Why Depression is overlooked?

Ensuring access to quality mental health care is a cornerstone of every health investment for a sustainable health system. A state of well-being where each individual realizes his or her own potential, can cope with the normal stresses of life and can work productively and being able to make a contribution to her or his community. Most of the times, depression is highly associated with other underlining causes such as diabetes, cancer, hypertension to just cite few. The range of prevalence lies between 15.5% to 22.7% pending on different studies conducted in Rwanda between 2000 and 2009. Of the 26.1% of PTSD found in 2009, 53.93% had major depression as first comorbid disorder. These risks are heavy when dealing with adolescents and young boys and girls. The association of suicide and mental health disorders are overwhelming. The Rwanda health sector has put in place different strategies to bring mental health services close to the population. Human Resources: Almost 1/2 community health workers are now equipped with basic skills on how to identify common mental disorders that include trauma (PTSD) and Depression. They were trained on how to fight stigma, orient families and patients throughout the health system structures. At health centers, general nurses (1 to 2) in all health centers in Rwanda are trained on diagnostic, treatment of simple cases of mental health disorders and proper reference of cases to upper level at district hospitals where at least 2 General Practitioners and 2 general nurses have been trained in the management of mental health cases. For each District Hospital, there is at least one mental health nurse and one clinical psychologist to help with mental illnesses. All range of psychotropic drugs are not only available but they are also included in the national essential drugs and medicines list in Rwanda reimbursed by the Community Based Health Insurance (Mutuelle de Santé). Finally, a tight relationship is found between quality of life in our population estimated using Global Burden of Disease indicators such as QALYS and DALYS/YLDs and depression. Every single individual needs everyones support. At work, employees and employer, peer’s relationship is key for a successful institutional. Relationship between husbands and wives, parents and children on one hand and children and teachers on the other hand needs to be mainstreamed to get healthy and prosperous generation. One of the testimonies from our patients who got depression outlines the need of support from family or relative, recognizing or knowing your status and seek care. Physical exercises and healthy diet are ingredients for healthy life for better productivity at work and better life of today and tomorrow. Dr Yvonne Kayiteshonga works with Rwanda Biomedical Center