Acceptability, feasibility and perceived benefits of integrating mental health and psychosocial support (MHPSS) into disease outbreak response in Western Uganda: a qualitative process evaluation study.

Introduction: Disease outbreaks cause widespread suffering, loss of lives and significantly increase the risk of mental health and psychosocial problems. Although mental health and psychosocial support (MHPSS) plays a critical role in addressing the needs of populations affected by outbreaks, limited efforts have been made to integrate MHPSS into outbreak response mechanisms. In this study, we developed, implemented and evaluated priority MHPSS interventions to examine acceptability, feasibility and perceived benefit of MHPSS interventions as part of outbreak response in Uganda. Methods: The interventions were implemented in Bundibugyo district, Western Uganda, from November 2024 to March 2025 and evaluated through a qualitative process evaluation. The interventions targeted primary healthcare workers, frontline responders, community leaders and district health team leaders. Study participants were selected purposively and data were collected through in-depth interviews. We used a thematic analysis combined with inductive and deductive approaches to capture emerging themes. Results: We conducted in-depth interviews with 19 purposively selected individuals representing community members, implementers and public health leaders. Participants perceived the interventions to be acceptable due to active engagement with the community leaders, community health workers, district leadership and collaboration with the local media. The findings strongly suggest that the programme was feasible because it was deliberately designed and systematically implemented with a community-driven approach. The feasibility of the programme was reflected across five key constructs: practicality, cultural appropriateness, perceived benefit, sustainability and implementation challenges. Participants reported that the interventions helped address serious mental health concerns, including reducing the risk of self-harm, suicide and stigma, while equipping frontline workers with stress management skills. Conclusion: Despite the high level of acceptability and feasibility reported, several challenges may hinder the uptake and scale-up of MHPSS interventions in outbreak-affected communities, particularly stigma and misconceptions surrounding mental health conditions. These challenges highlight the requirement for sustained community engagement and continuous sensitisation efforts.