We should care more about Mental health in this COVID-19 era

By Michael Aboneka Jr

It is undebatable that COVID-19 has caused deaths and left another lifelong impact on the lives of Ugandans since March 2020 when the pandemic was officially declared in Uganda. Majority of the focus has been on the prevention of further spread of COVID-19 and less about the social and economic life of Ugandans as many leaders have always retorted that they need to save life first and then deal with the rest later, which is not right. The model to fight COVID-19 needed to be a holistic one that touches all the spheres of life of Ugandans and not just focusing on one-saving lives yet actually more lives are being wasted away by mental health related problems.

COVID-19 has and continues to have a huge impact on the mental well being of Ugandans and this cannot be ignored and only focus on asking us to wash hands and stay safe. Since March 2020, there have been incidents of severe metal illness manifesting into depression, suicide, hypertension among others. These have been as a result of the biting effect of COVID-19 ranging from contracting COVID-19, losing loved ones to COVID-19, losing jobs and business, choking on loans thereby losing the only property to banks in default among others. The cases of domestic violence were further reported to be high during the pandemic and much can be traced back to mental disorders. Much as there is no public data on the impact of COVID-19 on mental health, the friends, and doctors I have interacted with indicate that most people have been diagnosed with mental related illnesses during this pandemic. Mental illness is the new disease killing us slowly and as a country, we need to invest heavily in metal health and save the population.

It is true that the COVID-19 pandemic has created an urgent need for an isolated space in which to manage patients with COVID-19 and this isolation alone is a major factor for mental illness. How many psychiatrists and counsellors were offered to the COVID-19 Patients? How many received counselling as part of the treatment? Did the government ever plan for counselling services during the pandemic as much as we planned for allowances PPEs? If we did, how much was planned and how many received this service? I wish I could have an answer to these questions! As we continue to ask whether there was ever any sort of mental health services offered to COVID-19 patients and the general public, we need to be aware of what the adverse effects of COVID-19 on mental health are otherwise we shall concentrate on telling Ugandans to wash their hands and mask up while they dying slowly by mental illness.

Be that as it may, the only national referral inpatient mental health unit in Uganda, Butabika Hospital, Kampala has about 638 inpatient psychiatric beds for a population of almost 44.2 million people and yet by December 2018, the bed occupancy rate of Butabika Hospital was 149% and even with the high demand for beds, some units were turned into isolations wards. By September 2020, the Hospital had treated 1,500 patients of which COVID-19 was one of the major drivers for the mental illnesses treated. Uganda has about 47 psychiatrics, most of whom are based in Kampala for a population of 44.2 million. This already is a ticking time bomb as numbers surge because of the impact of COVID-19 with a weak system to support the numbers and I hope as a country, we are ready to handle this outburst. Further, most mental health services are mainly concentrated around the city and yet even the few mental health units at the regional referral hospitals have been turned into isolation and treatment centres for COVID-19.  This means that mental health hasn’t been taken seriously as it should.

As Uganda, do we have mental health and psychosocial support in the COVID-19 response plans, was there enough money allocated to implement this plan? Do we have enough health workers, medical supplies, medicines and personal protective equipment to be able to deal with the surging number of mental illnesses? I hope that these questions too can be answered in the affirmative because mental health cannot be ignored especially at this time where COVID-19 has devastated the majority of the population.

We need to take mental health seriously as it is as dangerous as COVID-19. Masses needed to be sensitized about the available options of seeking support for anxiety, depression and other related mental issues. We should also have a collaborative approach on this matter with players such as the religious institutions, CSOs and others who offer this support to be readily available for all Ugandans. Further, we need to integrate several approaches to mental health such as models for community mental health care ensuring that psychiatric care is available in all medical and clinical centres and practices; provide free hotlines for the public to call in for support and make Psychosocial Support a priority.