Rwanda, located in eastern sub-Saharan Africa, is one of the few low- and middle-income countries to have a national plan to address the burden of mental disorders. After the 1994 genocide against the Tutsi population, the government createed a division specifically for mental health within the Rwandan Ministry of Health (MoH) as part of the post-genocide reconstruction of the health system. The goal of Rwanda’s national mental health policy is to reduce the treatment gap by increasing mental health services provided by primary care providers in rural health systems.
Training Primary Care Nurses to Provide Mental Health Services
Since 2012, Rwanda has focused on training providers in primary care settings to deliver basic mental health services. Partners In Health has collaborated with the Ministry of Health to design an approach supporting the integration of mental health care into primary care, Mentoring and Enhanced Supervision at Health Centres for Mental Health (MESH MH). In this program, experienced mental health providers sponsor a five-day program to train primary care nurses how to treat patients with severe mental disorders, particularly psychosis, depression, and bipolar disorder. The training is followed by a program of regular weekly structured supervision. Through the program, primary care nurses learn to perform basic patient assessments, provide treatment including basic medication management and psycho-education, coordinate community support, and manage follow-up care.
Since 2012, members of the MGB AMC Department of Psychiatry, led by Giuseppe Raviola at MGH and Stephanie Smith, MD at Brigham & Women’s Hospital, have collaborated with Rwandan colleagues and have been instrumental in developing this decentralized model of mental health care delivery in rural areas, leading to significant increases in the number of mental health providers in rural communities, as well as improving primary care providers’ ability to provide basic mental health services.
New Training Opportunities in Psychiatry
In addition, members of the MGB AMC Department of Psychiatry provide training and have supported the development of training programs in Psychiatry at the University of Global Health Equity (UGHE) in Rwanda. UGHE is a global university based in rural northern Rwanda, founded by Partners in Health and Inspired by Dr. Paul Farmer’s commitment to health equity and social justice.
Faculty from the MGB AMC Department of Psychiatry now support the education of second year medical students in neuroscience and psychiatry and third-year medical students in a 3-month clinical clerkship in psychiatry.
Members of the MGB AMC Department of Psychiatry are also collaborating with their Rwandan colleagues in the development of a new psychiatry residency training program at UGHE that will open in 2027. The overarching goal of the program is to train a new generation of psychiatrists who will support the development of a model of care delivery that improves access to mental health services, not only in Rwanda but in other parts of the world as well.
MGH faculty members participating in psychiatric education at the UGHE include: Dr. Rahel Bosson, MGH/McLean Adult Psychiatry Residency Associate Training Director, who works across McLean Hospital and MGH and has led integration of global mental health engagements within the MGH/McLean residency program through the development of a new Community and Global Psychiatry Track; Dr. Zeina Chemali, Vice Chair for Education at Cambridge Health Alliance and previous Director of the Neuropsychiatry Clinics and Training in the Departments of Psychiatry and Neurology at MGH; Dr. Rick Wolthusen of McLean Hospital, staff psychiatrist on the Schizophrenia and Bipolar Disorder Inpatient Program at McLean Hospital who has worked extensively in sub-Saharan Africa, including in Kenya and Ghana; Dr. David Kroll, Associate Vice Chair of Psychiatry at Brigham and Women’s Hospital and Director of Ambulatory Psychiatry Initiatives at MGB; Dr. Alex Mosckicki, staff psychiatrist on the Schizophrenia and Bipolar Disorder Inpatient Program at McLean Hospital; Dr. Ganaelle Joseph Senatus, staff psychiatrist at McLean Hospital; and Dr. Funso Oladunjoye, fellow in child and adolescent psychiatry at MGH/McLean Hospital.
You can read more about these programs HERE.
