Perspectives from participants’ co-design of coordinated care for severe mental illness in rural Eastern Uganda

Document Type

Journal Article

Role

Author

Published In

Cambridge Prisms: Global Mental Health

Volume

13

Article Number

e210

Publication Date

10-15-2026

Abstract

Coordinated, multicomponent care models improve outcomes in early psychosis in high-income settings, but how coordinated care can be adapted for rural, pluralistic, low-resource systems remains poorly understood. We aimed to co-design a locally feasible coordinated care model for people with severe mental illness (SMI) in rural Uganda and identify feasible delivery agents, role divisions, engagement with pluralistic care pathways, and anticipated implementation barriers. We conducted three iterative co-design workshops with 18 participants across parallel churchand mosque-based series in Buyende District, Uganda. Participants included biomedical and mental health workers, Village Health Team members, religious leaders, traditional healers, local leaders, people with lived experience of SMI, and caregivers. Transcripts were translated and analyzed using the Framework Method. Four themes emerged. Participants described sequential help-seeking across a pluralistic care landscape with directional referral asymmetries. They proposed distributing psychosocial support and medication follow-up across a tiered workforce, with relational trust as a key feasibility condition. Reintegration was framed through administrative endorsement and community economic institutions. Family psychoeducation was viewed as foundational and deliverable through task-shifting and peer caregivermentorship. Participants articulated a coordinated care model preserving core functions while redesigning delivery around a community-extended, task-shared workforce.

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