A new study has found that substance use, especially alcohol use problems play a key role in the increased mental health problems among refugees in Uganda.
In the study, the researchers gathered information from 15- to 34-year-old refugees in Nyumanzi, Boroli, Majji, and Mungula refugee settlements out of the total 19 refugee settlements in the Adjumani District. The findings were published by the Alliance Forum for Development (AFOD-Uganda) in a report entitled: Mental Health and Psychosocial Support (MHPSS) baseline assessment in Adjumani, in November 2021.
According to the report,
- Refugees had a 14% substance use rate.
- Common harmful substances consumed were marijuana, mairungi, and tobacco.
- Tobacco was the most consumed at least two-three times a day; with most chewing and smoking, respectively.
- The refugees shared 67% of the drugs consumed.
- 82% of refugee households faced mental health issues resulting from limited or no access to basic needs, such as food, illnesses, and loss of personal properties.
- Other factors for mental health issues included physical body injury (34%), gender-based violence (10%, especially rape cases among refugees), forms of affliction (20% torture) including workload, kidnap, feeling of guilt, and worthlessness.
The goal of the research was to identify the causes of the substance use problems among the refugees so as to develop solutions.
Mental health systems to support refugees are weak and uncoordinated according to Mr. Michael Mawa, a programs manager at AFOD.
- There is no functional mental health unit to support mental health cases at the district and regional levels.
- Staff capacity to provide mental health and psychosocial support (MHPSS) is limited.
- There is no or limited space provided to manage mental health patients at HCVs and district hospitals.
The current support for mental health and substance use problems offered by Adjumani Hospital is accessed by very few refugees. The COVID-19 pandemic brought to notice the glaring gaps in the mental health system that in turn give rise to gender-based violence, suicide and hopelessness.
Sr Alice Bunia, the officer-in-charge of Mental Health at Adjumani General Hospital, states that in the last two years the district recorded 5,000 cases of mental health disorders and about 10 cases of suicide each year.
Meanwhile, a recent World Health Organisation study estimates that one in five people in post-conflict settings suffer from mental health problems.
Many young refugees in Adjumani District are using substances and alcohol as a way to cope with the traumas they have faced.
Due to the economic hardships, refugee youth have formed cliques, especially in Ayilo 1, Pagirinya, and Maaji, and have resorted to excessive alcoholism, substance abuse characterized by violence, sexual harassment, among other crimes,” said Mr. Moses Nyang, the Refugee Welfare Council (RWC) secretary for Nymanzi Refugee Settlement, as per Monitor.Mr. Moses Nyang, the Refugee Welfare Council (RWC) secretary for Nymanzi Refugee Settlement
The report makes several recommendations to improve the mental health of refugees.
- Improve access to and utilization of mental health and psychosocial services by strengthening the capacity of lower community structures to identify and refer individuals for MHPSS.
- Training of village health teams (VHTs) and other community volunteers to identify mental health clients and provide first-care MHPSS.
- Train local leaders, including refugee welfare council leaders on aspects of mental ill-health.
- The District Council should consider reviving local ordinances (by-laws against the selling of harmful substances, such as alcohol and other drugs) and make operational funds available for effective monitoring of such legislative by-laws.