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Uganda: Address mental health in Health Bill – psychiatrists


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Psychiatrists want the Public Health (Amendment) Bill to provide for treatment of cases of mental health.

The Executive Director of Butabika National Referral Hospital, Dr Juliet Nakku said the concept of mental health is not clearly defined for purposes of the Bill.
She said that in its current form, the Act reads like an infectious and communicable diseases law, which should be amended.
"Public health should be defined as the art and science of preventing disease, prolonging life and promoting physical and mental health, sanitation, personal hygiene, control of infectious diseases and organization of health services," said Dr Nakku.

She added that catering for mental health treatment in the Bill will go a long way in checking on the high prevalence of mental health conditions in the country.

Dr Nakku said this while when she led a team of doctors from Butabika on Monday, 14 March 2022, to present their views on the Public Health (Amendment) Bill.

She called for the Bill to reflect its intention towards controlling non-communicable diseases, saying it did not recognise their public health burden as well as that of mental neurological substance use (MNS).
"The Lancet Psychiatry 2019 study found that people with depression have a 40 per cent higher chance of developing heart disease, hypertension, stroke and diabetes than the general population," she said.

She also said that the Bill provides for informed consent for the treatment of a mental illness but must cut across to allow for informed consent for such a patient who may also present with an infectious disease.

Dr Nakku urged the committee not to repeal section 44 of the principal act that provides for vaccination of inmates of institutions including mental hospitals.
She noted that repealing the section could potentially lead to discrimination of vulnerable groups of people like those in mental institutions and prisons, with regard to life saving vaccinations.

Nakku also made a case for monitoring of alcohol and drug rehabilitation centres, saying they have mushroomed in the country without a law to regulate them.
"These centres are mostly private for profit institutions and are admitting and holding citizens for extended periods of time and our prayer is that they should be brought under the ambit of Ministry of Health in the Public Health (Amendment) Bill," Dr Nakku said.

Hon Josephine Bebona (NRM, Bundibugyo district) reiterated the need to regulate rehabilitation centres to ensure that they cater for the needs of patients in need of refitting their mental health.
"Some people may fear to take their clients to Butabika and prefer those private centres but they must be carrying out their activities legally to protect their clients and health workers there," said Bebona.

Committee Chairperson, Hon Charles Ayume said that Butabika Hospital and other regional referral mental hospitals cannot easily superintend over all mental health issues in the country, thus the need to allow the private sector to come into play.
"People are smoking some of these narcotics and we need to start cascading their treatments to health centre IIs and IIIs. You might not have the entire leverage because at a point you will just be firefighting. It is time we push it to the community," said Ayume.

He added that it would be difficult to ensure informed consent for vaccination where there are high illiteracy levels in some areas of the country on such topics.

Distributed by APO Group on behalf of Parliament of the Republic of Uganda.

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