REPORT OF BUTABIKA NATIONAL REFERAL MENTAL HOSPITAL

AT CAVENDISH UNIVERSITY STUDENTS 19th MARCH 2015

BY

ABDIWALI ALI HASSAN Bcs (BH)

02/05819/146715/D

MARCH 2015

INTRODUCTION

Butabika National Referral Hospital, commonly known as Butabika Hospital is a hospital

in Kampala, Uganda's capital and largest city. It is the mental health national referral hospital

for the entire country's estimated population of 36 million in 2014.

BACKGROUND

Butabika Hospital was established in 1955, and currently is the only National Referral Mental

Health Institution in the Country. The Hospital provides specialised care to people with

mental illness. At the same time, it is a teaching hospital for all cadres specialising in Mental

Health ranging from nursing cadre to Postgraduate students. 

In addition to the above, Butabika Hospital also provides Out-patient services to the people

from the surrounding area.

Butabika Hospital is about 10 km East of Kampala City and it is the second biggest Hospital

in Uganda with a bed capacity of 550, though the number often ranges between 750-780. In

the next five years, the hospital aims at focusing more on developing and offering super

specialized services alongside the general mental health care services. To date, super

specialized services have started in the areas of Alcohol/Drug abuse, Psycho-trauma and

Child and Adolescent mental health care. More of such services are expected to develop in

other disciplines.

The Hospital currently handles a busy outpatient department with contact of about 350 clients

per day in both the general and mental healthcare areas. Over the years there has been an

increasing number of patients attended to at the hospital in spite of the inadequate human and

other resources.

In the years 2006, 2008 and 2009, the total numbers of patients attended to was 22,116,

23,966 and 25,440 respectively.

The Hospital continues to train different cadres in mental health, conducts mental health

related research and also offers support supervision countrywide.

Following the rehabilitation and refurbishment under the African Development Bank, the

Hospital infrastructure has been improved and equipped to be able to carry out all the above

functions given the appropriate and required human resources. 

Furthermore, these developments necessitate expansion of the existing structure to be able to

cope with the current demands on Butabika Hospital.

New positions are proposed in all departments to address the existing gaps.

VISION

A community aware of the importance of a complete state of physical, mental and social

wellbeing as a prerequisite for development and poverty alleviation through  reduced mental

health problems.

MISSION

To offer super specialized and general mental health services, conduct mental health training,

mental health related research and to provide support to mental health care services in the

country.

And hospital consist of many department

children ward sick ward

alcahol and drug unit lap and exry

private wing female sick ward

out patient department female adminstration ward

male adminstration ward occupational therapy ward

procurement female valescent ward

kireka ward male valescent ward

female recovery ward visitor/training house

admission block

Key functions/Objectives of butabika national referal mental hospital

The main functions of the hospital include:

A. To provide super specialized, curative and rehabilitative mental health services in the

country.

B. To undertake and support mental health related research.

C. To carry out and support training in mental health.

D. To provide outreach and mental health support supervision to Kampala district and

Regional Referral Hospitals.

E. To provide general health Outpatient services to the neighbouring population.

F. To provide advice to Government on mental health-related policies.

G. To advocate for mental health in the country.

There five access DSM in the hospital

clinic disorder access one

personal disorder access two

medical condition access three

psycological broplem access four

global assessmen access five

And there activity and servie providing alcohol and drugs rehabilition

psychometric assessment detoxification

nutrition therapy psychotherapy

occupatinal therapy vocational skills aseesment and training

spritula therapy family therapy

after care service home visit and follow up

community sensizatation program

There are many services that butabika hospital carry out

Mental Health Care

Core functions

a) Support diagnosis, management and recovery of people with mental illness

b) Provide social support to individuals and families with mental illness

c) Integrate patients into family and community systems

d) Support training of students in mental health

Activities

Resettlement of patients in their homes

Psychosocial support to patients and their relatives

Community education on community mental health promotion, support and

preventation.

Pre- service orientation on community mental health approaches.

Support supervision on injection control measures in the hospital.

Conduct integrated communicable disease surveillance

Psychiatric Socialwork Unit

Core function

To provide forensic and general psychiatric services to the populace.

Activities

1) Assessing of patients and offering the necessary interventions.

2) Carrying out mental health advocacy

3) Sensitizing, managing and controlling drug and substance abuse.

4) Conducting regular ward meetings.

5) Hands on training of students.

6) Running regular out patients clinics.

7) Conducting research.

8) Conducting regular technical support supervision to the lower health units.

9) Conducting mental health community outreaches.

Psychological Unit

Core functions

To apply psychological principles in the diagnosis and treatment of mental health problems.

Activities

Carrying out psychological assessment of individuals with emotional and other

cognitive disabilities

Planning and carrying out programs of psychological treatment for patients on

individual and ground basis as well as their families.

Promoting mental health through health education.

Participating in the supervision of clinical psychologists and counselor trainees on

placement.

Participating in community mental health activities.

Teaching.

Out-Patient Department

Core function

To provide essential and integrated preventive, curative, promotive and rehabilitative physical

and mental health care.

Activities

Assessment and treatment of outpatients.

Linking of community to the hospital through provision of Primary Health Care.

Surveillance of communicable diseases.

Training.

Clinic opened with bias in HIV/AIDS related counseling.

Technical support supervision of staff and students.

Conducting Child Health days in all primary and secondary schools adjacent to the

Hospital.

Records collection and management.

