Mental health is finally attracting greater attention with the government, Imbuto Foundation and other stakeholders deploying community-based mental health counselors. More than 100 counsellors have already been trained and deployed under a project dubbed “Baho Neza”, which is being piloted in districts with higher prevalence rates of mental health cases, namely; Nyamasheke, Nyaruguru, Nyagatare, Musanze, Bugesera, and Gasabo. A 2018 study by the Ministry of Health showed that Rwanda had a very high prevalence rate of mental health disorders, with depression topping at almost 12 per cent in the general public and 35.1 per cent among Genocide survivors. Posttraumatic stress disorder (PTSD), panic disorder, and alcoholism were the other prevalent mental health cases. The study also found that one in every five Rwandans lived with at least one form of mental health disorder, while a staggering 85.9 per cent of the population did not seek mental health services. Up to 38 per cent of the population did not know where to seek mental health and psychosocial support, pointing to low levels of awareness. Indeed, statistics indicate that only five per cent of people with mental health problems seek medical attention. It is believed that one of the underlying reasons why people rarely seek medical help for mental health distress is stigma, which victims fear might only exacerbate their situation. For a country with a traumatic history spanning generations this is a pressing issue that needs urgent attention. To systematically deal with this problem, there was always a need for concerted efforts at the grassroots level involving different stakeholders. Therefore, the ongoing deployment of an army of community-based mental health counselors will come in handy. However, training and deployment are not enough. For these counsellors to be impactful and effective, they’ll need full support from different segments of the community, such as local leaders, opinion leaders (like religious leaders and educationists) and parents, including through raising awareness and fighting mental health stigma. This is the only way they’ll win the trust and confidence of members of the public. The World Health Organization estimates that effective counsellors may handle up to 90 per cent of mental health cases, thereby helping to ease burden on healthcare facilities. As such, it is critical that the mental health counselors model is eventually not only replicated nationwide but also integrated in the mainstream primary healthcare system – just like the hugely celebrated community health workers model.
