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Government responds to scarcity of mental health doctors but is it enough?

Government responds to mental health doctors crisis, is it enough?
  • About 14 million Ugandans of the 43.7 million population have a mental illness.
  • Mental health issues are 32.0% more common than previous national estimates of 24.2%.
  • Countrywide, there are 53 psychiatrists.
  • There is one psychiatrist per 1 million population.

The Uganda Nurses and Midwives Examination Board (UNMEB) out of the 53,575 nurses and midwives, only 18 are sitting for examinations in mental health. So, the government has set out to lower entry requirements for mental health programmes. That said, will it be enough? What is "enough" on the matter?

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While unveiling the examinations roadmap yesterday, the Executive Secretary of UNMEB, Helen Mukakarisa, said the enrolment in mental health programmes should increase.

She noted that diploma-level entry requirements discourage potential sign-ups while certificate courses get more.

"There is a demand for nurses who deal with children in hospitals but the enrollment levels at certificate and diploma level are low compared to other courses where the numbers have doubled.

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"In courses like certificates in Nursing and Midwifery, the requirements are a bit favourable compared to the paediatrics and mental health where the requirements are high for one to enroll," she said.

Thus, the government is set to accept certificate holders to join the program with support from the Education Ministry in the form of scholarships.

"Government and other stakeholders have concluded that such courses with low enrollment, the government is going to review criteria for such courses at both levels to register an increment.

"The Ministry of Education has plans to give scholarships to students doing those courses given their demand in hospitals and given the big number of children being produced on a daily basis," she added.

Although the move is a step in the right direction, the government still has a wide base to cover before any real impact can be registered.

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According to a report by Mark Mohan Kaggwa, Sheila Harms and Muhammad A Mamun, published at The Lancet Psychiatry, there needs to be a restructuring in the primary care system.

Starting with the introduction of routine medical education about mental health patient care for all general practitioners.

This would be achieved by adding compulsory mental health rotations as a minor rotation (one-month rotation) to the four major medical internship programmes.

Aside from increasing care for patients with mental health issues, it will provide a conducive environment for students, interns and general practitioners to pick interest in joining the mental health workforce.

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The mental health care system also needs more incentives in terms of money and benefits to stop the leakage of labour into university lecturers, researchers, and high-income countries.

Although strides are being made to remove the stigma around mental health issues, beliefs like mentally ill people being 'incurable' or 'lost causes', have created barriers against treatment and funding from the government in the national budget.

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