The COVID-19 pandemic and attendant restrictions exacerbated deficiencies in Uganda’s already challenged mental healthcare system.
Many people with mental issues could not easily move to get their routine treatment when the government placed the country under total lockdown. This resulted into relapses and sometimes suicides.
Before the pandemic, the mental healthcare infrastructure was already weak with only 47 Kampala-based psychiatrists at the services of a 42 million-strong population.
The situation became worse after the regional mental health units at the regional referral hospitals were turned into COVID-19 treatment centres.
With these complexities, police recorded a rise in suicide cases by over 20 percent between January and June in 2020. The police statistics indicate a case increase to 275 from January to June in 2020 compared to the previous year’s 224 reported in the same period.
Although, the deputy police spokesperson, Ms Polly Namaye attributed the increased cases to poor living conditions during the lockdown, the Executive Director of Mental Health Uganda, Mr Derrick Kiiza disagrees.
“Attributing the increased cases of suicide to poverty and poor living conditions is a nonstarter because we have lived with poverty as long as humanity has existed,” he said, adding, “Some analysts attribute wrong reasons because they are not informed. I want to tell you that the trigger is mental health issues which were compounded by the lockdown.”
Other than failing to access routine medication because of restricted movements, especially public transport, many people also experienced psychological distress.
Sam Kato, who receives routine treatment for his bipolar illness at Butabiika National Mental Referral Hospital, relapsed and was admitted after his situation worsened.
“I became more anxious and I went into depression and I had to be taken for treatment,” he says
Mr Kiiza said his organisation recorded 11 cases of suicide the patients registered under Uganda Mental Health in West Nile and Northern regions between July and August 2021 when the country was put under the second total lockdown in June of 2021.
“We were able to know about these cases because they were registered members of our organisation. But there are so many other cases which must have happened in and outside the two regions and we didn’t know them because they were not registered with us. It’s police which must be have registered those cases,” he said.
Mr Kiiza said Mental Health Uganda has its finger on the pulse of West Nile and Northern regions because “they have been having more cases of suicide which is attributed to the armed conflicts in those two regions.” He reckons “it will take two to three generations for them to heal.”
Surprisingly, police statistics released in June 2020 indicate that some districts in Central, Western and Eastern regions had higher suicide case numbers in the first three months of the total lockdown compared to the districts in Northern Uganda. Lwengo district (16) had the highest number of suicide cases followed by Rukungiri (12), Tororo (12) and Nakaseke (11).
Another study done by Gulu Sheffield Mental Health Partnership in collaboration with Gulu Regional Referral Hospital in the same year documented 80 cases in the Acholi sub-region. The study spanned a longer period from January to October. Suicide by drinking poison accounted for an unprecedented 51 cases followed by hanging with 26. Suicide by drowning (two) and turning a gun on oneself (one) also figured on the list albeit to a low degree.
Agago district registered the highest number with 20 cases. It by Omoro (14), Gulu (13) and Pader (12) in that order. Amuru (eight), Kitgum (seven), Lamwo (four) and Nwoya (two) districts registered single dight deaths.
A study done and published by the global scholarly investigative forum, Frontiers in Sociology turned up grim findings in July of 2021 that indicate suicide ideation is becoming a public health concern among the youth in Uganda. The study recommended that more research be done to establish whether there is a connection between suicidal ideation among the youth and the effects COVID-19.
“Given the challenges associated with the COVID-19 pandemic, future studies should investigate the effects of COVID-19 on suicidal ideation and attempt,” the study report reads in part.
Mr Kiiza says attempting to commit suicide is regarded as a crime under Ugandan laws. This “criminalisation of suicide” is not, he adds, “helpful.” It explains why “relatives of the victims don’t normally report the cases.” Mr Kiiza says cultural practices around demonisation of people that commit suicide do not help in either understanding or addressing the root cause of what is fast-becoming a rampant problem in Uganda.
