Debate Over Mental Health Consent in Uganda

Butabika Hospital Faces Space Shortage Due to Increasing Alcohol-Related Mental Illnesses
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Involuntary Mental Health Treatment Types

Type of Involuntary Treatment Conditions for Application
Preventive When a patient is at risk of harm to themselves or others.
Temporary For short-term treatment of individuals who are a danger to themselves or others, or unable to care for themselves.
Court Authorized When court approval is granted for involuntary hospitalization.


There is a growing concern over the consent, rights, and protection of individuals with mental disorders as they are admitted to care or navigate the justice system. This issue has garnered attention as the country grapples with the rising prevalence of mental health conditions, affecting both children and adults.

As of 2021, a report by researchers from the University of Adelaide, Australia, revealed that the prevalence of mental disorders in Uganda stood at 23 percent in children and 24 percent in adults. This alarming statistic underscores the urgent need to address the treatment and care of those with mental health challenges.

Arthur Nsereko, the head of the Network of Public Interest Lawyers, has raised questions regarding the methods used for involuntary treatment, particularly hospitalization, and the overall treatment of individuals with mental health issues. He advocates for a human rights-based approach, emphasizing the importance of respecting patients as human beings with rights, not merely as patients. Nsereko also stresses the need for accountability when the rights of individuals with mental health disabilities are violated or abused.

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The Ministry of Health’s Assistant Commissioner for Mental Health, Dr. Hafsa Luswata, has highlighted the theme for this year’s World Mental Health Day celebrations: “Mental health is a fundamental human right.” This theme underscores the significance of preserving mental health as a basic human right and the collective responsibility to protect and promote it.

Mr. Nsereko’s main concern is the tendency to generalize all mental health cases, assuming that they require the same treatment approach. He emphasizes the need to recognize that mental health challenges can manifest at varying levels, and not every case warrants immediate intervention, such as restraining or involving the police.

In Nsereko’s view, individuals with mental health issues should be given the opportunity to participate in decisions about their treatment. While medical practitioners play a crucial role in advising on treatment options, Nsereko advocates for the individual’s involvement in determining the most suitable course of treatment, ensuring their preferences are considered.

Various methods of managing patients with mental health challenges, including seclusion (confining a patient to a room with no means of freely leaving) and electroconvulsive therapy (administering electricity to the brain to alleviate symptoms), have been debated. These methods often raise questions about the balance between patient rights and clinical necessity.

Dr. Harriet Birabwa-Oketcho, a senior consultant psychiatrist at Butabika Hospital, acknowledges the need to protect the rights of all patients while emphasizing the challenge of striking the right balance. She points out that involuntary hospitalization is sometimes necessary when a patient poses a danger to themselves or others and is unable to care for themselves.

Involuntary treatment, while preventive, temporary, or court-authorized, can be highly distressing for patients. The decision to admit someone against their will is often based on factors like past behavior, the need for care, inability to make decisions, and behavior that may be disruptive or harmful to others.

The debate surrounding mental health treatment in Uganda underscores the delicate balance between upholding individual rights and ensuring the well-being of patients. As the country grapples with the increasing burden of mental health conditions, finding a solution that respects rights while providing effective care remains a complex challenge.

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