Shifting to community-based mental health and psychosocial services in Uganda

Ensuring access to mental health care

Just before Christmas we visited our partner PACF in Uganda. Upon our arrival PCAF team members Dorothy, Ray, Wietse, Bree and Liz gave us a very warm welcome.

Fondation d’Harcourt has been collaborating with PCAF for two years to provide high quality mental health care and services to victims of traumatic events. One of the project’s main activities has been to lead community outreach programs to remote areas within four districts of Northern Uganda.

Recent research in line with WHO’s guidelines shows that individuals with no background in mental health can deliver, when properly trained, effective mental health care. With this in mind, PCAF started delivering cost-effective solutions at community level relying primary on healthcare staff and community mobilizers. This has allowed them to reach more people in need and to handle a larger variety of illnesses than previously.

Over the last year PCAF has identified and treated 8,600 patients at clinics and outreach sites. More community sensitization sessions were organized and new community mobilizers were trained, under the supervision of mental health specialists, to identify and refer patients for appropriate treatment. PCAF has considerably increased its staff’s skills and knowledge, effectively delivering evidence-based mental health and psychosocial support. Moreover, they have also improved their monitoring and evaluation system.

Ugandan Psychiatrist and Deputy Coordinator for PCAF Ray Odokonyero facilitated our encounter with the local community of Obalanga, a village in the Soroti district, one of most affected by the country’s 20-year conflict.

Almost a hundred people gathered around a large tree to meet us and share their stories. We were thrilled to discover that some of them, after attending the individual and group counseling sessions, had created a drama group. They then began sharing their experiences with others through reenactments of their traumatic experiences. These plays have truly helped them to overcome their fears and traumas.

We watched their performance in awe, surprised to see how everyone is beginning to regain confidence and even laugh and joke about what they lived through. We were particularly impressed by Alexis, a former patient and current leader of the drama group, and her ability to speak to and engage with the audience.

Travelling to Uganda was also an opportunity for us to meet Cathy, the Ugandan psychiatrist who supervises the project we are supporting in Burundi, where the political situation is still very tense. Our project there is part of a collaboration between PCAF and Village Health Works, a local grassroots non-governmental organization.

The first year of the project in Kigutu, Southwestern Burundi, focused on setting up and developing the capacities of the local mental health team under Cathy’s supervision. Regular training sessions have been carried out and the team has already begun to identify and treat patients. The project replicates PCAF’s intervention in Uganda and seeks to mitigate the overwhelming need for mental health services in Burundi. According to Cathy, work in Burundi is on its way to being as fruitful as in Uganda.

We value PCAF’s partnership and admire their commitment. It is a long journey that they have undertaken with the thousands of survivors of violence and war who struggle daily to regain their lives. The resilience Alexis and her drama group are showing is encouraging, and inspires us to continue walking side by side with them.