Published on 25/09/2025
Parliament has expressed concern over severe overcrowding and limited access to rehabilitation services at Butabika National Referral Mental Hospital, where the patient population exceeds its capacity by over 118%.
The hospital, designed to accommodate 550 patients, is currently managing over 1,200, with the Alcohol and Drug Unit, Uganda’s only government-run rehabilitation center, bearing the brunt of the strain.
Gorreth Namugga, Vice Chairperson of the Public Accounts Committee (PAC), highlighted these issues 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, with a capacity of just 80 patients, receives over 30 admission requests weekly. Patients who cannot be accommodated are admitted to other wards and later transferred, exacerbating overcrowding.
Dr. Juliet Nakku, Executive Director of Butabika Hospital, attributed the capacity constraints to a lack of development budget for infrastructure expansion. “The hospital is oversubscribed by 118%, which strains all aspects of service delivery,” Namugga reported, citing Dr. Nakku. She added that many patients turn to private rehabilitation centers charging exorbitant fees averaging UGX 75,000 per day due to the limited capacity at Butabika.
The hospital’s high caseload of alcohol and substance abuse patients is compounded by insufficient funding for public sensitization on the dangers of substance abuse. Parliament urged the government to allocate funds to expand the Alcohol and Drug Unit and support public awareness campaigns on substance abuse.
The report also flagged prolonged patient stays, with 150 patients remaining for over six months, 75 for over a year, and 20 for more than two years, against the hospital’s standard protocol of two to four weeks. Dr. Nakku explained that severe, chronic mental disorders and family abandonment hinder timely discharge, despite the hospital’s robust community and recovery program.
“Prolonged stays strain bed availability and resources, delaying new admissions and potentially harming patients’ mental and physical health,” Namugga said. She recommended a review of discharge protocols to address inefficiencies, early initiation of discharge plans, and the establishment of clear criteria for extended stays.
Parliament also called for collaboration with stakeholders to create comprehensive post-discharge follow-up and community-based support services. The Auditor General, Edward Akol, further highlighted critical staffing shortages. While the ideal nurse-to-patient ratio for mental health facilities is 1:10 and the doctor-to-patient ratio is 1:30, Butabika operates at 1:40 for nurses and 1:70 for doctors.
“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 collaborate with the Ministry of Health to enable regional hospitals to treat mental health conditions, thus decongesting Butabika.
Parliament’s recommendations aim to address overcrowding, improve staffing ratios, and enhance mental health services nationwide to ensure Butabika can effectively serve as Uganda’s primary mental health referral facility.
