Health
Ugandan Study Flags Girls and Senior Students as a Mental Health High-Risk Group
Based on research led by Max Bobholz and colleagues from Makerere University in Uganda, Essentia Institute of Rural Health, and the Medical College of Wisconsin in the United States.
Adolescence is meant to be a time of holistic growth and self-discovery, but for many Ugandan teenagers, this period is becoming a season of silent mental health struggles. A new study published in PLOS Global Public Health has uncovered a silent but growing crisis: nearly one in five Ugandan secondary school students in the study areas have signs of an emotional disorder. These conditions included anxiety, depression, post-traumatic stress disorder (PTSD), and adjustment disorders often involving excessive worry, sadness, fear, or mood instability. Also, one in 20 adolescents exhibited behavioral issues ranging from attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder to substance use and other risky behaviors like alcohol use.
The study, led by Max Bobholz, a PhD candidate in Public and Community Health at the Medical College of Wisconsin, surveyed a sample of 1,953 students aged 10 to 18 years enrolled in eight secondary schools in Iganga district in Eastern Uganda and Mukono district in Central Uganda. This was one of the most comprehensive efforts yet to understand the prevalence and drivers of mental health challenges among school-going Ugandan adolescents.
“We are looking at a generation facing a complex blend of stressors, namely, academic, social, and emotional,” says Bobholz. “Our findings show that certain groups are especially vulnerable, and schools need to be equipped to respond.”
This study results, published on June 12, 2025 was funded by the Swedish International Development Cooperation Agency (SIDA), a government agency of the Swedish Ministry for Foreign Affairs, through the Makerere University Postdoctoral Fellowship to one of the investigators, Dr. Catherine Abbo. Other researchers included Julia Dickson-Gomez, Arthur Kiconco, Abdul R. Shour, Simon Kasasa, Laura D. Cassidy, and Ronald Anguzu.
According to the study, girls bear a higher emotional burden. Researchers found that female students had nearly two times higher odds of suffering from emotional disorders such as anxiety or depression than their male peers.
Dr. Catherine Abbo, an Adolescent Psychiatrist and Associate Professor at Makerere University, attributes this to both biological and socio-cultural factors. “Puberty brings hormonal shifts that can heighten emotional sensitivity,” she explains. “But just as importantly, Ugandan girls often face intense pressure to conform to gender roles while also navigating issues like body image, harassment, and future uncertainty.” The researchers are calling for gender-sensitive mental health interventions, particularly in schools, where early support could help mitigate long-term mental health issues.
Higher associations in older teens?
Age also emerged as a key associated factor, with each additional year increasing the odds of behavioral disorders by 20%. “As adolescents grow older, they are more prone to risk-taking, impulsivity, and resistance to authority,” explains Dr. Simon Kasasa, a senior lecturer and biostatistician at Makerere University School of Public Health.
“Combine that with academic pressure and identity-related stress, and it’s no surprise we’re seeing more conduct issues in late adolescence,” Dr. Ronald Anguzu, an Assistant Professor in the Institute for Health and Humanity at the Medical College of Wisconsin, added. This study raises critical questions about whether and how Ugandan secondary schools support older students as they transition toward adulthood.
The unseen influence of family mental health
The study also found that adolescents with a family history of mental illness had twice the odds of exhibiting behavioral problems compared to those without such a history.
“This speaks to the intersection of genetics and environment,” says Bobholz. “Living in a household with people affected by mental illness can mean instability, stigma, and lack of emotional support, all of which weigh heavily on a developing mind.”
The authors recommend that school mental health screening include family mental health history and advocate for greater collaboration between education and health sectors to support at-risk households.
Private schools: High marks, higher stress?
Interestingly, students in private schools had 1.4 times the odds of experiencing emotional disorders compared to those in public schools. Private schools, often seen as academic havens, may inadvertently be cultivating high-pressure environments. “There’s an assumption that better facilities mean better well-being,” says Dr. Abbo. “But intense academic competition, social isolation, and a lack of trained counselors can create emotional pressure cookers.”
