Access to mental health services by refugees in Imvepi Refugee Settlement, Arua District, Uganda

Abstract

Background: Uganda continues to have an influx of refugees who are exposed to multiple traumatic events that put them at a higher risk of developing mental disorders as compared to the general population. The availability of human resources, equipment, and drugs to manage mental disorders in a timely fashion hasn’t been well documented within the refugee population in Uganda. Justification: This study aimed to examine access to the types of mental health services available for diagnosing and managing mental disorders, which will guide stakeholders on the development of easily accessible mental health interventions.

Objectives: To investigate access to mental health services by refugees within Imvepi refugee settlement.

Methods: A cross sectional study using a qualitative methodology was conducted in Imvepi refugee settlement. Participants were purposively selected using an inclusion criterion Qualitative data were collected using eight key informant interviews, six focus group discussions, ten in-depth interviews and two observational checklists. This data was then transcribed, electronically coded, and analysed through a thematic analysis using NVivo software.

Results: The study findings showed an evident lack of access to mental health services seen as unawareness of the availability of mental health services within the settlement. The lack of adequately trained mental health workers, persistent psychotropic drug stockouts as well as high transportation costs to get from one’s home to the health centres were the main concerns. Major barriers to accessing care included cultural beliefs and attitudes, stigma and discrimination, language barrier and lack of family or community support.

Conclusion: While the refugees were aware of mental disorders and had high mental health needs, poor access to trained mental health personnel and psychotropic medicines alongside poor geographic access were documented. Mental health stigma, lack of psychosocial support as well as language barrier were notable barriers to MH services. The government should provide more resources to develop better mental health policies that can close the mental health treatment gap. This will ensure increased training of mental health workers, improved availability of resources, and raised awareness within the community.