The study focuses on adapting an acceptance-based mental health intervention known as Acceptance and Commitment Training (ACT-W), initially crafted by Dr. Paul Flaxman and Ross McIntosh at City St George’s. The aim is to tailor this programme to fit the unique socio-cultural and economic landscape of Uganda, where a significant portion of the workforce suffers from mental health issues due to unstable employment conditions. This adaptation is vital, as there is a pressing need for accessible and effective mental health promotion programmes in the region. The programme promises to fill this gap by equipping employees with the necessary tools to manage stress, anxiety, and other common mental health issues at work, with its findings published in the journal PLOS Mental Health.
Globally, mental health challenges affect 15% of working adults, leading to substantial economic losses estimated at US$1 trillion and 12 billion working days annually. The burden is hefty in low and middle-income countries (LAMICs), which house 75% of the global labour force. In Uganda, a typical LAMIC, the situation is exacerbated by a scarcity of resources, with studies showing that 68% of Ugandan workers face mental health challenges. Moreover, over 78% of Ugandan employers provide no formal mental health support, a situation worsened by societal stigma which prevents many workers from seeking help. As a result, employees are often left to manage stress, anxiety, and other issues without adequate support, adversely impacting their productivity and overall quality of life.
Initially developed and tested in high-income countries like the UK, the ACT-W programme has been widely adopted in the UK’s National Health Service (NHS) to improve mental health among healthcare staff. The training promotes psychological flexibility, encouraging participants to endure uncomfortable internal states while engaging in actions that align with their values. This approach has proven effective in high-income settings, helping individuals focus on meaningful activities despite experiencing complex thoughts and emotions.
However, Uganda’s cultural and economic context necessitated adjustments to make the programme relevant to its workforce. Recognising the importance of communal values in Uganda, the researchers modified the programme to emphasise group well-being alongside individual goals. This involved collaborating with mental health providers in Kampala to adapt the programme’s content, incorporating more community-based values and adjusting the language and metaphors to align with Ugandan cultural views, which often interpret mental health through spiritual and traditional beliefs.
A significant challenge highlighted in the research is the stigma surrounding mental health in Uganda, where many are reluctant to discuss such issues openly, especially in the workplace. To combat this, the ACT-W programme includes elements that promote mental health awareness and education, aiming to reduce stigma by demonstrating that mental health can be improved through learning psychological and behavioural skills.
The benefits of the adapted ACT-W programme for Ugandan workers are considerable. It teaches employees how to skillfully relate to their emotions and remain mindful of their values even in challenging circumstances, potentially leading to enhanced mental well-being, increased job satisfaction, and improved productivity. The programme offers clear advantages for employers: healthier employees are more likely to perform well, take fewer sick days, and contribute to a more positive workplace atmosphere. In a country with limited mental health support, such interventions could be cost-effective to boost employee well-being and business performance.
Dr Khamisi Musanje, lead researcher from Makerere University, stressed the importance of improving mental health to create a more productive workforce for Uganda’s future. Dr. Paul Flaxman, co-researcher at City St George’s, echoed this sentiment, expressing enthusiasm about the study’s findings, which show that evidence-based mental health training like ACT-W can be adapted to diverse cultural contexts. The team is optimistic about expanding this initiative, planning to roll out the programme across Ugandan workplaces and evaluate its effectiveness. If successful, this could serve as a model for enhancing workplace mental health in other low-resource environments, improving lives and economic outcomes.
More information: Khamisi Musanje et al, Social validity of acceptance-based workplace mental health training for use in a low resource setting. A qualitative study with Ugandan mental health providers, PLOS Mental Health. DOI: 10.1371/journal.pmen.0000127
Journal information: PLOS Mental Health Provided by City St George’s, University of London