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Global spotlight on mental health


Adelaide priest Mgr David Cappo AO has addressed a global health summit in Berlin about mental health challenges in low-income countries such as Uganda.

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Mgr Cappo is co-founder and chief executive officer of YouBelong Uganda (YBU), a mental health support and advocacy organisation.

The former Commissioner for Social Inclusion for the South Australian Government and Vicar General of the Adelaide Archdiocese from 2000 to 2010 has been living in Uganda for much of each year, over the past seven years.

His work in the area of mental health in a country where evidence-based health services are drastically under resourced has caught the attention of leading international health professionals, resulting in an invitation to speak at the 2023 World Health Summit held annually in Germany.

In his address entitled ‘Nothing About Us, Without Us’ Mgr Cappo told the conference that people with severe mental disorders in countries like Uganda can be found in large over-crowded hospitals in “asylum-like conditions”.

“In Kampala, the national psychiatric hospital has over 1200 patients with only a bed capacity of 600,” he said.

“As there is very little community based mental health care in Uganda, this tertiary hospital ends up as a
de facto primary care facility.”

Mgr Cappo said a new and innovative approach was needed to begin to fill “this huge treatment gap”.

One innovation that is delivering successful results is called YouBelong HOME.

“We have developed new assessment and empowerment tools to resettle people back to their families, and with psycho-social and educational support, significantly reduce readmissions and assist families to manage relapses at home,” he said.

“And, as most families will take their family member to alternative care providers such as faith and traditional healers, it is important for YBU to connect and if possible, collaborate with this influential part of the informal health sector.”

The main goal at YBU is to strengthen the Ugandan health system.

“It is fragile, and there is next to zero mental health care within the community-based health centres,” Mgr Cappo said.

“As part of achieving this goal, we assist in training health workers at community health centres in mental health diagnosis and treatment planning, as we try to shift the focus away from institutional care in asylum-like conditions, to community-based care.”

Another innovation is a trial evaluating how someone in an advanced state of recovery from psychosis can be engaged within the various levels of the health system.

Youth consultative groups are being used to share vital information about how many of them struggle with their mental illness, particularly in schools where teachers have no understanding of mental health and “treat them harshly, shame them, or beat them”.

“This has led us to begin programs to train teachers in understanding mental illness in children and how to manage difficult behaviours in the classroom,” he said.

“When we engage, as in this context, with the lived experience of persons in recovery from psychosis, we engage with their human dignity, their human rights, their relational history and the recognition of their moral authority in being active agents of their own health care

“We are helping to invert the pyramid. For too long, persons with mental illness have been seen as passive objects of health care, and in many situations, treated as second class citizens.  A huge shift is occurring.

“The lived experience of people with mental illness, is more and more being placed at the top of the pyramid of care, driving the design of mental health research work, influencing mental health policy at government level, and assisting in the design and delivery of services.

“These important words, must become a reality…nothing about us, without us.”

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