The silent mental health crisis among men in Uganda


As we did our summer field work in a mental health clinic in Kabale, Uganda, both of us— medical doctors and public health researchers—couldn’t help but notice a striking discrepancy: the absence of men at the mental health clinic contrasted with a significant number of male adults battling mental health disorders and alcoholism in the community. This observation raised important questions about the prevailing lack of health-seeking behavior among men and the neglected issue of the mental health crisis in males in rural Uganda, and, further, across Africa.

Mental health remains a topic shrouded in silence and stigma, particularly among men in African societies. Traditional gender norms often emphasize stoicism and emotional restraint for men, leading them to suppress their emotions and avoid seeking help when facing mental health challenges. This societal pressure not only hinders their ability to cope with issues but also perpetuates the notion that mental health concerns are a sign of weakness. 

Current challenges of providing mental health services in Uganda

Uganda has a high prevalence of mental health conditions compared with other low- and middle-income countries.  A Lancet Psychiatry correspondence  reported that approximately 14 million people out of a population of 43.7 million, or about 32.0%, were affected by mental illness in 2022. This prevalence was higher than previous national estimates, which stood at 24.2%. The increase might be attributed to the persistent social stigma and taboos surrounding seeking mental health services, compounded by the impact of the COVID-19 pandemic, as many hospitals converted their mental health units into COVID-19 isolation units.

Mental health services are extremely under-resourced in Uganda, and the primary health care system in the country does not have adequate resources to effectively address mental health concerns. There are only 53 psychiatrists nationwide, approximately one psychiatrist for every million people, and less than 1 (0.78) psychiatric nurse per 100,000 individuals. Additionally, most of the mental health workers are concentrated in urban centers, such as Kampala, where the country’s only psychiatric hospital, Butabika National Referral Mental Hospital, is located. Because 83% of the population in Uganda lives in rural areas, those living in much of the country have little access to mental healthcare.

Mental health challenges among men

A recent survey reported during the National Mental Health Conference in Uganda in 2022  indicated that men in Kampala city were found to have a much higher incidence of mental illness compared to their female counterparts. According to the Ugandan Ministry of Health, alcohol dependency is among the main cause of psychiatric morbidity. Men in Uganda are estimated to have one of the highest alcohol per capita consumption levels in sub-Saharan Africa with 16 litres of pure alcohol consumed each year. The prevalence of Alcohol Use Disorder(AUD) in Uganda is estimated at 12.4% and the prevalence of alcohol dependence is estimated at 4.2% among males.

The reluctance of men to seek mental health services has severe consequences for individuals, families, and communities. Unaddressed mental health disorders can exacerbate substance abuse, domestic violence, and even lead to suicide. When men suffer silently, it creates a ripple effect that impacts their relationships, productivity, and overall well-being.

The association between alcoholism and mental health crisis is an important observation to work toward addressing the issue.  Many men resort to alcohol as a way to cope with emotional pain or societal pressures, leading to a vicious cycle of addiction and mental health deterioration. Addressing the underlying mental health concerns is crucial to breaking free from this cycle and fostering healthier coping mechanisms.

Factors contributing to the mental health crisis among men

As we looked further into this problem during the summer we spent in Uganda, we identified a number of factors that contribute to the lack of health-seeking behavior in men and the ignored mental health crisis in the country.

  • Cultural Norms: Cultural expectations regarding masculinity often discourage men from expressing vulnerability or seeking emotional support, creating barriers to addressing mental health issues openly.
  • Limited Access to Mental Health Services: In many African communities, mental health services are scarce, distant, or underfunded, making it challenging for individuals to access the help they need.
  • Stigmatization: The existing stigma surrounding mental health disorders leads to discrimination and isolation, further deterring men from seeking help.
  • Poverty and Other Social Determinants: Poverty, poor education, and other social determinants can exacerbate mental health conditions and make treatment more difficult. Individuals in poverty may not be able to afford treatment or transportation to healthcare facilities.

Addressing these challenges will require a combination of increased investment in mental health services, public education to reduce stigma, and policy reforms. It’s also crucial to take an integrated comprehensive approach that addresses social determinants of mental health, like poverty and education.


About the authors: AN Na is a gynecologist/obstetrician and public health practitioner, she is a Doctor of Public Health student at Harvard T. H. Chan School of Public Health.

Hailu Tamiru Dhufera is a physician and health policy researcher, currently studying for his Doctor of Public Health at Harvard T. H. Chan School of Public Health.

Competing interest: None

Handling Editor: Neha Faruqui

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