala, said the severe impact of low budgets on mental health services in Uganda is concerning. ‘The low budget affects human resources for mental health. With gaps in staffing, only a small portion of Ugandans will access services, and yet the need is substantial and costly,’ she said.
Ms Kudda explained that limited funding also shifts the burden of paying for psychotropic medication to individuals and their families, as government facilities often cannot stock these medicines. While efforts have been made to integrate mental health into general healthcare, Ms Kudda said this requires trained medical staff who can identify, support, and refer patients-a process hindered by meagre resources. Infrastructure and systems for mental health also suffer, with units in many hospitals remaining dilapidated due to low budget allocations.
Last week, Parliament expressed concern over severe overcrowding and limited access to rehabilitation services at Butabika hospital, where the patient population has surpassed capacity by more than 118 percent. The hospital, designed to accommodate 550 patients, is currently housing more than 1,200.
Recently, Dr Juliet Nakku, the executive director of Butabika hospital, attributed the situation to inadequate development budgets, which have stalled infrastructure expansion.
‘The hospital is oversubscribed by 118 percent, which strains all aspects of service delivery,” Dr Nakku said. According to the World Health Organisation (WHO), one in eight people globally; approximately 970 million, lives with a mental disorder. Recent research from The Onward Project on wellbeing and adversity (TOPOWA) reveals alarming trends among young women in Kampala’s slums. The study found that 65 percent of women aged 18 to 24 reported one or more mental health concerns, with 34 percent presenting with anxiety and nearly one in three reporting depression. Also, 46 percent reported having suicidal thoughts, and about 32 percent reported two or more mental health concerns.
Mr David Masaba, the Mbale regional mental health coordinator, revealed that mental health receives only 1 percent of the national health budget, of which 70 percent is allocated to Butabika hospital. ‘The remaining 30 percent of the budget is shared among 13 referral hospitals across the country, and it only caters for procurement of drugs, leaving out crucial activities such as community outreaches, empowering lower health facilities, and school-based programmes,’ Dr Masaba said. He added that mental health management is further constrained by inadequate staffing.
While collaboration with lower health facilities could ease the burden on referral hospitals, most of these facilities lack trained mental health personnel, leaving referrals on the verge of congestion. For example, Mbale hospital, which has a bed capacity of 34, is currently accommodating 40 patients. ‘Regionally, mental health cases are on the rise, mainly due to substance and drug-related issues, especially among the youth,’ he added. According to Ministry of Health statistics, 14 percent of Uganda’s population is affected by mental health conditions, a figure that represents about 33 percent of the global average. Among these, 22.9 percent are youth and adolescents.
Dr Masaba proposed strengthening lower health facilities through community mental health outreaches and regular technical support supervision as a sustainable solution to decongest referral hospitals. He also urged policymakers to advocate for increased funding to improve staffing, medicine supply, and mental health unit expansion. Meanwhile, non-profit organisations are stepping in to plug gaps. JENGA Community Development Outreach, based in Mbale District, has launched training programmes for cultural and religious leaders to improve community-level responses to mental health challenges.
Ms Jacent Nawanga, the team leader for health and wellbeing at JENGA, explained that the initiative was informed by delays in hospital referrals, often caused when patients are kept in churches and mosques under the belief that mental illness is a spiritual problem. ‘Most of these patients are delayed while being prayed for in churches and mosques. When no progress is recorded, they are eventually referred to hospitals, but sometimes too late,’ she said. Mr Steven Chemutai, a mental health expert, said several patients resort to private rehabilitation centres, which charge an average of Shs75, 000 per day, due to the limited space at Butabika hospital.
Ms Kudda said Uganda could see an increased prevalence of mental health conditions, which will strain the healthcare system and negatively impact the economic and social fabric of the country. ‘Productivity will dwindle. With a population of over 45 million, about 70 percent of whom are young people-the most productive yet high-risk age group-reduced productivity will push more individuals below the poverty line,’ Ms Kudda said. According to statistics from Butabika hospital, 24.7 percent of its admissions in 2022 were due to substance use. Out of those, 44 percent were due to alcohol, 25 percent were due to cannabis and 2.5 percent were due to substances like khat.
Butabika hospital
The Auditor General’s report on Butabika National Mental Referral Hospital for the audit year ended December 2024 revealed severe challenges in staffing, overcrowding, and limited rehabilitation capacity at Uganda’s only national mental referral hospital. According to the findings, Butabika hospital was allocated Shs2 billion for essential medicines and health supplies under the National Medical Stores during that financial year.
Ms Angela Nsimbi, a mental health activist and team lead at the Heart2Heart Chat Mental Health Programme, said Uganda still has a long way to go in addressing mental health challenges. She noted that although Butabika National Referral Hospital offers free medication, the supply is often inconsistent. ‘When drugs run out, many patients who cannot afford to buy medicine go without treatment for long periods,’ she said.