Occupational Therapy Department

Core function

To equip clients with skills to enable them to live independently in community with ability to

participate in balanced tasks related to productivity (work), leisure and self care.

Activities

Providing comprehensive clinical occupational therapy to the physically and

psychological handicapped patients.

Improving the patients’ quality of life by empowering them to participate in daily

activities.

Promoting general hygiene of patients on the wards by equipping them with skills to

maintain socially approved standards.

Offering day care services to Outpatients after discharge.

Offering OT services to hospital wards.

Offering psychosocial rehabilitation and community integration of patients.

Exploring potentials of recovering clients and indentifying specific areas for training

and re-training.

Establishing vocational opportunities to clients at community level through

establishing community projects.

Department of Support Services

To facilitate the Technical Departments, in their operations by ensuring the availability of

support facilities so that they can deliver quality services.

The Department comprises of four (4) divisions, namely:

Finance

Administration

Human Resource

Procurement and Disposal

Maintenance

Security

Laundry unit

Transport

Office management.

Management

Butabika Hospital is under the Ministry of Health and is semi autonmous. The Hospital has

departments which are further subdivided into units. All heads of departments are accoutable

to the Exective Director while the unit heads are accountable to the heads of department. 

The staff within the units are accountable to the unit /managers.

List Of Departments

1. Clinical

2. Nursing

3. Support services

Common disorders and Which priority condition(s) should be assessed?

1..Epilepsy / Seizures

Convulsive movement or fits / seizures

During the convulsion:

– loss of consciousness or impaired consciousness

– stiffness, rigidity

– tongue bite, injury, incontinence of urine or faeces

After the convulsion: fatigue, drowsiness, sleepiness, confusion, abnormal behaviour,

headache, muscle aches, or weakness on one side of the body

2..Depression

_Low energy; fatigue; sleep or appetite problems

_Persistent sad or anxious mood; irritability

_Low interest or pleasure in activities that used to be interesting or enjoyable

_Multiple symptoms with no clear physical cause (e.g. aches and pains, palpitations,

numbness) _Difficulties in carrying out usual work, school, domestic or social activitie

3..Psychosis

_Abnormal or disorganized behaviour (e.g. incoherent or irrelevant speech, unusual

appearance, self-neglect, unkempt appearance)

_ Delusions (a false firmly held belief or suspicion)

_Hallucinations (hearing voices or seeing things that are not there)

_Neglecting usual responsibilities related to work, school, domestic or social activities

_Manic symptoms (several days of being abnormally happy, too energetic, too talkative, very

irritable, not sleeping, reckless behaviour)

4..Developmental Disorders DEV/Children and adolescents

_Delayed development: much slower learning than other children of same age in activities

such as: smiling, sitting, standing, walking, talking / communicating and other areas of

development, such as reading and writing

_Abnormalities in communication; restricted, repetitive behaviour

_Difficulties in carrying out everyday activities normal for that age

5..Behavioural Disorders/Children and adolescents

_Excessive inattention and absent-mindedness, repeatedly stopping tasks before completion

and switching to other activities

_ Excessive over-activity: excessive running around, extreme difficulties remaining seated,

excessive talking or fidgeting

_Excessive impulsivity: frequently doing things without forethought

_ Repeated and continued behaviour that disturbs others (e.g. unusually frequent and severe

temper tantrums, cruel behaviour, persistent and severe disobedience, stealing)

_ Sudden changes in behaviour or peer relations, including withdrawal and ange

6..Dementia/ old people

_Decline or problems with memory (severe forgetfulness) and orientation (awareness of time,

place and person)

_ Mood or behavioural problems such as apathy (appearing uninterested) or irritability

_Loss of emotional control – easily upset, irritable or tearful

_Difficulties in carrying out usual work, domestic or social activities

7..Alcohol Use Disorders

_Appearing to be under the influence of alcohol (e.g. smell of alcohol, looks intoxicated,

hangover) Presenting with an injury

_Somatic symptoms associated with alcohol use (e.g. insomnia, fatigue, anorexia, nausea,

vomiting, indigestion, diarrhoea, headaches)

_Difficulties in carrying out usual work, school, domestic or social activities

8..Drug Use Disorders

_Appearing drug-affected (e.g. low energy, agitated, fidgeting, slurred speech)

_ Signs of drug use (injection marks, skin infection, unkempt appearance)

_Requesting prescriptions for sedative medication (sleeping tablets, opioids)

_ Financial difficulties or crime-related legal problems

_Difficulties in carrying out usual work, domestic or social activities

9..Self-harm / Suicide

_Current thoughts, plan or act of self-harm or suicide

_History of thoughts, plan or act of self-harm or suicide

* The Bipolar Disorder (BPD) module is accessed through either the Psychosis module or the

Depression module.

* The Other Significant Emotional or Medically Unexplained Complaints (OTH) module is

accessed through the Depression module.

References

1..Map Showing Central Kampala And Butabika With Distance Marker". Globefeed.com.

Retrieved 2 July 2014.

2.. Google, . "Location of Butabika Hospital At Google Maps". Google Maps. Retrieved 2

July 2014.

3.. BNRH, . "Profile of Butabika National Referral Hospital". Butabika National Referral

Hospital (BNRH). Retrieved 2 July 2014.

4.. Lydia Lakwonyero, and Simon Longoli (8 June 2009). "Uganda Lacks Psychiatrists". New

Vision. Retrieved 2 July 2014.