Contrasting concepts of depression in Uganda: implications for service delivery in a multicultural context

Depression is a rising public health concern worldwide. Understanding how people conceptualize depression within and across cultures is crucial to effective treatment in a global environment. In this article, we highlight the importance of considering both lay and professional perspectives when developing a culturally competent and contextually relevant model for service delivery. We conducted interviews with 246 Ugandan adults to elicit their explanatory belief models (EMs) about the nature of depression, its causes, social meanings, effects, help seeking, and treatment. Interviews were transcribed, content analyzed, and coded. We compared EMs of community members (n = 135) to those of professional practitioners (n = 111), whom we further categorized into traditional healers, primary care providers, and mental health professionals. We found significant differences between lay and professional EMs and between 3 types of professionals. Contrary to our expectations, lay concepts did not overlap more with traditional healers than with other professional EMs. We discuss the diverse concepts of depression in Uganda, the nature of group differences, and implications for service delivery and treatment.