Public Mental Health in Low-Resourced Systems in Uganda: Lay Community Health Workers, Context and Culture

In this chapter, I aim to answer questions relating to the utilization of lay community health workers within public mental health systems in low- and middle-income countries (LMICs) and discuss perspectives on wider implications for mental health care in low-resourced settings. Building on national health responses to the nodding syndrome—a mysterious neuropsychiatric illness that was and is still relatively prevalent in post-conflict northern Uganda—we implemented a community health worker (CHW)-led intervention within the government health system. Outcomes from this and other research studies are discussed from a translation of research to practice paradigm, on provision of psychological treatments and community-based mental health care in routine health services. I conclude with insights and recommendations on the need to include emic and etic perspectives in determining burden of mental illness or disease, utilization of LCHWs and other task shifting initiatives to deliver effective public mental health interventions within low-resourced settings, the importance of systematic contextualization of evidence-based treatments as a prerequisite to scale up, and the need for “dual” generation and syndemic interventions to address children and adolescent mental health problems.