MENTAL HEALTH: AN ESCALATING FORM OF DISABILITY

Commonwealth Parliamentarians with Disabilities (CPwD) Chairperson, Hon. Laura Kanushu, MP, Parliament of Uganda

According to the United Nations Convention on the Rights of Persons with Disabilities, “Persons with disabilities include those who have long-term physical, mental, intellectual or sensory impairments which in interaction with various barriers may hinder their full and effective participation in society on an equal basis with others.”

As Commonwealth Parliamentarians, we are obliged to not only protect and advocate for the rights of persons with disabilities (PWDs) but also prevent, where possible, the circumstances that lead to disability.

Although there are people who are at higher risk of developing a mental health or behavioural disorder, every person can develop such a disorder, no matter their background. In addition, just like any disorder, a person can have more than one. More than 26 million people worldwide are diagnosed with several mental illnesses at one time.

Despite the various existing categories of disability, cases of mental health disorders are on the increase globally. Over 970 million people around the world struggle with some form of mental illness, while 14.3% of deaths worldwide, or approximately 8 million deaths each year, are attributable to mental disorders. The impact of the COVID-19 pandemic on the mental health of victims, health workers, caretakers and society at large cannot be underrated. The fear of the unknown led to anxiety and the economic depression following the pandemic has made many people depressed, hopeless and abusive, among other psychological effects.

The grim reality is that everyone can develop a mental health disorder regardless of age, sex, race, educational background, level of education and economic status; hence the need for urgent and sustainable intervention.

Mental health is included in the United Nations Sustainable Development Goals (SDGs) as a priority for global development for the next 15 years. SDG 3 advocates for good health and wellbeing, with mental health targets being to ‘reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and wellbeing’ (target 3.4); and to ‘achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all’ (target 3.8).

Mental health can affect daily living, relationships and physical health, which impedes the development of other health and developmental targets in addition to aggravating poverty. This calls for adequate policies on education, employment, housing, social welfare and the environment to enhance the well-being of populations.

As Commonwealth Parliamentarians, it is pertinent that we take the initiative to advocate for mental health awareness and evidence-based public policy while identifying best practices that can inform policy change regarding mental health. In order to incorporate mental health into national policy, it is important to identify and engage key agencies and stakeholders relevant to this subject, and assess the status of the mental health of our citizens (the context, needs, demands, current policy, service inputs, processes and outcomes) and develop strategic plans and implementation frameworks in addition to regularly reviewing progress.

In addition, healthcare policy should transition from solely managing generally common illnesses to one that pro-actively promotes the health and well-being of citizens. Policy advocacy should be centred around the decentralisation of mental health services; the integration of mental health into Primary Health Care; the establishment of mental health inpatient units within the Regional Referral Hospitals; the training of general health workers in mental health (pre-service and in-service training); improving access to behavioural health services; the promotion of the psychological aspects of general health care; and the reduction of mortality associated with mental illness, both from suicide and from premature physical mortality among others.

The Parliament of Uganda enacted the Mental Health Act in 2018. The Act provides for mental health treatment at primary health centres, emergency admission and treatment, involuntary admission and treatment, voluntary and assisted admission and treatment, admission and treatment of persons with mental illness who are not ordinarily resident in Uganda, and the requirement to consent to treatment, among others. The law was assented to by the President of Uganda on 25 December 2018.

Since 1949, the month of May has been recognised the world over as Mental Health Awareness Month. The Parliament of Uganda is commemorating the event by launching a Mental Health Awareness Campaign which is running throughout the month. Activities include sensitisation about mental health, retreats for adolescents or parents, a wellness camp, counselling services and team building activities, among others. Participation can be physical or virtual, depending on what is convenient for each stakeholder.

Handling mental health challenges is not limited to commemorating May as the Mental Health Awareness Month but is part of the Parliamentary Service’s Employee Assistance Programme where the services of qualified, professional counsellors are at the disposal of Members of Parliament and parliamentary staff all year round.

The Committee on Health of the 11th Parliament of Uganda has been at the forefront in advocating for the allocation of more resources to the only national referral mental hospital in the country, Butabika National Referral Mental Hospital. Last financial year, the health facility received an increment in its budget for feeding the ever-increasing number of patients and completing the construction of some wards. Despite an increase in the number of mental health patients, the country has only 53 psychiatrists. To handle the increased need for psychiatric services, Butabika National Referral Mental Hospital has a toll-free line to respond to questions about mental health.

The sad reality is that cases of mental health disorders are likely to keep on increasing, yet there is denial among some segments of the population and a lack of prioritisation of mental health care and treatment.

Mental health is a crucial issue that impacts everyone and plays a key role in efforts to achieve social inclusion and equity, universal health coverage, access to justice and human rights, and sustainable economic development. Therefore, there is a need to address mental health by developing tools and strategies that utilise evidence-based approaches to prevention, treatment and health promotion. As the Commonwealth Parliamentarians with Disabilities (CPwD) network, and the larger Commonwealth Parliamentary Association, this form of disability should never ever be ignored. It is a cross-cutting form of disability which needs the concerted efforts of all stakeholders.

I call upon all Commonwealth Parliamentarians to take charge and address this form of disability!