Strategic Planning (Mental Health)

A survivor receiving mental health support
A survivor receiving mental health support

Further to the publication of the new Strategic Plan of Survivors Fund (SURF) for 2024 to 2028, we will be publishing several posts to provide more context of our work – and implications for the the survivors of the genocide against the Tutsi in Rwanda which we support.

Mental Health

Rwanda’s mental health context is deeply influenced by the 1994 genocide against the Tutsi, which had a profound impact on the psychological well-being of the population. The traumatic events significantly elevated the prevalence of mental health conditions such as post-traumatic stress disorder (PTSD), depression, and anxiety disorders among survivors and affected communities.

The Rwanda Mental Health Survey (RMHS 2018) conducted by the Rwanda Biomedical Centre (RBC) revealed the increased prevalence of various mental disorders within the general Rwandan population and within genocide survivors. Results from this survey indicated that:

  • Major depressive episodes (MDD) occurred in 12% of the general population and 35% of Survivors of the Genocide against the Tutsi.
  • Post-Traumatic Stress Disorder (PTSD) occurred in 3.6% of the general population and 27% of Survivors of the Genocide against the Tutsi.

Survivors and their families continue to present with considerable rates of posttraumatic stress disorder (PTSD) and substantial depressive and anxiety symptoms. Studies evidence a strong association between health problems and psychosocial factors such as social integration. Posttraumatic stress reactions were especially elevated in adult survivors who had experienced a high number of traumatic events, had poor physical health and were lacking in social integration.

Recognizing the pervasive impact of these traumas, the Rwandan government, alongside international partners, including Survivors Fund (SURF), initiated various interventions aimed at addressing the mental health needs emerging from this dark chapter in the nation’s history.

The Rwandan mental health system is integrated within the general healthcare framework, striving to make mental health services accessible across different levels of the health system. A notable feature is the decentralization of mental health services, with efforts to avail mental healthcare not just in specialized centers but also at district hospitals and health centers. Additionally, the community-based health care approach, which has been significant in other health domains in Rwanda, has also been utilized in mental health, engaging community health workers in raising awareness, conducting screenings, and facilitating access to care.

Rwanda’s approach to mental health is guided by strategic policy frameworks, notably the National Mental Health Policy, which articulates the visions, strategies, and priorities for enhancing mental health in the country. The policy emphasizes aspects like strengthening service delivery, enhancing human resources for mental health, raising awareness and reducing stigma, and fostering research and monitoring in mental health.

While considerable strides have been made in Rwanda’s mental health domain, challenges persist. These include ensuring widespread access to quality mental health services across all regions, addressing stigma and misconceptions related to mental health, and securing adequate human and financial resources for mental health. Furthermore, enhancing the capacity to address diverse mental health needs, including those emerging from contemporary stressors and challenges, remains pivotal.

Looking forward, enhancing mental health in Rwanda remains an intricate and multidimensional endeavor. Continuous efforts to bolster the mental health system, amalgamate mental health into general health and socio-economic development, and adapt to emerging mental health needs will be crucial in navigating the future trajectory of mental health in the country.

Implication for survivors and related vulnerable groups: Access to mental health support continues to be a critical need for survivors, and with specialist services so limited in Rwanda the burden to provide such treatment falls to local survivor’s organisations. With so many other competing needs, it is unlikely in the years ahead that this situation will change, which particularly disadvantages survivors due to the crippling effects resulting from PTSD. That there is increasing evidence for the intergenerational inheritance of trauma, makes the need to not only sustain but extend mental health support to survivors and second-generation survivors even more vital. 

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