Browsing by Author "James Mugisha"

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Barriers to treatment seeking for depression among elderly service users at Butabika national referral and teaching hospital, Kampala- Uganda
(Aging & Mental Health, 2025-01-15) Sumani, Ganafa; Japheth Kwiringira; James Mugisha; Eddy Walakira
Objectives Depression among the elderly is a significant public health concern in Uganda, where cultural, social, and healthcare-related barriers hinder access to treatment and support. This study examines the barriers to mental health service access faced by elderly service-users in Uganda. Method Using an interpretive phenomenological approach, in-depth interviews were conducted to capture the lived experiences of elderly Baganda service users receiving treatment at Butabika National Referral and Teaching hospital. Results The findings reveal an intricate interaction between cultural, social, economic, and healthcare system-related barriers. Key barriers include limited mental health awareness, financial constraints, fragmentation, drug shortage and geographical access. Social and cultural stigma further exacerbate these challenges contributing to delayed or avoided help-seeking behaviours among the elderly. Conclusion The study highlights the intersectionality of aging and mental health issues, underscoring the urgent need for a comprehensive, integrated approach to mental health care for the elderly. This research calls for targeted interventions to reduce stigma, increase mental health literacy, and improve the accessibility and affordability of care for vulnerable elderly populations in Uganda. Such services can improve mental health outcomes and quality of life for the elderly in Uganda.
From implementation to sustainability? A 5-year follow-up on a physical activity counseling program in Uganda for people with HIV and mental health conditions
(Psychological and Socio-medical Aspects of AIDS/HIV, 2025-09-01) Davy, Vancampfort; James Mugisha
Physical activity (PA) interventions benefit people living with HIV and co-morbid mental health conditions, but sustaining them in low-resource settings remains difficult. This study explored the long-term sustainability of a multi-stakeholder PA counseling program in a rural Ugandan fishing community, five years post-implementation. The program integrated a PA counseling into routine HIV care, combining motivational interviewing and self-determination theory. It began with sessions led by health care providers and later transitioned to lay-led group sessions that focused on goal-setting, identifying barriers, and fostering community support. Using a context–mechanism–outcome (CMO) framework and Strengths, Weaknesses, Opportunities, and Threats (SWOT) analysis, a focus group (n = 10) involving patients, lay health workers, and staff identified key influencing factors. Although the program ended, PA awareness and some brief counseling persisted. Lay health workers remained partially active despite unpaid roles and limited supervision. Early success was supported by family involvement, and stakeholder enthusiasm, while long-term delivery was hindered by funding gaps and persistent stigma. Sustainability was supported by co-creation, community engagement, and task-shifting, but depended on material support and health system integration. Future efforts should prioritize early financial planning, integration into existing systems, and strengthening of lay roles through stable funding and supportive policy.
Lay-health workers-led physical activity counseling in Ugandan people living with HIV and suicidal ideation
(Taylor & Francis, 2025-01-18) Davy, Vancampfort; James Mugisha; Tine Van Damme
The aim of this one-group quasi-experimental study was to assess the efficacy of 8-week physical activity (PA) counseling program delivered by lay health workers (LHWs) in reducing suicidal ideation among people with HIV in Uganda. The counseling, based on the self-determination and motivational interviewing frameworks, consisted of 15-20 minute individual sessions for individuals from remote areas or 60-90 minute group sessions within the health center. Thirty-five (26 women, median age = 29.5years) participants completed the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), HIV/AIDS Stress Scale (HSS), World Health Organization Disability Assessment Schedule-2 (WHODAS-2) and Simple PA Questionnaire pre- and post-intervention. Post-intervention only 2 of the 35 participants reported suicidal ideation (PHQ-9 item 9 ≥ 1) (p < 0.001). Significant reductions in GAD-7, PHQ-9, HSS, SIMPAQ sedentary and WHODAS-2 scores and an increase in SIMPAQ PA score were observed. LHWs-led PA counselling is promising in reducing suicidal ideation in most people with HIV in low-resourced settings.