Pathways to care for psychosis in rural Uganda: Mixed-methods study of individuals with psychosis, family members, and local leaders

Pathways to care for psychosis in rural Uganda: Mixed-methods study of individuals with psychosis, family members, and local leaders

Abstract Background Low- and middle-income countries (LMICs) bear a disproportionate burden of mental illness, with limited access to biomedical care. This study examined pathways to care for psychosis in rural Uganda, exploring factors influencing treatment choices. Methods We conducted a mixed...

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Main Authors: Yang Jae Lee, Kayera Sumaya Nakaziba, Sophie Waimon, Grace Agwang, Kailash Menon, Sam Samuel, Aaron Damon Dyas, Travor Nkolo, Haba Ingabire, Jason Wykoff, Olivia Hobbs, Rauben Kazungu, Job Basiimwa, Robert Rosenheck, Scholastic Ashaba, Alexander C. Tsai
Format: Article
Language:English
Published: Cambridge University Press 2024-01-01
Series:Cambridge Prisms: Global Mental Health
Subjects:
Pathways to care
care-seeking behaviors
traditional healers
religious leaders
Uganda
global mental health
psychosis
Online Access:https://www.cambridge.org/core/product/identifier/S2054425124001432/type/journal_article
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Summary:Abstract Background Low- and middle-income countries (LMICs) bear a disproportionate burden of mental illness, with limited access to biomedical care. This study examined pathways to care for psychosis in rural Uganda, exploring factors influencing treatment choices. Methods We conducted a mixed-methods study in Buyende District, Uganda, involving 67 in-depth interviews and 4 focus group discussions (data collection continued until thematic saturation was reached) with individuals with psychotic disorders, family members, and local leaders. Structured questionnaires were administered to 41 individuals with psychotic disorders. Results Three main themes emerged: (1) Positive attitudes towards biomedical providers, (2) Barriers to accessing biomedical care (3) Perceived etiologies of mental illness that influenced care-seeking behaviors. While 81% of participants eventually accessed biomedical care, the median time to first biomedical contact was 52 days, compared to 7 days for any care modality. Conclusions Despite a preference for biomedical care, structural barriers and diverse illness perceptions led many to seek pluralistic care pathways. Enhancing access to biomedical services and integrating traditional and faith healers could improve mental health outcomes in rural Uganda.
ISSN:2054-4251

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