As Women’s’ Month is celebrated, WINS will honour several recent scientific breakthroughs by women. The first article focuses Ethel Nakimuli-Mpungu’s development of a culturally sensitive psychotherapy programme for treating depression and HIV in Uganda.
Ethel Nakimuli-Mpungu‘s group psychotherapy programme, SEEK-GSP, focuses on providing mental health support to hard-to-reach communities in Uganda. It deals with depression and HIV. Using lay health workers to build supportive relationships, it emphasizes developing coping skills and promoting economic empowerment.
Etheldreda Nakimuli-Mpungu is a professor, researcher, epidemiologist and psychiatrist at the Department of Psychiatry in the Faculty of Medicine at Makerere University in Uganda. Her research is focused on supportive group psychotherapy as a first-line treatment for depression in people with HIV.
Nakimuli-Mpungu graduated in Medicine from Makerere University‘s Faculty of Health Sciences in 1998. After obtaining her PhD, her mother’s advice was to not just be a doctor, but “one who does good to people”. Her career started in Kampala in the surgical department, then continued with children. From 2001 to 2012 she worked in psychiatric care at Butabika National Referral Mental Hospital. In 2006, she resumed graduate studies in Psychiatry at Makerere University’s College of Health Sciences and was awarded an MA. In 2012, she received a doctorate in psychiatric epidemiology from Johns Hopkins University in Baltimore, USA.
While working at Butabika Hospital, Nakimuli-Mpungu noticed a large number of HIV/AIDS patients were admitted, also suffering from serious mental health problems. She realised that at the time, nobody knew how to help them. “There was this idea in the medical community that they were beyond help”, she said. This spurred her on to undertake her own research and observations, confirming that HIV-positive individuals are more likely to be diagnosed with depression, in part due to the stigma surrounding the disease. One symptom of depression is neglect of self-care, which for some HIV patients means not taking their medication. Nakimuli-Mpungu felt there could be a dual approach to the two diseases. However, at the time there was nothing published in scientific literature which could serve as a basis for implementation of such a treatment.
She launched a research programme to explore the possibilities of a treatment addressing both issues. Since most medical centres in Uganda lack funding, as well as training for and staff to work on mental health care, Nakimuli-Mpungu focussed on the potential of group therapy as a treatment. Her first pilot programme recruited 150 people with HIV and concomitant depression. The recruits were split into two groups: one group received Nakimuli-Mpungu’s group therapy sessions, the other standard HIV education sessions at a clinic. Whilst over time all patients’ depression decreased, the group therapy saw a continuation of decrease of depression even after the sessions ended.
This initial study led to a larger programme, which started in 2016. In this instance, 1140 patients were treated at over 40 health centres across northern Uganda. Again, participants were split into two: one half received “culturally appropriate psychotherapy,” while the others received general HIV education. This time, treatments were provided by trained, non-professional healthcare workers over a course of eight weeks. The group undergoing psychotherapy showed less incidences of major depression than the other group. It also showed reduced symptoms of PTSD, greater adherence to medication and lower rates of alcohol abuse, among other outcomes. Positive outcomes were most notable among male patients.
Awards
- The 2005 International ASTRAZENECA/APIRE Young Minds in Psychiatry Award.
- The 2007 International FulbrightScience & Technology Award.
- The 2016 Ugandan Presidential National Independence Medal of Honour.
- The Elsevier Foundation Awardfor Early Career Women Scientists in Biological Sciences in the Developing World in 2016.
- She was also on the 2020 BBC’s annual most influential 100 Women2020.
