Let us Talk Project

Let us Talk Project is designed to reduce the treatment gap for depression and anxiety among 70% of depressed women who never receive treatment for depression in Uganda. The project will provide free mobile-phone-based psychotherapy to women from low-income households experiencing depression, anxiety, suicidal thoughts and behaviour. The project will pilot the  provision of Tele-Psychological First Aid (PFA) to women experiencing mental distress, and Group Support Therapy (GSP) to those with depression and anxiety. GSP is a highly cost-effective culturally sensitive therapy provided by lay health workers over 8-weekly sessions. The therapy has been proved to alleviate symptoms of depression, PTSD, and suicide.

If scaled appropriately, the project will led to greater access to depression treatment and suicide prevention in Uganda; slowing the spread of the COVID-19 pandemic, averting morbidity and mortality due to suicide, and accelerating short-and long-term adaptive functioning and coping especially among low-income women.

Depression is a prevalent and serious mood disorder characterized by persistent sadness. In Africa, 1 in 23 people suffer from the disorder, and in Uganda, about 3 in 10 people suffer from the mental illness.  Uganda is ranked among the top six countries in Africa with high rates of depression, ranging from 4% to 30%. However, access to basic mental health care is met with several barriers; and depression—especially among rural poor women is characterized by delayed help-seeking and is a major source of Disability Adjusted Life Years (DALY).

WHO estimates that 7-8 people suffering from depression in low-income countries like Uganda never receive treatment. Furthermore, the current pandemic measures have not only triggered an increase in rates of depression, it has also made it harder to access care and treatment for the mood disorder. Yet untreated depression accounts for 13% of the global burden of disease and is predicted that by 2030, depression will be the leading cause of disease burden globally.

Let Us Talk Project hopes to reduce the treatment gap for depression especially among low-income women, through provision of free mobile-phone based Psychological First Aid and group psychotherapy.  

Let us Talk project will establish a Mental Health Centre to provide TeleMental Health Services. The center will raise awareness about mental health with an emphasis on depression, anxiety, and suicide through interactive radio programs.

Also, the Centre will provide mobile-phone Psychological First Aid (PFA) to support women and girls cope with emotional distress, confusion, fear, anxiety, panic attacks, suicide thoughts, and behavior. PFA will be based on 5 principles; Addressing Safety, calming practices, build hope, improve adaptive practice and social connection.

The Centre will also provide mobile-phone-based psychotherapy in form of Group Support Therapy (GSP) to women experiencing depression and anxiety. GSP is a highly cost-effective therapy provided by lay health workers over 8-weekly sessions. The therapy has been proved to alleviate symptoms of depression, PTSD, and suicide. The project will pilot the online application of GSP among low-income women with support and supervision from the Department of Psychiatry, and School of Psychology, Makerere University.

Women experiencing symptoms related to depression, anxiety and those with suicidal behavior will be encouraged to seek free mobile-phone-based services through toll-free lines.

The project will serve women experiencing depression, anxiety, and those with mental distress due to the impact of COVID-19 pandemic. Emphasis will be put on low-income women who are most likely unable to afford specialized mental health care living in and around the Busoga Sub-region, Eastern Uganda.

 Busoga sub-region is the 3rd poorest region in Uganda. There is compelling evidence that shows that the COVID-19 pandemic is disproportionately impacting women and girls. According to the Ugandan Ministry of Finance, Planning, and Economic Development (2020), it is anticipated that more women will become poor due to the COVID-19 pandemic. In addition, the pandemic has also stretched their caregiving roles, increasing rates of violence against them, reducing social support, and making more women vulnerable to to experiencing frequent stress, anxiety, and depression. 

Due to several factors, twice as many women as men experience depression yet in Uganda, 7 out of every 10 women are unable to access treatment for depression. Before the outbreak of the pandemic, there were several barriers to accessing care and treatment for depression or anxiety. With the pandemic, the government is prioritizing infection control measures and limited efforts have been made to address the mental health needs of low-income women.

 The Let us Talk Project is a collaborative initiative stemming from several engagements and consultations between CCUg and 20 female local leaders from 18 villages in Mayuge and Jinja districts. Our first efforts to address mental health issues started in July 2020 when we provided face-to-face and mobile-phone-based suicide prevention counseling to 42 women and girls with suicidal thoughts and behaviour. We also provided group therapy to more than 98 women from 5 villages in Jinja and Mayuge district.  

Over time, we have learned that many low-income women are not only ignorant about the mental illnesses they experience, those with depression or anxiety never receive formal care. This significantly impairs their functioning; severing their ability to care for themselves and their families, contributing to violence and abuse, and household poverty.  

