By Eronie Kamukama

Sexual abuse against mentally ill children is a hidden problem in Uganda. There are many mentally ill children abused on a daily basis but it is hard to know the prevalence rate of this problem.


According to Dr. Catherine Aboo, a child psychiatrist at Mulago National Referral Hospital, this is because it is a complex societal issue that not many people want to talk about.

Who are the commonest perpetrators of this sexual abuse?

  • Family members
  • Mentally ill people

How does this sexual abuse happen?

She says children are dependent on adults and these are the same people who abuse them. She says the perpetrators of the rape and defilement always coerce these children and get into manipulative relationships with them.

In most cases, these children trust their adults who use this to abuse them and in turn, the children will not come out to talk about it because they are embarrassed about it.

Aboo says it is worse for mentally ill children because this affects their development levels which compromises their ability to talk about it.

How can one know a mentally ill child has been sexually abused?

Like many normal children, Dr. Aboo says there are signs that can show a parent or guardian that a mentally ill child has been abused.


  • Inappropriate sexual talk/gestures/expression
  • Clinging to certain people
  • Fear of people especially the perpetrator
  • Change in behavior
  • Loss of appetite
  • Loss of sleep/Nightmares
  • Child becomes miserable and cries a lot

What is the impact of sexual abuse on mentally ill children?

Dr. Aboo says the impact is unpleasant and even worse for mentally ill children because unlike other children, their mental health is already compromised. The impact is physical, emotional and psychological.

It exposes them to Post Traumatic Stress Disorder, a mental health condition triggered after seeing or experiencing terrifying events.


She also says early initiation to sex retards the development of these children in understanding normal sexual issues. Some of them develop illicit sexual behavior and could become prostitutes.

Physically, the children are prone to sexually transmitted diseases and rupturing of their sexual organs since they are still growing.


Dr. Aboo explains that the traumatized child can be treated using cognitive behavior therapy. According to  Wikipedia, this therapy seeks to change the way a trauma victim feels and acts by changing the patterns of thinking or behavior, or both, responsible for negative emotions.

One can also use play therapy where playing is used to link a child’s inner thoughts with their outer world.  According to the Centre for Play Therapy at the University of North Texas, it helps a child to get relief from the traumatic events, resolve psychosocial difficulties and obtain optimal growth and development.


Advice for Parents and Guardians

Dr. Aboo advises parents to seek help as first as they notice changes in a child. She says, however, that prevention is key and that everyone in society should take responsibility for their moral behavior so that children do not have to go through such assault.

Parents should make the home environment safe, stable and conducive for nurturing the child. They should avoid motivating sexual abuse in their homes to protect the child.

The absence of internal restraint in society  is a major cause and so communities should work together to disapprove these acts against mentally ill children

Dr. Catherine Aboo, Child Psychiatrist- Mulago National Referral Hospital



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