The checklist includes maintaining social networks, identifying what stresses them and maintaining regular sleep routines. But experts say it’s unrealistic for people in mental distress to monitor themselves, adding that because people’s mental health hasn’t been paid attention to, many of them are sliding back to mental illness.
The question on how to effectively
handle persons that develop a mental illness in the management of COVID-19, remains largely ignored, even as the Ministry of Health (MOH) adjusts its treatment
homecare guidelines by the Ministry of Health allow persons with mild disease and the asymptomatic to
be managed in auxiliary facilities and at their homes and offers them a list of things they should and shouldn’t do
for their mental wellness.
The checklist includes maintaining social networks, identifying what
stresses them and maintaining regular sleep routines. But experts say it’s
unrealistic for people in mental distress to monitor themselves, adding that because people’s mental health hasn’t been paid
attention to, many of them are sliding back to mental illness.
Currently, Dr Hafsa Lukwata, the mental health focal person
at the Ministry of Health says that three people have tested positive for the virus have presented
with severe depression and are already undergoing treatment at Entebbe Grade B
hospital. Some other 43, mostly returnees from abroad presented with
anxiety disorders and stress but have since been discharged.
She said they designated
Entebbe to handle the psychiatric problems too since Butabika didn’t have capacity
to offer this care.
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However, while those admitted with COVID-19 have a chance of
having their mental wellness assessed, experts worry that with homecare, many might
go unnoticed and present later with complications since being a new disease, diagnosing
one with COVID-19 would be depressing.
Dr Juliet Nakku,
a psychiatrist and the Executive Director of Butabika National Referral hospital
says that giving people tips is not enough but adds it can be a tough
call for the government to set up a proper homecare programme. She says it would
require a huge investment in terms of human resource.
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Currently, the country has a total of 46 psychiatrists, and only eight of these are attached to Butabika Hospital, where they are supported by psychiatric clinical
officers and mental health nurses. The others are teaching at various universities. Nakku says it takes more than these to offer the necessary care
in the community.
The World Health Organization Uganda
Country Representative Dr Tegnen Woldermariam told URN that the organization requires
countries to include issues like how to handle stigma and mental wellness in
their homecare protocols for COVID-19 because both illnesses have been shown to
attract backlash from communities.
He says helpful interventions should start with sensitizing people
who live with a positive case to understand what they ought to do and not to
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But, the homecare guidelines remain silent about this. Lukwata, however, tells URN that they have
provided families with a toll-free number to contact the Ministry in case
the patient deteriorates and requires hospitalization for either COVID-19
symptoms or others like severe mental illness.
Dr Hillary Irimaso, a psychiatrist in private practice said
while the government is neglecting aspects of mental health, COVID-19 has presented
an opportunity to explore if community health services can actually work.
He said world over, there is a shift from people accessing
services from the health services to finding them where they are. For him, unlike other illnesses where one can
easily tell that they are unwell, for mental health, it’s the reverse.