Paulson was born alone, the only child of his mother and father. Growing up, he lived at his father’s extended family homestead. He attended school until Senior 6, and then began doing manual work around the village.

Paulson was earning well, in fact, he managed to save one million shillings. However, one of the leaders at church started to notice a change in Paulson. He was working so much – at home, in the village and at church – he was too overactive, he barely slept. He was also becoming very talkative.

Something wasn’t right. Paulson’s family took him directly to Bosa Mental Health Unit at Mulago Hospital. Paulson remembers being given an injection, and then tablets to take. He was sent back home.

Paulson began to take the medication every day. He didn’t know what it was for, or whether he was going to get better. Then, something very frightening happened. Paulson’s tongue went out, “like a dog”, he says. Paulson went to Mengo Hospital and they recognised this as a side effect of the medication he was taking, called Haldol, and so they changed it. Nevertheless, this was a very scary experience for Paulson and his family.

Over the next few years, Paulson went back to Mulago for reviews, mostly by himself, although at times friends would accompany him. He remembers frequent changes in his medication, yet still, Paulson lacked a proper explanation for his condition. It wasn’t until the Community Mental Health Initiative (COMHI) started providing information and psychosocial support at Bosa Mental Health Unit, that Paulson came to understand his diagnosis of bipolar disorder and why he was taking medication.

The years of suffering with this illness and the associated stigma had led many of Paulson’s friends to abandon him, he felt dumped. At his father’s homestead, he lacked siblings to care for him. He does however remember that his grandmother, church and primary school friends were supportive. When staff from COMHI began to visit Paulson at home, he began to feel hopeful again. It was empowering to know that people were coming to visit him and cared about him.

Unfortunately, as things started to improve for Paulson, he suffered a major relapse when the clinic was out of stock of his medication. As his symptoms worsened, Paulson was taken to his mother’s side. From there he was taken to a traditional healer, then a herbalist, who used herbs to treat mental illness and charged Paulson’s Uncle a lot of money. First, Paulson’s hair was cut off, he was chained by his hands and legs and herbs were placed on his body. He remembers now how much they itched his head. He was left there for 5 days. One night, when Paulson was unchained, he managed to escape. He moved the whole night through the unfamiliar area, walking 5 miles before a local pastor found him the next morning and took him home. Luckily, Paulson could remember his father’s phone number and his uncle was sent to collect him. By this time, Paulson was very far from his home and very tired. The herbal treatment had led to no improvement in his health.

From there, Paulson was taken back to father’s homestead. Paulson knew he needed his medication and was taken to outpatient department at Butabika by a friend. He had never seen Butabika before. After a few visits to the outpatient department at Butabika without major improvement, Paulson was admitted to Butabika for the first time. He recalls he met peers in similar situations and some who had suffered more. During the weeks, he was visited by his father, brother and church members. However, other family members did not make the journey to see Paulson, which made him feel rejected.

He was discharged after 6 weeks in hospital. He returned to his father’s homestead, but he was not working. He tried to reconnect with friends, but he heard whispers… “He’s mad” … “He should be at Butabika”. He gave up. He started waking up late. He lost hope. He now recalls thinking: “I don’t know how I can become someone again in my life”.

At this point, one of Paulson’s primary school teacher asked his family, “What are you planning for Paulson?” She could see he had potential and was able to connect him to a job at a furniture mart. It was difficult for Paulson, now in his mid-20s to learn alongside teenagers. However, when he became a Sales Manager, he started to really excel. For the first time since his illness began, he was able to make money and save. This helped Paulson to buy new clothes, support his grandmother and feel like an important person in the community. He had a purpose, and his self-esteem grew day by day.  

During this time, Paulson continued to travel to Butabika for reviews, although the journey was far. He saw people on the ward, and he thought, “How do I help these people?”. It was then that he heard about an opportunity to become a peer support worker. As he began his training alongside fellow peers he thought: “all the people around me are service users, I have a new family to share with”. During the training, Paulson acquired the skills to help people on the ward. He felt empowered to use his lived experience to support others going through similar challenges.

Today, Paulson has a wife who knows about his challenges but wouldn’t give up on him. He has a baby boy, is growing his business and is living a happy and productive life.

Paulson’s story shows how you can overcome the challenges of being produced alone and having bipolar disorder. Paul faced stigma and barriers to work when he first returned from Butabika. However, he has demonstrated how, if given the opportunity, people who have faced mental health challenges can work and can be productive in the community.

Everybody has a right to health, to work, to a family life and to be a member of their community, including people facing mental health challenges. We must fight against stigma and discrimination.