Parliament has expressed serious concern over extreme overcrowding and limited rehabilitation services at Butabika National Referral Mental Hospital, where the patient population has surged beyond capacity by over 118%.
The hospital, built to accommodate 550 patients, is currently managing more than 1,200, with the Alcohol and Drug Unit, the country’s only government-run rehabilitation center, under the greatest strain.
Gorreth Namugga, Vice Chairperson of the Public Accounts Committee (PAC), highlighted the challenges while presenting the committee’s report on the Auditor General’s findings for National Regional Referral Hospitals and Specialized Health Institutions for December 2024 during a plenary sitting on September 9, 2025.
She noted that the Alcohol and Drug Unit, which can hold only 80 patients, receives over 30 admission requests each week. Patients who cannot be accommodated are admitted to other wards before eventual transfer, worsening overcrowding.
Dr. Juliet Nakku, Executive Director of Butabika Hospital, attributed the crisis to insufficient development funding for infrastructure expansion.
“The hospital is oversubscribed by 118%, which strains all aspects of service delivery,” Namugga cited. She added that many patients are forced to seek private rehabilitation centers, where fees average UGX 75,000 per day.
The hospital’s rising caseload of alcohol and substance abuse patients is compounded by limited funding for public awareness campaigns. Parliament urged the government to allocate resources to expand the Alcohol and Drug Unit and strengthen public sensitization on substance abuse.
The report also revealed prolonged patient stays, with 150 patients admitted for over six months, 75 for more than a year, and 20 for more than two years, far exceeding the hospital’s standard two-to-four-week protocol. Dr. Nakku explained that chronic mental disorders and family abandonment hinder timely discharge, despite active community and recovery programs.
“Prolonged stays strain bed availability and resources, delaying new admissions and potentially affecting patients’ mental and physical health,” Namugga said.
She recommended reviewing discharge protocols, initiating early discharge planning, and establishing clear criteria for extended stays.
Parliament called for collaboration with stakeholders to develop comprehensive post-discharge follow-up and community-based support services.
The Auditor General, Edward Akol, also flagged critical staffing shortages. While recommended ratios are one nurse per 10 patients and one doctor per 30 patients, Butabika operates at one nurse per 40 patients and one doctor per 70 patients.
“These ratios, more than double the recommended standards, increase workload, stress, and compromise care quality,” Namugga noted. She urged the hospital to assess staffing needs, work with the Health Service Commission to fill vacancies, and partner with the Ministry of Health to enable regional hospitals to treat mental health conditions, reducing pressure on Butabika.
Parliament’s recommendations aim to tackle overcrowding, improve staffing, and enhance mental health services nationwide, ensuring Butabika can continue to serve as Uganda’s leading mental health referral facility.