Previous research in 47 secondary schools across five districts (Rakai, Kyotera, Masaka, Lwengo, and Kalungu) in southwestern Uganda found that economic and family support helped reduce absenteeism among adolescent girls in secondary schools. However, this support did not significantly improve behavior or reduce grade repetition. The region, which includes districts like Rakai and Masaka, also faces a higher burden of HIV, adding to the challenges young people experience.
Meanwhile, a review of data from 42 primary schools in Luwero District identified school-based mental health interventions such as cognitive behavioral therapy and mindset-building approaches as being particularly effective. Researchers now suggest that integrating these strategies, along with efforts to reduce school violence, could go a long way in improving the mental health of Ugandan adolescents.
A-Level pressure: Academic ambition meets mental health strain
The study also found a correlation between advanced (A’level) education and increased risk of emotional disorders. “We selected one school district from each region based on population and past academic performance. As these students prepare for university or the job market, the pressure to succeed becomes enormous,” says Kasasa. “They’re facing a future full of uncertainty, with very little structured mental health support to help them cope.”
A wake-up call for Uganda’s education and health systems
The authors of this study assert the urgent need for school-based mental health programs, especially in private and A-level institutions. These programs should offer routine screening, emotional support, and training for teachers to recognize warning signs of mental health disorders.
Importantly, this study adds weight to calls for a national adolescent mental health policy, tailored to Uganda’s context, with interventions that bridge health, education, and social services.
“Our data shows that mental health challenges are not a fringe issue,” says Bobholz. “They are widespread, significant, and deeply tied to school, home, and society.”
The COVID-19 school closures between 2020 and 2022 deepened feelings of isolation and financial strain, with out-of-school adolescents reporting depression rates as high as 21.5% to 50% higher than their peers who remained in class, according to research published in February 2025. Yet Uganda invests less than 1% of its health budget in mental health, with just one psychiatrist per million people, leaving many teens to cope through cheap alcohol used by 28% of urban youth or untrained healers, as reported by the government paper The New Vision in April 2025. With only 26% of students completing lower secondary school and 35% of the population under age 24, these mental health challenges now pose a serious threat to the country’s future.
Mercy Akankunda of Proven Foundation, a Ugandan NGO supporting vulnerable groups, warns that mental health struggles are quietly eroding the well-being of the country’s youth, over 12 million strong and making up 35% of the population. “These teens are not just statistics. They are the future of Uganda, she asserts. If Uganda hopes to reap the dividends of its young population, addressing adolescent mental health must become and remain a national priority, not just for treatment, but for prevention, resilience, and hope.
Reference:
Bobholz, M., Dickson-Gomez, J., Abbo, C., Kiconco, A., Shour, A.R., Kasasa, S., Cassidy, L.D., & Anguzu, R. (2025). Correlates of behavioral and emotional disorders among school-going adolescents in Uganda. PLOS Global Public Health. Read the study here
Health
Ministry of Health Launches National University Health Screening Initiative at Makerere 92nd Guild Medical Camp
Despite a morning downpour, the two-day 92nd Makerere University Guild Annual Medical Camp successfully commenced on September 17, 2026 with a launch at the Freedom Square.
The Launch marks a strategic partnership between the Ministry of Health and higher education institutions to advance physical well-being and awareness of students from public and private universities.
Presiding over the event, the Minister of State for Health (General Duties), Hon. Anifa Kawooya Bangirana, launched the intensified testing and active case finding for Malaria, HIV/AIDS and Sickle Cell Disease.
Ministry officials emphasized that laboratory screening and diagnostic testing are critical entry points for early detection, linkage to care, appropriate clinical management, surveillance and prevention, and the Ministry of Health pledges full support to strengthen these services across universities nationwide.
