Why we need urgent mental health interventions for Rwandan youth

Thursday October 10 2019

 

DR. JOSEPH RYARASA NKURUNZIZA
By DR. JOSEPH RYARASA NKURUNZIZA
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In September this year, a 26-year-old lady jumped from the fourth floor of a high-rise building in Kigali.

In the following month, the media reported yet another suicide incident of a 36-year-old man in the outskirts of Kigali. This trend in the rise of the number of suicide cases is not unique to Rwanda but represents a concerning global public health issue.

World mental health day today is an opportunity to raise global awareness on suicide. The day is themed “suicide prevention” to call for action by governments to set up mechanisms for suicide prevention and for society as a whole to talk about suicide and play a role in reducing the number to suicides.

Data from the World Health Organization (WHO) shows that nearly 80% of all suicides occur in low- and middle-income countries contrary to popular belief that suicides is a mental health issue for developed countries.

Moreover, every 40 seconds, a person loses their life to suicide – meaning that close to 800,000 people commit suicide every year. Among the most affected by suicide are young people between the age of 15 and 29 years old, of whom suicide is the second leading cause of death.

While mental health interventions are a necessity for every society, it is more so important in societies that have experienced cycles of conflict, Genocide, war or mass atrocities. It is evident that Rwandan is unique and the youth face a particularly challenging context in regard to their mental health.

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Trans-generational trauma

Youth born after the 1994 genocide against the Tutsis experience trans-generational trauma as a result of their parents’ past wounds and in some cases recurring trauma stemming from a variety of issues such as discovering the remains of family members killed in the genocide not to mention of course identity crisis.

Intergeneration transmission of trauma might also be affected by the parenting behaviour. This behaviour might be a risk factor originating from the parent’s traumatic past they underwent. 

Our interventions demonstrate that parents might be less sensitive to their children which might affect the children developmental stages. There is need to make sure we avoid children growing up in violent environment.

Such wounds and trauma affect their psychosocial and mental wellbeing, making them vulnerable to suicide.

The need for urgent mental health interventions particularly for our youth cannot be stressed any further. As ex-perpetrators who have completed their sentences are released and integrated into communities there is a need for psychosocial interventions to prepare survivors and youth born from survivor families so that they can cope well without experiencing recurring trauma.

On the other hand, ex-perpetrators too need to be prepared to live peaceably with communities they wronged and refrain from using wounding or traumatizing language that may trigger trauma.

Imprisonment also leads to personal and collective trauma due to the fact that the foundation of the society which is the family which had a disruption due to the imprisonment of one of the parents, the released prisoners might be involved in domestic violence.

Additionally, emphasis should be placed on advocating for affordable and accessible mental health care as well as deconstructing stigma around mental health. To achieve this, policy makers must prioritize mental health in the socio-economic development of the country.

Major change

We have implemented peace building approaches to address deep wounds from the past, reduce trauma and psychological distress, and build resilience, forgiveness and social tolerance in Rwanda.

Data generated over the course of the peace building programme empirically demonstrates the positive impact of psychosocial group therapy modelled on peacebuilding approaches on at least two major change aspects.

(1) It effectively reduces trauma, revenge tendencies as well as anger, and builds positive psychological resilience, social trust and tolerance. These outcomes have direct benefits for individuals and broader society in terms of increasing general psychosocial wellbeing, economic participation and social cohesion.

(2) It effectively reduces the likelihood of participants engaging in violence and victimisation and increases the likelihood of individuals engaging in formal mechanisms for formal civic participation as well as informal forms of family and interpersonal conflict resolution and mediation. 

Our work is perhaps a starting point to discuss youth mental health. However, more work is yet to be done to address the mental health for the population, particularly for the youth.

Stigma on mental health continues to limit the populations’ awareness and subsequently treatment of mental health problems.

A large percentage of the population lacks awareness on diagnosis, treatment options and information on where to seek support when needed.

The task is not insurmountable. Policy makers, international development community and non-state actors all have a role to play in making sure that mental health is not relegated to the peripheral of Rwanda’s development.

The youth are the future of this country making up 39% of the total population and their mental health should be a priority as we prepare them to take the reins of the country’s development.

The author is the Executive Director at Never Again Rwanda. He can be reached via @JosephRyarasa

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