Abstract
There are significant barriers to the development of a ‘balanced model’ of mental health in low-income countries. These include gaps in the evidence base on effective responses to severe mental health issues and what works in the transition from hospital to home, and a low public investment in primary and community care. These limitations were the drivers for the formation of the non-government organization, YouBelong Uganda (YBU), which works to contribute to the implementation of a community-based model of mental health care in Uganda. This paper overviews an intervention protocol developed by YBU, which is a combined model of parallel engagement with the national mental hospital in Kampala, Uganda, movement of ‘ready for discharge’ patients back to their families and communities, and community development. The YBU programme is theoretically underpinned by a capabilities approach together with practical application of a concept of ‘belonging’. It is an experiment in implementation with hopes that it may be a positive step towards the development of an effective model in Uganda, which may be applicable in other countries. Finally, we discuss the value in joining ideas from social work, sociology, philosophy, public health and psychiatry into a community mental health ‘belonging framework’.
Highlights
This is a commentary paper focused on a community mental health intervention in East Africa that supports people living with severe mental illnesses (SMIs) transition from hospital to home
There are significant barriers to the development of a ‘balanced model’ of mental health in lowincome countries. These include gaps in the evidence base on effective responses to severe mental health issues and what works in the transition from hospital to home, and a low public investment in primary and community care. These limitations were the drivers for the formation of the nongovernment organization, YouBelong Uganda (YBU), which works to contribute to the implementation of a community-based model of mental health care in Uganda
We describe the resultant intervention and its underpinning theoretical framework that combines principles of ‘belonging’ and ‘capabilities’ with a family-centred support model that the authors contend is suited to a resource challenged setting such as Uganda
Summary
There are significant barriers to the development of a ‘balanced model’ of mental health in lowincome countries These include gaps in the evidence base on effective responses to severe mental health issues and what works in the transition from hospital to home, and a low public investment in primary and community care. The YBU programme is theoretically underpinned by a capabilities approach together with practical application of a concept of ‘belonging’ It is an experiment in implementation with hopes that it may be a positive step towards the development of an effective model in Uganda, which may be applicable in other countries.
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