“WE ARE TRAINED TO BE SILENT”: EXPLORING MENTAL ILLNESS COMMUNICATION AMONG UGANDAN WOMEN IN THE UNITED STATES (U.S.)

Abstract

Approximately 1 in 3 Ugandan adults suffers from mental illness and has limited access to mental illness treatment and resources. Moreover, women are twice as likely to experience mental illness as men. Further, due to mental illness stigma and limited resources, 85% of adults with depression are from low and middle-income countries like Uganda and do not seek out treatment for their mental illness. Although existing research has documented that early treatment is critical to managing mental illness before it progresses, these studies were mostly conducted in Western-centric contexts. Given the paucity of mental illness research in the African context, specifically regarding women, this dissertation investigated and documented the unique experiences of Ugandan women in the U.S. with the issue of mental illness, drawing from the Situational Theory of Publics (STP) and the Culture-Centered Approach (CCA). Twenty qualitative, semi-structured interviews were conducted among Ugandan women, living in the U.S. Specifically, the study posed five research questions that examined (1) how Ugandan women in the U.S. conceptualize the issue of mental illness (2) the role of culture in their conceptualization of mental illness (3) how stigma informed their perception of mental illness (4) their perceived constraints when deciding to seek, or not to seek, mental illness treatment (5) these Ugandan women in the U.S’ evaluations of, and experiences with both medical and media mental illness treatment campaigns. Twelve Ugandan women in the U.S. aged 30 to 40 who live in the U.S. were sampled using the network sampling approach for the study. Eight women participated in two rounds of interviews each, and the other four participated in one round of interviews. In total, nineteen semi-structured interviews were conducted via Zoom and one over email. The data collected was analyzed thematically. The study findings revealed that the participants were mostly active publics who had a high level of involvement with the issue of mental illness, a high problem recognition, and low levels of constraint recognition. This increased their information-seeking, information-processing, and treatment-seeking behaviors regarding mental illness. The study also revealed that the CCA element of culture informed the participants’ constraint recognition. The study findings further indicated that the CCA aspect of structure informed the participants’ constraint recognition and their agency. Ultimately, the research findings confirmed the continuous interaction of the three CCA tenets, culture, structure, and agency, to inform people’s beliefs, practices, and understanding of health within a given cultural context. Practically, the study concluded that the use of STP to segment the study participants as active publics provided very critical information for relevant mental health entities to create effective mental illness treatment campaigns for Ugandan women in the U.S.