Community pharmacists' role in mental health service provision in Uganda : an analysis of barriers and facilitators

Abstract

Background: Mental disorders contribute substantially to the global burden of disease, yet many low-resource settings like Uganda lack accessible mental health services. Community pharmacists, often the most accessible health professionals, remain an under-exploited resource for early detection, counselling and referral. This study assessed how Uganda community pharmacists engage with mental health care, the obstacles they face and the support needed to expand their role. Objective: To assess the scope of mental health care services provided by community pharmacists in Uganda, and to identify the barriers and facilitators that impact the delivery of these services. Methods: A qualitative, cross-sectional design was conducted using in in-depth interviews with eighteen participants (fifteen community pharmacists and three key informants from urban (Kampala) and rural (Ishaka) settings obtained by purposive sampling. Transcripts were imported into NVivo 14 and an inductive thematic analysis was conducted to identify major themes and subthemes reflecting service scope, barriers and facilitators. Results: Pharmacists routinely offer medication dispensing, basic counselling, and patient education, but rarely screen or give adequate counselling. Key barriers include inadequate mental health training, regulatory ambiguity, high workload, stigma, and absence of private consultation spaces, with rural areas experiencing more acute resource constraints. Identified facilitators encompass enhanced mental-health curricula and continuing professional development, supportive infrastructure and clarified scope-of-practice regulations, inter-professional collaboration, and public awareness campaigns. Conclusion: Community pharmacists in Uganda represent an underutilized resource for mental health care constrained by educational, regulatory and infrastructural limitations. Addressing these impediments through targeted curriculum enhancements, regulatory reforms to expand and clarify pharmacists’ scope, infrastructure investment, and networked care models could transform pharmacies into front-line hubs for mental health promotion, early detection and referral.