Prioritise mental health in Public Health Bill - Butabika hospital

The Executive Director of Butabika National Referral Hospital, Dr Juliet Nakku, says mental health is not well defined in the current Public Health Act which, she says, defines mental health as an infectious and communicable disease.

“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 Nakku.

She said the inclusion of mental health treatment in the Bill, in a manner well defined, will help fight the high prevalence of mental health challenges in the country.

Dr Nakku, along with a team of doctors and psychiatrists from Butabika Hospital, was presenting her institution’s views on the Public Health (Amendment) Bill.

She called for the Bill to broaden its scope in controlling non-communicable diseases, adding that it did not recognise their public health burden as well as the attendant challenge 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.

Nakku added that the Bill provides for informed consent for the treatment of mental illness and this informed consent should also apply for a patient who may be suffering from an infectious disease.

However, 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 said the repeal of this section would have negative effects such as the discrimination of vulnerable groups of persons such as those in mental institutions and prisons, with regard to free and life preserving vaccinations.

Dr. Nakku said it was an important to subject alcohol and drug rehabilitation centres to closer scrutiny, saying they have mushroomed around 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.

Josephine Bebona, the Bundibugyo district MP, agreed saying regulating the said rehabilitation centres will ensure that they better cater to the needs of mental health patients.

“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, Charles Ayume said that Butabika Hospital and other regional referral mental hospitals could not solely handle all mental health issues in the country, that’s why the private sector needs to play a big role in doing the same.

“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.

In contrast to Dr. Nakku’s submission, Ayume noted that it would be difficult to ensure informed consent with regard to vaccination due to the high illiteracy levels in some areas of the country when it comes to such treatments.