Ionescu, Alma; (2025) Resistance In The Everyday: An Ethnographic Study of Mental Health Activism in Uganda. Doctoral thesis (Ph.D), UCL (University College London).

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Abstract

Global Mental Health (GMH) practitioners and scholars have highlighted the necessity to centre voices of everyday people in the process of addressing mental health challenges globally. Activism is one mechanism through which these experiences and perspectives can be heard, but remains overlooked in GMH. This thesis explores the realities of mental health activism in Uganda, with attention to how activists envision, navigate, and negotiate processes of change. My work is anchored in a critical paradigm, drawing on theories of power, activism, and care. I conducted over 80 hours of observations, narrative interviews with activists (n=41), focus group discussions (n=6), and semi-structured stakeholder interviews (n=9) in Kampala, Uganda. Data was analysed using reflexive thematic analysis. My analysis is presented across four chapters. I start by mapping the status quo within which people experience ill mental health, highlighting insufficiencies and injustices in care, alongside everyday experiences marked by structural stigma. These form the foundations which drive demands for change. Next, I explore the varied activist conceptions of how needs for mental health should be legitimised, defined, and satisfied, grounding their perspectives in social dimensions of mental health. Then, I explore how activists engage in practices of radical care. I discuss how radical care differs from mainstream offerings of care in that it makes people feel known and explore the various ways in which it achieves this. Finally, I examine the difficulties activists face in their ability to care as they navigate complex broader socio-political context and unequal worlds, while also facing heavy emotional demands of caring. Put together, this study argues that positive change for mental health requires an active commitment to embracing complexity, and a move away from simplistic and linear solutions, such as policy change alone, that have traditionally dictated the parameters within which success is defined.

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