Voices from the ground: Qualitative perspectives on Ugandan national mental health system strengths, challenges, and recommendations.

Mental health capacity building is a growing priority in Ugandan healthcare systems. Despite increased governmental attention to community mental health and mental healthcare needs, no empirical assessments document qualitative perspectives from stakeholders in the Ugandan mental health system. The goal of the current needs assessment study was to systematically explore stakeholders' perceptions of strengths, challenges, and recommendations for enhancing capacity in the national mental health system in Uganda. Using ethnographic research methods, data were collected from 15 key informant interviews and four community focus groups with a total of 44 stakeholders involved in mental healthcare in Uganda. Thematic analyses of data yielded several themes in each domain, including 1) system strengths reflected in the existing policy and action plan, free medications, growing private sector, and partnerships and collaborations; 2) system challenges including socioeconomic constraints, stigma, and limited family engagement; and 3) recommendations surrounding enhanced education and training, integrating systemic approaches, and policy advocacy. We describe clinical, research, and policy implications that can inform systemic mental health efforts in Uganda and comparable global settings.