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Purpose – The purpose of this paper is to explore the ways in which "mental health" difficulties are approached in low-income countries, using a case study of Uganda focus down upon the issues. Design/methodology/approach – The study involved two phases. The first was the collection and analysis of documentary evidence and interviews with policy makers in Uganda. The second involved interviews with health staff, traditional healers and the public in the Buganda Kingdom of Uganda. Interviews were conducted in English or Luganda and translated as necessary. No external sources of funding to declare. Findings – There are differing perceptions of mental health and illness in Uganda and there exists culturally accepted sources of support for distress. This highlights the important role of traditional healers and the paper argues that they should be recognised for their work in mental health care. Research limitations/implications – The paper is a small-scale study of one area of Uganda (Buganda Kingdom), the extent to which it can be generalised is therefore very limited. However, the research is sufficient to indicate the benefits of traditional healers in mental health care and supports an argument towards a public mental health model. Practical implications – The paper argues for a move in priority away from a focus upon a biomedical model of mental health support towards a public health model and the meaningful engagement of traditional healers. This would also necessitate a refocus of spending in the wider society. Originality/value – The paper poses a challenge to the Global Public Health movement and questions the relevance of expanding biomedical psychiatry in low-income countries. The paper also adds weight to emerging literature on the value of a public health approach to mental health and illness, especially in the developing world. [ABSTRACT FROM AUTHOR]