Held under stewardship of the Makerere University Dean of Students office, the camp offered a comprehensive suite of health services to the student body and the wider community. Attendees had access to the following services:
- General and Specialist Consultations
- Sickle Cell, Malaria RDT and HIV Screening
- Eye Care and Laboratory Diagnostics
- Free Essential Medicines
- Reproductive Health Counseling
- Mental Health Counseling
While addressing the attendees, Hon. Kawooya emphasised that health is synonymous with national economic productivity.
She guided the youth to prioritise well-being, and avoid living in denial for it is the first step to refusing help. This will help build a firm foundation for any future contributions to national development.
The Minister further warned students against risky behaviours, including substance abuse and sexual immorality, which she described as poisonous.
She advocated for responsible reproductive health practices, urging students to utilise resources available to protect themselves for the future.
Why you should Know Your Status
Prof. Charles Olaro, who is the Director General of Health Services at the Ministry of Health, Uganda reflected on his time at the university during the peak of the HIV epidemic, recalling a visit from the late Bongole Lutaya.
He noted that today’s youth have not witnessed the severity of the AIDS due to the availability of care and ARVs, which can create a false sense of security.
“People are in care and you have not seen the real slim disease. You have not seen it”
He added that some attending are products of mothers that undertook prevention of mother-to-child transmission of HIV, and they gave birth to negative children. But now when we are grown up, they are reckless with their sexual life.
Prof Olaro summarized his remarks by noting that health is an irreplaceable asset and that decisions made today have significant future ramifications. They urge the audience to take the opportunity to know their status, whether for HIV or sickle cell disease, as this is the essential entry point for care and life planning.
Benefits of knowing your status:
- It serves as the entry point for receiving necessary care.
- It allows for better life planning.
- It enables individuals to manage other aspects of their lives effectively.
- It prevents future health complications.
Genetic Awareness and Blood Donation
Associate Professor Richard Idro the Deputy Principal of the Makerere University College of Health Sciences (MakCHS) emphasised the importance of seeking appropriate information with a focus on genetic awareness. He advised the students to know their status before marriage to prevent passing on genetic conditions.
“One day when you fall in love, you know that preferably you should not marry somebody who is also carrying a certain gene.”
He then delved into the importance of treating HIV and clearing malaria parasites, which he addressed exhaustively.
From this, Dr Idro’s focus turned to blood donation where he acknowledged a number of people that had already participated in the exercise at the Uganda Red Cross Society tent.
“I see the Red Cross at one corner. As we passed there, 36 people had donated blood. Although, gentlemen, I saw very few of you donate blood.”
He concluded by challenging the young men present and reminding them that they can donate blood up to four times a year and still remain healthy.
Empowering Ambassadors of Global Health Awareness
The Ministry of Health called upon the students attending the camp to serve as ambassadors for global health awareness in their respective institutions.
The Executive Director/Commissioner National Health Laboratory and Diagnostic Services (NHLDS), Dr. Susan Nabadda Ndidde advised the students to make sure that they mobilise and intensify testing for all these diseases.
“We will work with you as a Ministry to provide the tests to make sure that we know your status and prevent these diseases in time.”
She wrapped up her message by thanking Makerere for allowing the Ministry of Health to partner on this cause and urged the students to embrace this opportunity and make sure they leave after establishing their status.
By bringing these critical services directly to campuses, the government fosters a healthier, and more informed generation capable of driving Uganda’s future development.
Students Appreciate the Medical Camp
According to Denise Kainomugisha, the Chairperson of the Makerere University School of Public Health (MakSPH) and Vice Minister of Health in the 92nd Guild, the Camp served as a vital platform for capacity building.
“The screening, the testing, the sports science, was all handled by the student volunteers under supervision” she confessed.
She also explained that the camp extended to broader public health goals and additionally fostered leadership and collaboration among students, who were encouraged to work together to address community health needs.
Concluding her remarks, Kainomugisha expressed gratitude to the respective partners for providing both financial support and the opportunity for students to take on active roles throughout the Medical Camp.
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