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

Abstract

The major purpose of this chapter is to identify and describe community-based mental health interventions in Rwanda and to illuminate their evolution and current function in preventing and treating mental health problems, while promoting healing and restorative mental health practices, especially in light of the 1994 Genocide. The chapter provides an introduction to health and mental health care in Rwanda along with offering historical and contextual perspectives of mental health services there, including discussions of Indigenous and Western medical approaches. The genocide is addressed by discussing its psychosocial implications and the emergence of trauma- and genocide-related mental health problems. Issues pertaining to the aftermath of the genocide are explicated as they relate to the following contemporary areas: the lived experiences of survivors; the increase in psychosocial, psychiatric, and substance abuse problems; and the special needs and concerns of women. The final section of the chapter details the emergence of post-genocide mental health responses, delineating the following distinct eras: the period immediately following the genocide, 1994–1997, and the assistance of international NGOs; the first decade post-genocide, during which mental health care services were reestablished, continued developing, and were integrated into the larger health care sector; the second decade after the genocide, in which community-based mental health interventions flourished; and the growing recognition of the need for specialized services and genocide-specific psychotherapeutic responses, as well as for establishing sufficient education and training for local mental health professionals. The chapter concludes with a recap of major points, emphasizing lessons learned and progress made.