To curb the prevalence of mental health problems in Rwandan communities, there needs to be early detection and prevention mechanisms, officials and civil society say. A community-based approach supported by counsellors is being implemented and could help reduce the number of mental health cases referred to hospitals, The New Times understands. Over 20 per cent of the Rwandan population (or one in five people) live with at least one form of mental health disorders, figures from the Rwanda Biomedical Centre (RBC) showed in 2018. The rate of mental health disorders is 50 per cent among survivors of the 1994 Genocide against the Tutsi. Depression is the most prevalent mental health condition both among the general population (12 per cent) and genocide survivors (35 per cent), followed by posttraumatic stress disorder (PTSD) and panic disorder, and alcoholism. RBC says, however, that only five percent of the people with mental health problems seek medical services. To respond to the mental health burden, community-based counsellors are being trained in a nationwide campaign to equip them with basic knowledge needed to diagnose and respond to mental conditions. A project called “Baho Neza”, developed by the Imbuto Foundation in partnership with the Ministry of Gender and Family Promotion and RBC, is implemented by a number of non-government organisations. The project started in six districts with the highest prevalence of mental health issues: Nyamasheke, Nyaruguru, Nyagatare, Musanze, Bugesera, and Gasabo. “The people we have trained will sensitize their communities to mental health problems, focusing on the family as the basic unit of the society,” said Aimée Josiane Umulisa, a clinical psychologist, working for the Association of Graduate Student Survivors of the 1994 Genocide against the Tutsi (GEARG). “They will pay attention to the three groups that are most at risk, that is, a big number of survivors of the Genocide against the Tutsi, women and children victims of sexual violence, and young people who are drug addicts.” In addition to promoting help-seeking behaviours and emotional well-being, Umulisa said, the Baho Neza campaign will also address issues of stigma and discrimination in the society. As one of the project implementers, GEARG has so far trained 112 counsellors in Jali and Nduba sectors of Gasabo district. Umulisa said they will continue in Bugesera District. The counsellors said they were prepared to take on the new task. “We have been trained on how to listen to people with mental health problems and how to make them comfortable so that they can open up for us to help them find solutions or to determine the support they need,” Straton Niyonsenga said. Speaking to The New Times, Yvonne Kayiteshonga, the head of RBC’s mental health division, said the community-based approach is needed to reduce the mental health burden in Rwanda, as recommended by the World Health Organisation. “The WHO says that when the community is aware and skilled about mental health, 90 per cent of the cases do not need to be referred to hospital, except for the severe cases,” Kayiteshonga said. “The community-based counsellors are needed for us to have early detection and prevention of mental health disorders, and as the community gets educated, some behaviours and disorders are normalised and people seek treatment without stigma.”
