Sammendrag
Abstract
Background: Child mental illness contributes signifcantly to the burden of disease worldwide, and many are
left untreated due to factors on both the provider and user side. Recognising this, the Ugandan Ministry of Health
recently released the Child and Adolescent Mental Health (CAMH) Policy Guidelines. However, for implementation to
be successful the suggested policy changes must resonate with the service users. To better understand the sociocultural factors infuencing parental mental help-seeking, we sought insights from parents in the Mbale district of
eastern Uganda.
Method: In this qualitative study, eight focus group discussions were conducted with mothers and fathers in urban
and rural communities. Parents of children younger than 10 years were purposively selected to discuss a vignette
story about a child with symptoms of depression or ADHD as well as general themes relating to child mental illness.
The data were analysed using qualitative content analysis.
Results: Descriptions of severe symptoms and epileptic seizures were emphasised when recognising problem
behaviour as mental illness, as opposed to mere ‘stubbornness’ or challenging behaviour. A mixture of supernatural,
biomedical, and environmental understandings as underlying causes was refected in the help-seeking process, and
diferent treatment providers and relevant institutions, such as schools, were contacted simultaneously. A notion of
weakened community social support structures hampered access to care.
Conclusion: Awareness of symptoms closer to normal behaviour must be increased in order to improve the recognition of common mental illnesses in children. Stakeholders should capitalise on the common recognition of the
importance of the school when planning the upscaling of and improved access to services. Multifactorial beliefs
within the spiritual and biomedical realms about the causes of mental illness lead to multisectoral help-seeking, albeit
without collaboration between the various disciplines. The CAMH Policy Guidelines do not address traditional service
providers or provide a strategy for better integration of services, which might mean continued fragmentation and
inefective service provision of child mental health care.
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