Employers should understand the importance of promoting a favorable working environment because it not only favors the welfare of employees but also boosts efficient productivity and has lasting impact on the society in general.

The call was made by Dr. Yvonne Kayiteshonga the Mental Health Division Manager at Rwanda Biomedical Centre (RBC) during an event that was held recently to mark World Mental Health Day.

The World Mental Health Day is celebrated across the world every year on the 10^th of October.

This year’s theme "Mental Health in the workplace”addresses the value of promoting well-being in work settings.

The International day is an opportunity to mobilize actions around a specific mental health topic of concern to people all over the world. 

The World Health Organization points out that depression heads the list of causes of illness and disabilities worldwide and that those who experience depression or other disorders may be unable to work or may be less than fully productive.

The event was hence aimed at supporting mental health and wellbeing in the workplace, provide individuals and employers with information about how they can support self-care and wellbeing, address the negative attitudes and prejudice associated with mental ill-health in the workplace and spread the understanding of employment practices that support good mental health.

Kayiteshonga said that a healthy workplace benefits workers and employers alike and that everybody is urged to advocate in communities on behalf of all people living with mental illnesses to ensure adequate services and freedom from stigma to get the help they need.

Research done by RBC shows that 1 in 4 adults will experience mental health difficulties and 1 in 5 people in the workplace experience a mental health condition.

Many of the illnesses, it is observed, can be treated though access to treatment is often difficult and also the stigma that may arise prevents people from seeking services even when they are available.

"Mental health has critical impact on economic development and wellbeing. Employment is critical in promoting recovery for individuals, communities and nations. Up to 80% of individuals with serious mental illnesses are unemployed while 70% want to work,” she pointed out.

Kayiteshonga cautioned that everyone can be prone to mental illness and that prevention and seeking early treatment is paramount.

"No one has immunity against mental illness. People who are facing these illnesses are scared of admitting that they are and refrain from seeking help but this only makes it worse,” she warned.

She mentioned that awareness of the causes, early detection of the signs of burn out, participation of all employees in decision making, recognition of good performers are some of the factors that can help fight stress in the work place.

"Encourage employee assistance programs, set up talk free spaces, create an atmosphere of hope, employers can become agents of change, this will help in fighting causes that lead to stress."

Dr. Jean Damascene Iyamuremye the Director of  Psychiatric Care in Rwanda Biomedical Centre said that with such interventions, the workers’ welfare ought to be improved more so on the issue of mental health.

"Most workers are faced with conditions of mental illness; some of those illnesses include stress which is 80%, depression which is at 40%,” he pointed out.

He added that when an employee has a mental illness and solutions are not sought for, it could cause permanent damages.

"What is observed is that, workers have a lot of responsibilities, and those who get the signs of these illnesses tend to ignore them by not getting treatment. At the end of the day that’s when you find workers who resign without a reason, become addicted to drugs but when you trace all of it you find that stress was the reason.”

A call to employers

Patrick Kananga the Occupational, safety and health specialist at Ministry of Public Service and Labor called onto organizations to abide by the laws protecting employees because it is through these that a healthy welfare of workers is maintained.

He said that employees should be able to take leave and when an employee works and exceeds normal working hours with let’s say more than two hours the employer has to give them compensation as  the law indicates. 

He said, not following the lawcan be a weakness that can result in mental health related effects.  "We request employers  to respect labour laws but they should also understand the impact of ensuring a healthy welfare for workers.

"You cannot use an employee who is tired and expect results or profits. What we request is to understand this and not just do it as a law, they should do it but also knowing why they are doing it,” he pointed out.

"The security and welfare at the job impacts the family.  When a worker is not mentally well, the stress or depression not only affects performance at work but the welfare back home. You can imagine the impact this can have on society,” Kananga added.

Elia Ngoga, a Human Resource Specialist manager at Ministry of local government called onto both employers and employees to work together and beat the factors that could in any way be the cause of mental illnesses at work.

"It is a role for both the employer and employee to know what stress is and how to prevent it. Poor planning is one of the factors; there should be mobilization and proper timing for certain activities in organizations,” he said.

Way forward

"The enemy of mental health is ignorance. Ignorance leads to lack of service, human resource, funds, and respect. We have been emphasizing the sensitization of people about mental health through all possible channels. We have created mental health services from community level to district level. We have been able to integrate psychotic drugs into the national list of essential drugs, meaning people can access the drugs at an affordable price, " states Dr. Kayiteshonga. She adds that, "mental health services have also been integrated into Mituelles de Sante insurance. This is a great achievement.”

The Ministry has built strong partnerships with other stakeholders in t mental health services so that they are not only found in medical centers but also in the communities.  These organisations have assisted in addressing mental health issues. This has improved the accessibility of treatment or medicine by the victims.

The Ministry of Health has worked with the Ministry of Education to incorporate a Post Graduate Diploma in the curriculum. "Today, Rwanda is invited to share their success story in dealing with mental health.”Despite the great work the Ministry of Health through RBC  has done in educating masses about mental health, the issue of stigma is still prevalent in society. There has also been a lack of sufficient resources to conduct its operations, purchase drugs and carry out research. Additionally, donors have been strict on many things like figures, of which these can only be got by carrying out comprehensive research. Such strict regulations have limited resources being invested into mental health. There is also a challenge of donors focusing on other killer diseases like HIV/AIDS. The Ministry is committed to sensitizing people about mental health, training more people to work in mental health, psychiatry specialiasation and  to focus on child psychiatry as well.

To deal with aftermath of the 1994 Genocide against Tutsis, the Government of Rwanda devised a number of strategies to assist those presenting mental health problems resulting from the genocide.

These included treatment of patients with mental health issues. Mental health services have also been decentralized, as all Hospitals are now staffed with at least one psychiatric or mental health nurse.

Two general practitioners and two general nurses from each district hospital are trained each year in psychiatric care and since 2014, a total 468 health centers across Rwanda had one or more general nurses trained in mental health.

The decentralization of mental health care improved the geographic accessibility and reduced transfers to mental health reference structures.  During the annual commemoration of the genocide against Tutsis, health professionals in health facilities receive refresher trainings on mental health issues. District hospitals work with the community members to coordinate patient care.