Exploring the relationship between religiosity and coping strategies among individuals with mental illness in Uganda: a cross-sectional study

Mental illnesses are leading causes of disability worldwide, and individuals often turn to religion as a source of support and resilience. In Uganda, where religious participation is deeply embedded in society, the influence of religiosity on coping strategies among individuals with mental illnesses remains underexplored. This study examined the relationship between religiosity and coping strategies among people with mental illnesses at Mbarara Regional Referral Hospital in southwestern Uganda. A cross-sectional study was conducted among 400 adult outpatients at Mbarara Regional Referral Hospital. Religiosity was assessed using the Duke University Religion Index (DUREL), and coping strategies were measured using the Brief Coping Orientation to Problems Experienced (Brief COPE) scale. Exploratory factor analysis was used to classify coping strategies into positive and negative. Multivariable logistic regression examined associations between religiosity dimensions and positive coping while adjusting for socio-demographic and clinical factors. Negative coping strategies were more prevalent (61.2%) than positive strategies (38.8%). In adjusted analyses, higher organizational religious activity was associated with increased odds of positive coping (adjusted odds ratio [aOR] = 1.32, 95% CI: 1.10 to 1.57), while higher non-organizational religious activity was associated with reduced odds of positive coping (aOR = 0.69, 95% CI: 0.60 to 0.81). Family history of mental illness (aOR = 1.67, 95% CI: 1.06 to 2.26) and a diagnosis of bipolar disorder (aOR = 1.95, 95% CI: 1.01 to 3.76) were also associated with greater use of positive coping. Organizational religious activity is independently associated with adaptive coping among individuals with mental illness, whereas non-organizational religious activity is linked to reduced likelihood of positive coping. The high reliance on maladaptive coping strategies underscores the need for comprehensive, culturally sensitive mental health interventions that integrate psychosocial and faith-based support. Further longitudinal research is needed to clarify causal pathways.