Let us talk project will therefore address the mental health needs of low-income women experiencing depression, anxiety, and mental distress; providing cost-effective culturally sensitive psychotherapy and psychological first aid.  

The project will considerably expand access to mental health care and treatment for depression/anxiety to several categories of women; including hard-to-reach women, restricted by mobility issues due to COVID-19 restrictions, mental or geographical challenges. This will promote early detection and treatment for depression; encourage collective care, sharing, learning and problem solving among women from different walks of life. This will also stimulate collective mental health promotion, care, and healing among low-income women.  

Furthermore, it will enhance their functionality, productivity, and promote their ability to navigate the short and long term negative effects of COVID-19 pandemic. Group Therapy will provide women with an opportunity to learn critical skills and build a local support system to not only improve their mental health but also navigate other social and economic issues.

The outbreak of the COVID-19 pandemic has worsened rates of depression, stress, and anxiety leaving many people without access to mental health care services. More so, current pandemic measures restrict mobility and face-to-face interactions. Therefore, there is a huge unmet need for depression/anxiety treatment; which needs to be addressed through alternative methods that reduce physical interactions to safeguard public health.

 With increased phone ownership (69%) and internet connection among women, the challenge (unmet need for depression treatment) aligns with the solution (tele-mental health) and the target population (women).

Several studies have shown that Tele-mental health is an effective alternative to conventional mental health care. We hope to pilot the implementation of tele-mental health in Uganda using tested and proven effective model of group therapy—Group Support Therapy. 

Piloting of tele-therapy for depression and anxiety will be conducted in the Busoga sub region; majorly 5 districts of Jinja, Mayuge, Kamuli,  Iganga, Bugiri, with a centre providing the services situated in Jinja district.

We plan to test the service provision among 1,000 low-income women.

Tele-psychotherapy through the use of audio and videoconferencing provides an alternative way of delivering mental health care as compared to physically accessing the services from health facilities. With the current COVID-19 pandemic mobility and interaction restrictions, Tele-psychotherapy will provide an opportunity to low-income women access care without leaving the comfort of their homes, reducing costs associated with travel, the risk of infection, and stigma associated with physically accessing mental health care.

 In addition, Let Us Talk Project utilizes Group Support Therapy (GSP), a cost-effective culturally sensitive therapy delivered by lay mental health workers over 8-weekly sessions. The project will employ trained lay mental health workers to provide talk therapy delivered through mobile-phone-based audio and video conferencing. This will increase access to mental health care in a country with inadequate mental health professionals while using the power of groups to share, learn and support each other to heal from depression and anxiety. 

 If scaled properly, the project will revolutionize access to depression care and treatment in Uganda, significantly reducing the current treatment gap.

The project is not currently serving beneficiaries; however, we plan to serve 1,200 people in 1 year, and in 5 years, we plan to reach 100,000 people.

Access to mental health care is human right which is vital for good health, survival and development.

We plan to increase access to depression treatment to 100,000 women by 2026. We plan to have external evaluations to evaluate the quality of tele-mental health services provided. 

3 full time and 1 volunteer.

3 of the team members are trained mental health professionals with experience in providing individual and group therapy. In the past 12 months, they have provided mobile-phone-based and face-to-face therapy for depression. All the team members live in the community that we hope to address depression in.

In the past, we have actively worked with female local leaders being representatives of women in 18 villages, as we developed the idea. We hope to engage some of these local leaders to be trained as lay mental health workers to provide tele-psychotherapy.

Our team is comprised of 2 male and 2 female team members. We hope to co-opt female local leaders to serve as lay mental health workers, fostering local input and participation in the solution.

At an institutional level, the project is bound by the organizational equal opportunities policy which encourages working with people with diverse backgrounds without discrimination related to sex, gender, race, educational level, nationality, marital status, disability status among others.

We would like to partner with organization with a proven track record of supporting the growth of tele-mental health venture.

To partner with individuals with experience implementing tele-mental health projects especially for under served populations.

We seek the support of seasoned experts who can help evaluate and support us to promote our model of delivery.

We would like to partner with organization with a proven track record of supporting the growth of tele-mental health venture.

To partner with individuals with experience implementing tele-mental health projects especially for under served populations.

We seek the support of seasoned experts who can help evaluate and support us to promote our model of delivery.

The Let us Talk Project is an innovative mental health initiative to reduce the treatment gap for depression among low-income women who are most likely unable to afford specialized mental health care. If we win the Foundation funds, we will be on our path to reach 100,000 women with tele-mental health services, establish a big mental health centre that also provides emergency admissions for women with mental distress, or those with psychotic depression, who might need urgent admissions.