A Community-Based Mental Health Intervention: Promoting Mental Health Services in Rwanda

Mukamana, Donatilla; Levers, Lisa Lopez; Johns, Kenya; Gishoma, Darius; Kayiteshonga, Yvonne; Mohand, Achour Ait

doi:10.1007/978-3-319-70134-9_36-1

Cited by 5 publications

(8 citation statements)

References 34 publications

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“…This may result in negative reception of mental health care (Munyandamutsa et al, 2012 ; Mutabaruka et al, 2012 ). Furthermore, access to mental health services in Rwanda remains low, regardless of the efforts the government of Rwanda has made for attenuating the high prevalence of mental disorders (Wakida et al, 2018 ; Mukamana et al, 2019 ). To our knowledge, no study was carried out to explore the barriers to the utilization of mental health services from the perspectives of mentally ill patients; this study in part pursues to address this research gap.…”

Section: Introductionmentioning

confidence: 99%

Exploring Barriers to Mental Health Services Utilization at Kabutare District Hospital of Rwanda: Perspectives From Patients

Muhorakeye

Biracyaza

2021

Front. Psychol.

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Barriers to mental health interventions globally remain a health concern; however, these are more prominent in low- and middle-income countries (LMICs). The barriers to accessibility include stigmatization, financial strain, acceptability, poor awareness, and sociocultural and religious influences. Exploring the barriers to the utilization of mental health services might contribute to mitigating them. Hence, this research aims to investigate these barriers to mental health service utilization in depth at the Kabutare District Hospital of the Southern Province of Rwanda. The qualitative approach was adopted with a cross-sectional study design. The participants were patients with mental illnesses seeking mental health services at the hospital. Ten interviews were conducted in the local language, recorded, and transcribed verbatim and translated by the researchers. Thematic analysis was applied to analyze the data collected. The results revealed that the most common barriers are fear of stigmatization, lack of awareness of mental health services, sociocultural scarcity, scarcity of financial support, and lack of geographical accessibility, which limit the patients to utilize mental health services. Furthermore, it was revealed that rural gossip networks and social visibility within the communities compounded the stigma and social exclusion for patients with mental health conditions. Stigmatization should be reduced among the community members for increasing their empathy. Then, the awareness of mental disorders needs to be improved. Further research in Rwanda on the factors associated with low compliance to mental health services with greater focus on the community level is recommended.

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Section: Introductionmentioning

confidence: 99%

Exploring Barriers to Mental Health Services Utilization at Kabutare District Hospital of Rwanda: Perspectives From Patients

Muhorakeye

Biracyaza

2021

Front. Psychol.

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“…During the pre-colonial period, traditional practices were the earliest forms of treatment for mental health. Traditional practices were a form of healing that originated from early Rwandan culture to address the "ancestral spirit of a deceased family member who was unhappy or angry" (5). Mental health treatment involved a diviner or traditional healer who intervened to address the unhappy or angry spirit which could be an ancestor from family lineage (5).…”

Section: Public Health System and Mental Health Integrationmentioning

confidence: 99%

“…Traditional practices were a form of healing that originated from early Rwandan culture to address the "ancestral spirit of a deceased family member who was unhappy or angry" (5). Mental health treatment involved a diviner or traditional healer who intervened to address the unhappy or angry spirit which could be an ancestor from family lineage (5). Within the Rwandan context, there are different treatment options such as the "ritual of Kubandwa and Guterekera, which paid homage to certain spirits" (p.4).…”

Section: Public Health System and Mental Health Integrationmentioning

confidence: 99%

“…For example, one of these rituals paid their respects to Ryangombe, a divinity, representing the source of love, peace, and fertility (6). These indigenous healing practices were widespread throughout Africa and efforts were made to realign broken ancestral harmony that caused mental illness (5). Moreover, protection was a common belief that centered around God and ancestral spirits to protect individuals and their families.…”

