The YouBelong Uganda (YBU) 40+ Per Month Model is a focused deinstitutionalisation initiative designed to support Butabika National Referral Mental Hospital, which continues to experience overcrowding—with approximately 1,300 patients accommodated in a 550-bed facility.

The 40+ Per Month Model provides a systematic pre-discharge, return-home, and post-discharge support process, including structured assessments, family engagement, group peer-led psychoeducation, and follow-up through phone support and community based sharing groups. By ensuring that each discharged person and their family is prepared, supported, and connected to ongoing community services, the model aims to reduce relapse and readmission, improve recovery outcomes, and offer the Ministry of Health a scalable model for national adoption.

Since 2017, YBU has worked closely with the hospital to strengthen safe and sustained return-home pathways for persons recovering from severer mental illness. Building on this collaboration, the 40+ Per Month Model was established in August 2025 as a structured model to increase the number of successful weekly discharges, reduce long-term institutionalization, and promote community-based mental health care. While we aim to return home from hospital a minimum of  40 persons per month, often the YouBelong HOME team achieves a level of 60 per month return to family and community. We continue to evaluate the 40+ per month innovation, and we will keep refining it, to maximize our deinstitutionalisation work.

Key learnings highlight the role of peer-led group discussionssessions in building insight in the impact of severe mental illness, and personal experiences of better management of the recovery process. Peer support plays a core role in the YouBelong HOME program, and is extremely valuable in teaching medication adherence, as well as the importance of organised follow-up calls with the YouBelong HOME team, in identifying and addressing any difficulties in resettlement back to family. The model has also benefited from close collaboration with local health centres as well as the Butabika outreach clinic teams, which go out provide care and medications close to where people are living. Although small in number, YouBelong hopes to assist in increasing their prominence, in its deinstitutionalisation strategy.

In addition, experience has reinforced the importance of early and active family involvement, which remains central to relapse prevention, daily support, and long-term recovery stability. Despite these, ongoing challenges include variations in family readiness, limited interventions for persons with substance use comorbidity, and gaps in access to medication—areas that continue to inform model improvement.