Mental Health Care, Built to Last
In Uganda, a district is a local government area responsible for running its own health clinics, schools, and community services. District-led mental health integration is one where StrongMinds partners with that local government to build mental health care directly into the public services already in place, rather than running a separate program alongside them.
For example, health workers who already visit homes start screening for depression and teachers already in classrooms get trained to support students. Over time, the goal is for the district to take on the funding and leadership itself, until the work no longer depends on StrongMinds at all.
14.7 million Ugandans are living with a mental illness.
85% lack access to mental health services.
More than 25% of women in Uganda are affected by depression.
Integration, Not Limitation
In most of our work, StrongMinds is the main implementer, running programs directly. This approach is different: instead of adding a new program, we help systems that already exist absorb mental health as part of their normal work. Health center staff, teachers, community and gender officers, refugee liaison officers, even prison and police officers, each folds basic mental health screening or support into the job they already do, using a shared set of tools and training rather than a separate StrongMinds effort running alongside them.
It starts with community awareness and the appointment of a district Mental Health Focal Person: a formal government role dedicated to leading the work locally. From there, routine depression screening and IPT-G (group interpersonal therapy) get folded into existing health and community services, delivered by trained local volunteers rather than clinical staff.
Mental health becomes a line item in district plans and budgets, and as local ownership grows, the district gradually takes on more responsibility for running and financing the work — while StrongMinds shifts into a technical support role: identifying gaps, training Village Health Teams, mentoring focal persons, strengthening referral pathways to district hospitals for people who need more intensive care, and supporting community outreach. The goal: government funds and runs this as part of its own development priorities, not as a program that depends on outside support.
Starting with the District Scorecard
Before treatment even begins, StrongMinds uses a district scorecard, a social accountability tool that measures how far a district’s mental health integration has progressed, and brings that assessment to a dissemination meeting with local stakeholders, so priorities get agreed on together rather than handed down. It’s the first of five scorecard tools StrongMinds has developed to help districts track their own progress.
The Masaka Pilot
1,162
people enrolled in treatment
861
people completed therapy
134
community facilitators trained (health workers, district officers, and community leaders)
31
teacher facilitators, school leaders, and district education officers equipped to support students’ mental well-being
134
Village Health Team volunteers became community mental health advocates
5
health centers now offering monthly mental health outreach
Local ownership followed close behind: the district committed to paying community facilitators a stipend for each therapy session they run and contributed $530 from its own budget to training, showing a district choosing to invest its own money because it saw the results.
Government Ownership, District by District
Across 34 districts, mental health is increasingly becoming part of how governments deliver services.
In Health Systems
- Village Health Teams are promoting mental health awareness and linking people who need support to care.
- The Ministry of Health is piloting mental health indicators through its User Assessment Tool in Mayuge and Wakiso.
- Abim District has ensured that every health facility has a dedicated mental health budget.
In Education Systems
- School Guidance and Counseling Committees have been established, with teacher facilitators helping bring mental health into the classroom, reinforced nationally by Circular 20 and the Mental Health and Psychosocial Support Guidelines.
- Kamuli now requires schools to report on mental health in their termly reports.
- Jinja City has built mental health into school timetables.
- Masaka has integrated mental health and psychosocial support into its Continuous Professional Development program for teachers.
Beyond Health and Education
- Community and Gender Officers are working with para-social workers and people with lived experience to strengthen community support.
- In refugee settlements, Refugee Liaison Officers are connecting displaced populations to mental health services.
- Within Internal Affairs, prison officers and police volunteers are being equipped to recognize and respond to mental health needs.
- Religious and cultural leaders, already trusted voices in their communities, are being engaged to help shift attitudes toward mental health and reduce stigma.
To track progress, StrongMinds has introduced five scorecard tools, including the district scorecard mentioned above, that let local governments measure and strengthen mental health integration across sectors themselves. Alongside the scorecards, client outcomes are tracked directly: depression symptoms are measured with the PHQ-9 scale before treatment, then again at 14 days and 6 months after therapy ends, to check whether the improvement is holding.
Care Where People Already Are
Integrating mental health into primary health care is one of the most consistently recommended health system reforms worldwide. Rather than waiting for people to reach a specialized hospital, this approach strengthens support at the community, school, facility, and district level, building on government-supported therapy groups that StrongMinds Uganda has already tested and refined.
- Reduces stigma, through community dialogue, radio talk shows, and public conversations between residents, health workers, and local leaders.
- Improves access to care by putting support inside the schools, clinics, and community roles people already trust and use.
- Catches problems early, through routine depression screening rather than waiting for a crisis.
- Creates a safety net for severe cases, with clear referral pathways connecting people to district hospitals and specialized care when they need more than group therapy can offer.
- Builds a mental health workforce that stays, by training the community volunteers, teachers, and local leaders who keep the work running long after StrongMinds steps back.
Where This Goes Next
Signed MOUs, mental health built into district development plans and budgets, and districts recruiting mental health professionals as the Ministry of Health recommends.
Moving them from administrative coordinators to decision-makers with real authority over mental health budgets, medicine supply chains, and oversight of group therapy across facilities.
Taking the same path Masaka followed, from district leadership buy-in to trained community and school facilitators, and walking each new district through it toward full local ownership.
Keeping district health, education, and multisectoral committees talking to each other, alongside gender, refugee, and internal affairs actors already involved, so mental health stays everyone’s responsibility rather than one office’s alone.