"A constant struggle to receive mental health care": health care professionals' acquired experience of barriers to mental health care services in Rwanda.

Journal: BMC psychiatry

Volume: 15

Issue: 

Year of Publication: 2016

Affiliated Institutions:  Department of Community Health, School of Public Health, College of Medicine and Heallth Sciences, University of Rwanda, Kigali, Rwanda. lrugema@nursph.org. Department of Public Health and Community medicine, The Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden. gunilla.krantz@socmed.gu.se. Department of Clinical Sciences, Obstetrics and Gynecology, Umeå University, Umeå, Sweden. ingrid.mogren@umu.se. Department of Biostatistics and Epidemiology, School of Public Health, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda. jntagani@nursph.org. Department of Nursing, Umeå University, Umeå, Sweden. margareta.persson@umu.se.

Abstract summary 

In Rwanda, many people are still mentally affected by the consequences of the genocide and yet mental health care facilities are scarce. While available literature explains the prevalence and consequences of mental disorders, there is lack of knowledge from low-income countries on health care seeking behavior due to common mental disorders. Therefore, this study sought to explore health care professionals' acquired experiences of barriers and facilitators that people with common mental disorders face when seeking mental health care services in Rwanda.A qualitative approach was applied and data was collected from six focus group discussions (FGDs) conducted in October 2012, including a total of 43 health care professionals, men and women in different health professions. The FGDs were performed at health facilities at different care levels. Data was analyzed using manifest and latent content analysis.The emerging theme "A constant struggle to receive mental health care for mental disorders" embraced a number of barriers and few facilitators at individual, family, community and structural levels that people faced when seeking mental health care services. Identified barriers people needed to overcome were: Poverty and lack of family support, Fear of stigmatization, Poor community awareness of mental disorders, Societal beliefs in traditional healers and prayers, Scarce resources in mental health care and Gender imbalance in care seeking behavior. The few facilitators to receive mental health care were: Collaboration between authorities and organizations in mental health and having a Family with awareness of mental disorders and health insurance.From a public health perspective, this study revealed important findings of the numerous barriers and the few facilitating factors available to people seeking health for mental disorders. Having a supportive family with awareness of mental disorders who also were equipped with a health insurance was perceived as vital for successful treatment. This study highlights the need of improving availability, accessibility, acceptability and quality of mental health care at all levels in order to improve mental health care among Rwandans affected by mental disorders.

Authors & Co-authors:  Rugema Lawrence L Krantz Gunilla G Mogren Ingrid I Ntaganira Joseph J Persson Margareta M

Study Outcome 

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Statistics
Citations :  Wang PS, Aguilar-Gaxiola S, Alonso J, Angermeyer MC, Borges G, Bromet EJ, et al. Use of mental health services for anxiety, mood, and substance disorders in 17 countries in the WHO world mental health surveys. The Lancet. 2007;370(9590):841–50. doi: 10.1016/S0140-6736(07)61414-7.
Authors :  5
Identifiers
Doi : 314
SSN : 1471-244X
Study Population
Men,Women
Mesh Terms
Adult
Other Terms
Study Design
Study Approach
Qualitative
Country of Study
Rwanda
Publication Country
England