Section: Public Health System and Mental Health Integrationmentioning

confidence: 99%

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Rwanda's Resiliency During the Coronavirus Disease Pandemic

et al. 2022

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The coronavirus disease (COVID-19) pandemic has illustrated the wide range of preventative measures and responsive strategies of low- and middle-income countries (LMICs). LMICs have implemented lessons learned from previous periods of epidemics and uncertainties. Rwanda's pre-existing decentralized healthcare and mental health system which are in response to the mental health distress from the 1994 genocide, continues to be a formidable system that collaborate and combine efforts to address people's mental health needs. COVID-19 has heightened or exacerbated people's mental health within the country. Rwandans have been exposed to and endured adversities, yet their cultural forms of resilience serve as a mental health protective factor to also overcome COVID-19. Nonetheless, Rwanda has engaged in interventions targeting public safety, social and economic protection that specifically address vulnerable communitie's mental health needs. Lessons from preparedness for the Ebola virus disease (EVD) epidemic has contributed to Rwanda's organization and approach to combating COVID-19. Policies and best practices that were enacted during the EVD outbreak have guided Rwanda's response within the healthcare and mental health system. Coincidentally, this outbreak emerged during the 26th commemoration of the 1994 genocide against the Tutsi. Although for the first-time post genocide, Rwanda was not able to engage in public traditional forms of collective mourning and community healing, evidence of Rwandan's resilient spirit is demonstrated. Community resilience has been defined by Magis [401] as the “existence, development and engagement of community resources by community members to thrive in an environment characterized by change, uncertainty, unpredictability and surprise.”. Referring to this definition, community resilience has been an interwoven into the cultural framework that guided Rwandans in past challenges and continues to be evident now. Rwanda's resilience throughout this pandemic remains through ongoing psychoeducation, community awareness of mental health concerns, collective messages of highlighting mental health support, and solidarity. The global community can gain knowledge from Rwanda's learned lessons of their past which has positioned itself to stand on its resilient values in times of uncertainty such as COVID-19 and endeavor to overcome through national cohesion.

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“…Mental health infrastructure, resources, and personnel, both 'traditional' and 'modern,' were destroyed during the genocide (Mukamana et al 2019). In the initial aftermath numerous international organisations, including those focussed on children rolled out psychological assistance programmes, based largely on Western bio-psychological framings of trauma (Mukamana et al 2019). For example, the UNICEF Trauma Recovery Programme provided counselling for children.…”

Section: Introductionmentioning

confidence: 99%

‘No-One Can Tell a Story Better than the One Who Lived It’: Reworking Constructions of Childhood and Trauma Through the Arts in Rwanda

Pells

Breed

Uwihoreye

et al. 2021

Cult Med Psychiatry

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The intergenerational legacies of conflict and violence for children and young people are typically approached within research and interventions through the lens of trauma. Understandings of childhood and trauma are based on bio-psychological frameworks emanating from the Global North, often at odds with the historical, political, economic, social and cultural contexts in which interventions are enacted, and neglect the diversity of knowledge, experiences and practices. Within this paper we explore these concerns in the context of Rwanda and the aftermath of the 1994 Genocide Against the Tutsi. We reflect on two qualitative case studies: Connective Memories and Mobile Arts for Peace which both used arts-based approaches drawing on the richness of Rwandan cultural forms, such as proverbs and storytelling practices, to explore knowledge and processes of meaning-making about trauma, memory, and everyday forms of conflict from the perspectives of children and young people. We draw on these findings to argue that there is a need to refine and elaborate understandings of intergenerational transmission of trauma in Rwanda informed by: the historical and cultural context; intersections of structural and ‘everyday’ forms of conflict and social trauma embedded in intergenerational relations; and a reworking of notions of trauma ‘transmission’ to encompass the multiple connectivities between generations, temporalities and expressions of trauma.

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A Community-Based Mental Health Intervention: Promoting Mental Health Services in Rwanda

Cited by 5 publications

References 34 publications

Exploring Barriers to Mental Health Services Utilization at Kabutare District Hospital of Rwanda: Perspectives From Patients

Exploring Barriers to Mental Health Services Utilization at Kabutare District Hospital of Rwanda: Perspectives From Patients

Rwanda's Resiliency During the Coronavirus Disease Pandemic

‘No-One Can Tell a Story Better than the One Who Lived It’: Reworking Constructions of Childhood and Trauma Through the Arts in Rwanda

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