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
The 92nd Guild Ministry of Health is set to host the Annual Makerere Guild Medical Camp, a three-day outreach that will bring free and essential medical services to students, staff, and the surrounding community. The camp will run from 17th to 19th September 2026, from 8:00am to 5:00pm each day, at the Freedom Square.
Themed around promoting student wellness for academic excellence, the medical camp is organised under the leadership of Hon. Wamezaya Ebenezer, the Minister of Health in the 92nd Guild Government, in alliance with several partner organisations supporting the university’s health and wellness agenda. The initiative reflects a growing recognition within student leadership circles that academic performance is closely tied to the physical and mental wellbeing of the university community.
Comprehensive Range of Services
The medical camp will offer a wide range of services designed to address both routine and specialised health needs. On the general health side, attendees will have access to general and specialist medical consultations, allowing students, staff, and community members to seek professional advice on a variety of health concerns without the usual costs associated with private or even public healthcare.
Screening services will also be a central feature of the camp. Organisers have confirmed that sickle cell testing, malaria rapid diagnostic testing, and HIV screening will be available on site, giving participants the opportunity to know their status and receive guidance on appropriate next steps. Eye care services and laboratory diagnostics will round up this category, addressing common but often neglected areas of student health.
Beyond diagnostics and consultations, the camp will provide free essential medicines to those who need them, easing the financial burden that often accompanies treatment even after a diagnosis has been made. Reproductive health counseling will also be offered, giving students a confidential space to discuss matters that are frequently overlooked in general campus health conversations. Mental health counseling completes the list of available services, an inclusion that speaks to the increasing attention being paid to psychological wellbeing within the university community.
A Camp Open to the Wider Community
While the camp is organised by the Guild Ministry of Health and centred on student welfare, its reach extends beyond the student body. Organisers have made it clear that the free medical services will be available to students, staff, and members of the whole Makerere community, positioning the event as a broader public health contribution rather than a strictly internal university affair. This inclusive approach mirrors similar outreach efforts previously undertaken by student leadership and university departments, which have sought to position Makerere University not just as a centre of learning but as an active contributor to community welfare in the areas surrounding its campuses.
Freedom Square, long regarded as the symbolic heart of student activity and expression at Makerere University, was selected as the venue for the three day event. Its central location and historic significance make it an accessible and fitting site for an initiative of this scale, expected to draw considerable numbers of participants over the course of the camp.
Health as a Pillar of Academic Success
The organisers have anchored the medical camp around the message of promoting student wellness for academic excellence, a theme that underscores the connection between health and academic performance. University life often places significant demands on students, both physically and mentally, and untreated health concerns can quietly undermine academic progress long before they become visible crises. By bringing screening, treatment, and counseling services directly to students at no cost, the Guild Ministry of Health is addressing barriers that might otherwise prevent students from seeking care, whether due to cost, distance, or stigma, particularly around mental health and reproductive health matters.
The inclusion of mental health counseling alongside more traditional physical health services is particularly notable. It signals an evolving understanding among student leaders that wellness cannot be addressed through physical checkups alone, and that psychological support deserves equal standing within campus health initiatives. Similarly, the presence of reproductive health counseling reflects an effort to normalise conversations that many young people find difficult to initiate on their own.
What to Expect
Over the three days, participants can expect a structured environment at Freedom Square, with separate service points catering to the different categories of care on offer. Medical professionals will be on hand to conduct consultations and screenings, while counselors will provide guidance on reproductive and mental health matters in a setting designed to protect privacy and encourage openness.
Given the scale of services on offer and the open invitation extended to staff and community members in addition to students, organisers anticipate strong turnout throughout the three day period. Those interested in attending are encouraged to plan their visits within the stated hours of 8:00am to 5:00pm to take full advantage of the services available.
For any inquiries regarding the medical camp, members of the university community and the public have been directed to reach out to Hon. Wamezaya Ebenezer, the Minister of Health, through the contact provided by the Guild Ministry of Health.
Building on a Guild Tradition
The Annual Makerere Guild Medical Camp is not a new concept within student governance at the university. Successive Guild Ministries of Health have used the medical camp as a recurring platform through which they translate campaign promises around student welfare into visible action. Each edition tends to build on the lessons of the one before it, with organisers typically expanding the range of services offered as new partnerships are secured and as feedback from previous camps is incorporated into planning.
This year’s edition, organised under the 92nd Guild Ministry of Health, appears to place particular emphasis on breadth of service, combining preventive screening, curative consultation, and psychosocial support within a single three-day window. The decision to bundle sickle cell testing, malaria and HIV screening alongside eye care and laboratory diagnostics suggests an intention to make the camp a one stop point for health assessment, reducing the need for participants to seek out multiple providers across the city for basic checks they might otherwise postpone indefinitely.
Why Timing Matters
The scheduling of the camp in September places it at a point in the academic calendar when many students are settling back into campus life after recess, a period during which health concerns accumulated over the break, whether physical ailments left unattended or emerging mental health pressures tied to academic anxiety, tend to surface. Offering free consultations and counseling at this juncture allow students to address these concerns early, before they compound into more serious complications that could interfere with coursework, examinations, or general campus participation.
For staff members and residents of the areas surrounding the university, the timing also offers a convenient opportunity to access services that might otherwise require travel to distant health facilities or extended waiting periods within an already strained public health system. In this sense, the camp functions as a modest but meaningful supplement to existing healthcare provision in the vicinity of the university.
As the 17th of September approaches, the Annual Makerere Guild Medical Camp stands as another example of the Guild Ministry of Health stepping beyond the boundaries of policy and advocacy into direct, hands-on service delivery, a model that continues to shape the character of guild ministries at Makerere University. Students, staff, and members of the surrounding community are encouraged to take advantage of the free services on offer and to look out for further communication from the Guild Ministry of Health as the event draws closer.
For more info, reach Hon. Wamezaya on +256784541248
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