To mark World Mental Health Day 2024, AVSI Rwanda is celebrating the success of the CARE project. Over five years, the project has provided more than 10,000 people with access to mental health care and raised awareness among 87,000 individuals about mental health conditions and how to support those affected.
Providing mental health services in Rwanda's remote areas: the CARE project
Mental health care services in Gicumbi, and Nyanza were limited, with only few trained professionals available and widespread stigma surrounding mental health conditions. Many people with mental health issues lacked access to essential care, and communities often had little understanding or resources to address these challenges.
Recognizing this critical need, AVSI Rwanda - in partnership with the Neuropsychiatric Hospital of Ndera and the University of Rwanda and funded by Fondation d'Harcourt - launched the CARE Project to improve access to mental health care, train healthcare providers, and reduce stigma across these districts. Over the years, thanks to Support International (a founding partner of AVSI Foundation), the Else Kröner-Fresenius-Stiftung also decided to get involved and has funded the same activities in the Gatsibo district.
Through a comprehensive approach, the project has not only enhanced care but also empowered communities to support those with mental health challenges.
59 mental health professionals trained
The CARE project has been instrumental in developing a skilled workforce to address mental health needs effectively. Over the course of the project, 59 mental health professionals, including psychologists, nurses, and social workers, attended intensive five-day training sessions led by experts in mental health.
These sessions focused on the latest treatment methods for conditions such as depression, psychosis, and epilepsy. Additionally, non-specialized healthcare providers received targeted training in mental health awareness and initial care response. This capacity-building initiative has significantly improved the quality of mental health services available across the districts, ensuring comprehensive support for individuals in need.
Over 10,000 people treated thanks to community health workers
A cornerstone of the CARE project has been its focus on community engagement. To empower local volunteers, the project used an Interactive Voice Response (IVR) system - a phone-based training method that allowed community health workers to receive lessons and guidance directly through their mobile phones. This system made training more accessible, especially for those in remote areas, as they could learn at their own pace and in their local language. Through this innovative approach, 2,270 community health workers were trained to identify and assist individuals with mental health challenges. As a result, the project successfully identified 10,593 individuals with mental health issues, ensuring that they received the necessary support and care.
Beyond treatment: rehabilitation and community reintegration
The CARE project established a robust referral system by closely collaborating with local health centers, hospitals, and trained community health workers. This system works by enabling community volunteers, trained through the project, to identify individuals with mental health issues and refer them to the nearest health facilities for treatment. Healthcare providers, also trained under the project, ensure a seamless process by coordinating follow-up care and rehabilitation. Over the course of the project, the system facilitated access to medical care for 5,533 individuals with mental health issues. As a result, a large number of these individuals reported significant improvements in their mental health, with 4,839 individuals successfully reintegrated into their communities following treatment and rehabilitation efforts.
Occupational therapy, group discussion, savings and credit groups to start over
The CARE project has been vital in mental health rehabilitation, engaging 1,415 individuals in occupational therapy activities that focus on restoring fine motor skills through hands-on tasks like crafting and sewing, establishing routine and structure to promote stability, and enhancing cognitive and emotional training through problem-solving exercises. Additionally, the therapy prepares participants for the workforce by simulating work environments and developing job-related skills, thereby boosting their confidence for reintegration into society. Alongside these activities, the project facilitated 69 psychoeducational groups with 2,283 participants to promote mental health awareness and peer support, further enhancing the recovery journey.
As part of the rehabilitation process, the project initiated 55 savings and credit groups, benefiting 1,250 members. These groups not only provided financial stability but also fostered a sense of community among individuals facing mental health challenges, promoting long-term recovery and inclusion.
Reducing stigma and raising awareness
A significant achievement of the CARE project has been its success in reducing stigma associated with mental health. Through monthly awareness sessions and mass sensitization campaigns, the project reached over 87,000 individuals, encouraging communities to understand and support mental health care.
Maniriho Charles’ journey
The project gave me my life back. I now understand the importance of taking my medication and have hope for the future
Maninho Charles, a 24-year-old from Gicumbi
In 2020, after a traumatic experience, Charles developed severe mental health issues, including depression, anxiety, and psychosis. His condition led to aggressive behaviors, suicidal thoughts, and hallucinations, which caused him to lose his ability to work, strained his family relationships, and drained their finances. Unable to interact with others, he lost opportunities for income and independence.
Initially treated at the Neuropsychiatric Hospital Ndera, Charles’ recovery was delayed when he stopped taking his medication and sought traditional healing, costing his family over 800,000 Rwandan Francs (about $660)—a significant amount compared to the more affordable treatment at health centers. However, in October 2020, a community health worker trained by the CARE project intervened, guiding him back to the local health center for proper treatment.
With a combination of medication, psycho-education, and participation in psycho-educational groups and savings and credit associations set up by the project, Charles regained control of his life. He has since started a small business, obtained his driving license, and even purchased a motorbike. Today, he contributes to his family’s financial stability, and thanks to the CARE project’s anti-stigma campaigns, he has reintegrated into his community with dignity and hope.
Looking ahead: expanding the impact
On the Word Mental Health Day AVSI Rwanda celebrates and reflects on the success of the CARE project.
The CARE project has paved the way for its expansion into two additional districts in the Southern Province, where AVSI Rwanda is replicating the effective strategies used in Gatsibo, Gicumbi, and Nyanza.
Additionally, this success has created opportunities for AVSI Rwanda to collaborate on a European Union-funded project focused on the rights of youth with intellectual disabilities. This new initiative aims to strengthen civil society organizations, organizations of people with disabilities, and duty bearers in Gicumbi, Gatsibo, and Nyanza, further reinforcing support systems for both mental health and disability rights.
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