One in four Ugandans fighting mental illness

In busy towns and remote villages, a quiet crisis is unfolding. It doesn’t scream for attention like a flood or a political scandal.

It whispers – through the sleepless nights of a mother battling depression, the erratic behavior of a teen hooked on cannabis, or the silence of a child too troubled to speak.

According to psychiatrist Dr Hillary Irimaso’s Overview of Mental Health Issues and Substance Misuse in Uganda, presented to a gathering of Namilyango Old Boys on May 2, 2025, nearly one in four Ugandans—both adults and children—are struggling with a mental health disorder.

Mental illness and substance misuse are affecting nearly one in four Ugandans (24.2 percent of adults and 22.9 percent of children),” according to Dr Irimaso’s overview.”

Yet the country continues to treat this reality as a footnote rather than a national emergency. At the heart of Dr Irimaso’s presentation is a simple but powerful reminder: mental health is not just about illness, it is about the full spectrum of human wellbeing. Health, he notes, must be understood holistically—encompassing physical, mental and social aspects.

Mental health, specifically, is about our ability to manage stress, relate to others, and contribute meaningfully to our communities. Mental illness, on the other hand, refers to disruptions in thinking, mood or behavior that impair a person’s daily life. It’s not just about clinical diagno- sis. It’s about the ability—or inability—to cope, to connect and to live fully. Uganda’s numbers tell a stark story.

The overview cites a systematic review that found 24.2 percent of adults and 22.9 percent of children are living with a mental illness. Depression and anxiety are the most common culprits, often hidden behind forced smiles or misunderstood anger. Among young people, depression affects almost one in four, while anxiety disorders—including panic attacks and social phobia—affect about one in seven.

Post-traumatic stress disorder (PTSD), a condition that can follow experiences such as violence or abuse, is increasingly common, especially among survivors of conflict and displacement.

The crisis doesn’t stop there; Uganda is also facing a wave of substance misuse, particularly among youth and in urban areas. Alcohol remains the most commonly abused substance—cheap, accessible and deeply ingrained in social life. Cannabis use is rising, especially among adolescents who often turn to it for escape.

Khat, a stimulant chewed in some regions, and prescription drugs like opioids and sedatives are also being misused, sometimes with deadly consequences. The report notes that substance abuse is not confined to any one group—it affects men and women, rich and poor, young and old.

But it is Uganda’s youth who are especially at risk, caught in the crossfire of unemployment, peer pressure and growing hopelessness. One of the most difficult challenges Uganda faces is what experts call “dual diagnosis.”

“This refers to people who suffer from both a mental health disorder and a substance use problem. Often, individuals with untreated depression or trauma turn to drugs or alcohol to numb their pain. But this self-medication only deepens the crisis, creating a vicious cycle that is difficult to break.”

Dr Irimaso warns that Uganda lacks integrated systems of care to treat both conditions together, which severely limits recovery. Why are so many people falling through the cracks? The reasons are as complex as they are painful.

Poverty, unemployment, and social instability leave many people without the support they need to maintain mental well-being. Traditional beliefs often stigmatize mental illness, labeling sufferers as cursed or possessed. Instead of seeking medical care, families may turn to spiritual healers or isolate the affected person entirely.

For survivors of war, displacement, and domestic violence, trauma goes untreated. The availability of cheap alcohol and drugs, coupled with weak regulation, makes matters worse. The costs of neglecting mental health go far beyond individual suffering.

Untreated mental illness contributes to broken families, absenteeism from school and work, rising cases of domestic violence, and increased crime. The economic burden is significant—lost productivity, greater demand on health services, and the societal cost of jailing people who need psychiatric care, not punishment.

According to the report, Uganda’s national development is being quietly undermined by this invisible epidemic. Yet for many Ugandans, professional mental healthcare remains out of reach. There are simply not enough qualified psychiatrists, psychologists, or trained counselors—majority are concentrated in major cities.

Medication is expensive and not always available. Rural communities often rely on informal networks and traditional remedies. Even when services exist, stigma and lack of public awareness prevent many people from seeking help.

Uganda passed the Mental Health Act in 2019 and has a national mental health policy, but implementation has been slow, and funding is scarce. Cultural and structural barriers continue to block progress. Mental illness is still a taboo subject in many homes, places of worship and schools. Services are centralized and hard to access.

Many people don’t even recognize what they are experiencing as a treatable condition. There’s little education about mental health in public schools or community settings. And because the health system prioritizes infectious diseases, mental health is often left behind.

But there is hope. Dr Irimaso highlights promising interventions. Community-based programs, mobile clinics and peer support networks are beginning to fill the gaps. The ministry of Health has rolled out the Mental Health Action Plan, which includes awareness campaigns and plans to decentralize services.

Some NGOs and schools have launched psychosocial support programs. International partnerships are helping to train more professionals and increase access to care. The key, Dr Irimaso insists, is to act now— and to act together. Uganda needs a national conversation that breaks the silence and challenges stigma. Resources must be allocated to build and sustain mental health infrastructure.

Community leaders, educators, faith institutions and youth groups, all have a role to play. Families need tools and knowledge to support loved ones. And perhaps most importantly, those suffering need to be seen—not as weak or dangerous, but as human beings deserving compassion and care.

If Uganda fails to act, the consequences will continue to ripple through generations. But if it rises to meet this challenge, the country can build not only a healthier population, but a more resilient, productive, and humane society. As Dr Irimaso puts it, “Mental health is not a luxury—it’s the foundation for everything else.”