1. Our approach
Mental disorders account for one of the largest and fastest growing categories of the burden of disease worldwide. Mental ill-health can have devastating effects on individuals, families and communities, with one in every two people experiencing a mental illness in their lifetime. As many as 80% of those with a common mental disorder, and up to 50% of those with a severe mental disorder, do not seek or receive treatment. Mental ill-health also weighs heavily on societies and economies.
UPHLS seeks to address greater efforts to promote mental health and improve early diagnosis and treatment of those with mental illness would improve the lives of ordinary Rwandan. Health systems know very little about whether the health care delivered seeks to improve people’s well-being and their ability to play an active role in society. It is only when we measure outcomes reported by patients themselves – such as quality of life – that important differences in the outcomes of care emerge.
2. UPHLS Intervention Plan
There is a significant need for mental health care services in rural areas of identified districts of Rwanda. While the prevalence of mental illness is similar between rural and urban residents, the services available are very different. Mental healthcare needs are not met in many rural communities across the country because adequate / targeted services are not present, they are mostly found in few and distant specialized hospitals or centers. Providing mental health services can be challenging in rural areas.
The following factors are particular challenges to the provision of mental health services in rural communities in Rwanda :
• Accessibility – Rural residents often travel long distances to receive targeted services, are less likely to be insured for mental health services, and are less likely to recognize an illness.
• Availability – Chronic shortages of mental health professionals exist and mental health providers are more likely to practice in urban centers and specialized hospitals.
• Acceptability – Personal identification for mental health patients in crisis and the stigma of needing or receiving mental healthcare and fewer choices of trained professionals who work in rural areas create barriers to care.
3. situation analysis
According to WHO, One in four people in the world will be affected by mental or neurological disorders at some point in their lives. Around 450 million people currently suffer from such conditions, placing mental disorders among the leading causes of ill-health and disability worldwide.
Treatments are available, but nearly two-thirds of people with a known mental disorder never seek help from a health professional. Stigma, discrimination and neglect prevent care and treatment from reaching people with mental disorders, says the World Health Organization (WHO). Where there is neglect, there is little or no understanding. Where there is no understanding, there is neglect.
In a new report entitled "New Understanding, New Hope" the United Nations health agency seeks to break this vicious cycle and urges governments to seek solutions for mental health that are already available and affordable. Governments should move away from large mental institutions and towards community health care, and integrate mental health care into primary health care and the general health care system.
A nationwide study conducted in Rwanda in 2003 revealed PTSD (Post Traumatic Stress Disorder) prevalence within 28.54% of adult population. In the same study, a comorbidity dominated mainly by depression was noted within 53.93% of the population suffering from PTSD.
A study that was conducted by Bolton in 2002 and limited to Bugesera region testifies to the serious existence of depression within the local population by 15.5%.
Dependence on drugs and other Psycho-active substances pose a new challenge and there is no strategy today to supervise treatment of that phenomenon that generates mental suffering and destabilizes the social fabric.(Reference : National Mental Health Policy in Rwanda)