As Rwanda prepares to celebrate the World Mental Health Day on October 10, the ministry of health is drumming up awareness of mental health problems.

Mental health problems can have a severe impact on someone’s life. (Internet photo)

While mental health issues are less unknown compared to other forms of disease and illnesses such as malaria HIV/Aids and many more, they have a serious effect on society which sometimes goes unnoticed.

According to the World Health Organization (WHO) statistics, about 450 million people worldwide die of mental health related complications.

However, just after the 1994 genocide there were only a handful of mental disorders that were reported at Ndera, the mental illness reference hospital. For example, according to the statistics compiled by the Ministry of Health, in 2000 there were only 8000 cases reported at the hospital compared to the 25,000 cases which were reported seven years later.

On top of that Rwanda records the highest level of post traumatic stress disorders which is mostly caused by the genocide compared to other countries within the region.

A recent research conducted on 1000 recipients indicate that 2.65million people (approximately 28.54%) of the total population in Rwanda have in some way suffered from post traumatic stress disorders.  

According to Dr. Achour AIT Mohand, a psychiatrist working with the Ministry of health, the fact that there are a lot of people going for consultancy does not mean that mental illness is get rampant but the number of consultations is evidenced due to the fact that there mental health care services are available to the public.

“Over the years we have witnessed increased awareness of mental health issues, access to services, qualified personnel and all this has led to increased number of patients visiting psychiatric hospitals,” Dr Mohand.

Best in the region

The mental health policy which according to Dr Mohand is the best in the region has prioritized mental health, promotes awareness, integration and decentralization of mental services, inter-sector collaboration which ensures that the ministry of health, Non Governmental Organizations (NGO’s) as well as other stakeholders are on the same page as well as concentrating on training and supervision.

As regards decentralization of psychiatric services huge steps have been made. While referral psychiatric hospitals such as Ndera and the psycho-social consultation services were being overburdened by the number of patients it received annually many of which could be handled without much expertise required, the tables have been turned around as 37 out of the 44 district hospitals offer psychiatrist services across the land. On top of that, out of the 37 district hospitals that offer psychiatric services there are six of them that have offer improved psychiatric services compared to the rest.

“Having a decentralized mental health system has reduced the burden on referral hospitals with district hospitals handling 19000 cases which I believe is a tremendous achievement as far as decentralizing mental health services is concerned,” Dr. Mohand pointed out.

He further indicated that decentralizing the mental health system and the use of the health insurance schemes such as Mutuelle has allowed more people to access psychiatric services.

Furthermore, it has also significantly reduced cases forwarded to the referral psychiatric hospitals as most mental illness cases are usually handled at the district hospitals or at the district hospitals which offer improved psychiatric services. “Last year only 2% of the psychiatric cases were transferred to the referral hospitals,” Dr. Mohand revealed.

Despite the tremendous efforts made in bringing closer psychiatric services to the community, the psychiatric fraternity is faced with huge capacity issues. For instance, there are only three specialized psychiatric doctors. These are complimented by psychiatric nurses who graduate from Kigali Health Institute (KHI) as well as clinical psychology graduates at the National University of Rwanda (NUR).

According to Darius Gishoma, a mental health lecturer at KHI there is seven doctors who are currently undergoing post graduate courses in psychiatric abroad.

Gishoma conceded that the profession lacked skilled staff. “It’s true we do not have enough psychiatric nurses, clinical psychology professionals as well as specialized doctors but we are confident we are heading in the right direction,” Gishoma said.

He added that although the capacity was still low, efforts to train and refresh those who were in the profession was going on in a move to beef up the capacity of the psychiatric staff. “We are no where we want to be but we hope to gradually increase the capacity,” Gishoma said.

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