Citation

Mwesiga EK, Nakasujja N, Muhwezi WW, Musisi S. Lancet Psychiatry 2021; ePub(ePub): ePub.

Copyright

(Copyright © 2021, Elsevier Publishing)

DOI

10.1016/S2215-0366(21)00070-5

PMID

33740413

Abstract

As seen elsewhere, the COVID-19 pandemic in Africa has created an urgent need for an isolated space in which to manage patients with COVID-19. In high-income countries such as China, the UK, and the USA, standalone units were built to cater for the extra isolation space required to manage a surge in COVID-19 confirmed cases. In much of Africa, building such units was not possible because of financial, infrastructural, and human resource constraints. Mental health units that conventionally stand alone, far from other health services, were deemed appropriate for the isolation of patients with COVID-19. In Uganda, the only national referral inpatient mental health unit (Butabika Hospital, Kampala, Uganda) has only 638 inpatient psychiatric beds for a population of almost 50 million people. Between Jan 1 and Dec 31, 2018, the bed occupancy rate of Butabika Hospital was 149%. Even with such a high demand for beds in Butabika Hospital, lower level regional psychiatric units were converted into isolation units for COVID-19.3

The transformation of psychiatric units into isolation centres in low-income countries such as Uganda requires mental health providers to adopt new care models that do not involve these standalone units. Models for community mental health care, such as integrating psychiatric care into everyday clinical practices, are crucial during this pandemic. Integrated mental health care is an attempt to combine behavioural health services wholly or partly with general and specialty medical services. Care models that ensure staff and patient safety while managing psychiatric and non-psychiatric patients together should also be promoted. For example, the Safewards model aims to...

Language: en