Skip to content

Why therapy should be culturally appropriate

[Trigger warning: this blog talks about suicide]

Dr Ethel Nakimuli-Mpungu understands the tragedy of mental illness from a deeply personal level: her brother was 26 when he took his own life after struggling with a severe mental health condition for 10 years.

“I have lived the pain, the anger and the shame. The denial, the guilt and the blame,” she told the audience at a recent TEDx Talk in London. “Despite the fear, we must act on mental health issues.”

Ethel studied psychiatry at Makerere University College of Health Sciences in Uganda. Her research, published in The American Journal of Psychiatry, highlighted the burden that mental health problems have on people living with HIV AIDS in Africa. 

She was later offered a doctoral degree in psychiatric epidemiology at John’s Hopkins University in the USA to continue her work.

It was whilst she was studying in America, away from her family and with a four-month-old baby, that she began to feel the effects of depression herself. “The hunter for solutions of depression had become the hunted, my thoughts became increasingly negative: I was a bad mother, I was a bad wife, I was a bad student.”

But when she went to seek support, she was told she didn’t have the right insurance and there was no therapist appropriate for her. She realised she needed to help herself. She combatted depression by creating a support network around her, she shared her problems more often and got an online job so she could make regular trips back to Uganda to see her family and friends.

Sadly, her colleague, also a full-bright scholar in the same graduate programme, did not survive depression and died by suicide

It was this devastating experience that galvanised Ethel further to tackle depression: “I thought about the people living with HIV AIDS in Uganda, struggling with depression with no access to treatment. I made a decision: I was going to help them,” Ethel said.

Tackling depression in Uganda comes with unique challenges, as Ethel explains: “Research has shown that poverty is highly associated with depression. In the African context, any intervention for depression must address the issue of poverty.”

And the stats back this up: 350 million people are living with depression, 7 out of 10 of those people are living in poverty. And out of those 7, 5 of them do not have access to treatment.

Ethel’s plan was to create a culturally sensitive programme that could tackle depression in people living with HIV and AIDS, that would be able to be implemented in Africa.

We’re funding her work to develop and run this programme – which trains health workers to deliver group psychotherapy.

“In Africa, we see our communities as an extension of ourselves, so our group approach is not only a good fit for our culture but it also allows greater access to the programme,” Ethel says.

The groups are also separated by gender, as problems men and women face in these areas differ. Those attending the sessions are given skills to be able to combat depression.

She’s seen huge positive impact from the programme, men and women feel more empowered to tackle their symptoms, enabling them to live full lives. “We have a formula here that works!” she says. 

Now she wants to see it embedded into other health services and spread across Africa. As Ethel says, this work can “not only save lives, but enable people to thrive.”

Last updated: 18 December 2017

Subscribe to our newsletter. Get the latest news on mental health.

© MQ: Transforming mental health 2016 | Registered charity in England / Wales: 1139916 & Scotland: SC046075 | Company number: 7406055