Dr. Nakku is advocating for decentralization—expanding services to regional and community health centers to enable early intervention and reduce pressure on the national facility.
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A tense session in Parliament this week has brought Uganda’s mental health crisis into sharp focus, with officials from Butabika National Referral Hospital warning that the country’s primary psychiatric institution is overwhelmed and under-resourced.
Appearing before the Parliamentary Public Accounts Committee (PAC) on March 16, Executive Director Juliet Nakku painted a picture of a system stretched beyond its limits.
“We are stretched beyond capacity,” she told lawmakers.
Her testimony revealed stark staffing shortages: just 14 psychiatric specialists are currently serving more than 1,000 patients. On the wards, the imbalance is even more severe, with one nurse responsible for up to 60 patients—conditions that health workers say make meaningful care increasingly difficult.
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The hearing comes amid a rise in mental health cases across Uganda, including depression and suicide, as stigma and limited access to services continue to hinder early treatment. As a result, Butabika remains the country’s main point of care, absorbing cases from across the nation.
Dr. Nakku told MPs that sh120bn is urgently needed to begin addressing the crisis. The funds, she said, would support recruitment of critical staff, expansion of infrastructure, and improvements in patient care.
However, the hospital’s challenges are not limited to capacity alone.
Officials from the Office of the Auditor General raised concerns over financial accountability during the same session. Billions of shillings allocated for hospital activities were not fully accounted for, with only half of 72 planned activities clearly documented. The findings prompted questions from lawmakers about transparency in the use of already limited resources.
The discussion also exposed deeper societal tensions surrounding mental health. Asuman Basalirwa asked whether some conditions could be linked to witchcraft—reflecting beliefs still held in parts of the country.
In response, Dr. Nakku emphasized that treatment at Butabika is grounded in medical science. While some patients arrive with cultural explanations for their illness, the hospital focuses on clinically diagnosable conditions.
Beyond the committee room, experts warn that the crisis at Butabika reflects a broader structural issue. With mental health services largely centralized in Kampala, many patients only receive care once their conditions have become severe.
Dr. Nakku is advocating for decentralization—expanding services to regional and community health centers to enable early intervention and reduce pressure on the national facility.
For now, the strain is visible inside Butabika’s wards.
Patients fill overcrowded rooms. Nurses move quickly between beds. Doctors juggle heavy caseloads with limited support.
As Parliament weighs its next steps, one reality remains unchanged: Uganda’s mental health system is under pressure—and time, for many patients, is running out.