Mental health experts in Rwanda say that effective care must be grounded in the medical workers' understanding of a patient’s culture and language.

Speaking during a recent session in the Senate, leading psychologists, educators, and mental health practitioners emphasised that cultural literacy and linguistic understanding are important to mental health care.

Their concern was focused on aligning Rwanda’s mental health curriculum with the cultural realities of its people and the complexity of their lived trauma, especially in the wake of the 1994 Genocide against the Tutsi.

Vincent Sezibera, a clinical psychologist, pointed out that healing psychological wounds requires more than clinical knowledge; it demands deep cultural fluency.

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According to Sezibera, Rwandans in distress express their suffering in ways that cannot be captured by textbook definitions of depression or anxiety.

"Understanding their idioms, symbolic language, and historical references that frame their past pain is critical for practitioners,” he told the Senators, during the session in which the Minister of State for Health Dr Ivan Butera gave a presentation on the status of mental health issues in Rwanda.

Sezibera stressed that simply hearing a patient speak is not enough; a clinician must comprehend the language beyond words and grasp the social and cultural contexts those words are said. This, he argued, should be deeply embedded in the education and practical training of students in Rwanda.

Jane Abatoni Gatete, Executive Secretary of ARCT-Ruhuka, an orgnanisation of trauma councellors, underscored Sezibera&039;s point by contrasting Western therapeutic norms with local practices.

In Western societies, she said, avoiding eye contact may signal a problem in rapport or self-esteem.

"In Rwanda, the same gesture could be a sign of respect or humility. Without culturally adjusted interpretation, such differences could lead to misdiagnosis or ineffective support," she said.

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Abatoni called for a stronger focus on family and community-based care structures.

She advocated an approach that assesses the quality and levels of service delivery from informal support within families to community health workers, professional counsellors, psychologists, and specialized clinical services.

"This must be framed through 'Do No Harm,' an ethical principle critical in post-conflict recovery that warns against introducing external solutions without contextual understanding,” she said.

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Sezibera also stressed the need to adapt training programs to reflect Rwanda’s specific psychological landscape.

Unlike other nations where certain disorders remain under-acknowledged or are hidden due to stigma, Rwanda faces a unique challenge born out of the trauma of the Genocide against Tutsi .

"Training students to address issues such as schizophrenia, childhood developmental disorders, couple and family conflicts, and aging-related mental illnesses must include local historical trauma insights,” he said.

Sezibera, who is a professor at the University of Rwanda, noted that clinical psychology departments are growing in both enrollment and depth of learning material, and that modules on Rwandan history and culture should now be integrated into early-stage curricula.

"Students should not just learn theories of trauma; they should learn to analyze proverbs, naming conventions, and intergenerational narratives to better understand psychological continuity and change,” he added.

Sezibera noted that regular curriculum reviews are necessary, especially to integrate more material on cultural context and historical trauma.

Senator Jean Pierre Dusingizemungu voiced concern that the mental health effects of other critical historical episodes, such as colonial oppression or the 1959 displacement of Rwandans, are rarely addressed in mental health training.

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"These events shaped collective identity and continue to influence how trauma is internalized and transmitted,” Dusingizemungu noted.

In response, Sezibera saif it was crucial to study the scale and depth of intergenerational trauma, and how cultural tools such as proverbs and family naming practices can either heal or perpetuate psychological wounds.

Charles Nkubili, Director General of Ndera Neuropsychiatric Teaching Hospital, praised the government’s strategy to expand the health workforce, noting that the number of psychiatry and neurology students is steadily increasing.

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"With more graduates in the pipeline, we will make significant strides in strengthening the mental health care system,” he added.

Rwanda has increased the number of students entering the mental health field, with annual intakes rising from 68 in 2022 to 300 in the 2022/2023 academic year, according to the Ministry of Health.

There are over 900 clinical psychologists, with around 400 working in the public sector and others serving in organizations such as Ibuka, Avega, among others.