REPORT OF BUTABIKA NATIONAL REFERAL MENTAL HOSPITAL AT CAVENDISH UNIVERSITY STUDENTS 19th MARCH 2015

1. 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

2. 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

3. 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.

4. 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 inthe 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

5. 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.

6. 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.

7.  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

8.  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

9. 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)

10. 4..Developmental Disorders DEV/Children and adolescents

11. _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)

12. _ 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)

13. _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.

14. 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.