In 2017, Vincent Sezibera and his teammates conducted a survey to measure the prevalence of mental disorders, associated co-morbidities and knowledge and utilisation of mental health services nationwide within Rwanda. The survey titled ‘Rwanda Mental Health Survey’ was published in 2018. From the data collected, the team found that 61.7 per cent of the interviewed people had awareness of mental health services but only 5.3 per cent reported having used existing services. In addition, among Genocide survivors who were interviewed, 76.2 per cent were aware of the availability of mental health services, but only 14.1 per cent reported they have used the services. According to Sezibera, the team also realised that major depression prevalence rate ranged from 11 to 37 per cent on average, which was alarming given that 37 per cent represents almost one in three persons, and not forgetting that the disorder is associated with suicidal behaviours and attempts, of which some turn out to be successful. The team was also aware that mental health services were decentralised to the lowest level in the country, health centres, yet most people weren’t seeking mental health support. From the data, they found out that among the factors that fuelled this issue included beliefs and misconceptions people had regarding mental health and disorders; both the causes and treatment models. “We found out that instead of going to seek for help at the health facilities, a number of people opted to go to church leaders and traditional healers which gave us that sense that there are beliefs or misconceptions behind; either that mental health illness is caused by supernatural forces or demonic possession,” he said. “We also have a clear indicator that when youth don’t have information about mental illness, they browse on Google and get millions of information and sometimes, what they get from there is not necessarily the right information because we don’t control who is posting what,” he added. With that in mind, the team concluded that despite high prevalence of mental disorders among the general population and Genocide survivors, utilisation of available mental health services was low and that a comprehensive approach to mental health was needed for prevention of mental illness and promotion of mental healthcare services. Sezibera notes that the fact that Rwanda has made significant progress at deploying ICT infrastructures across the country, which increased the use of technology-based services and that tele-mental health could be an opportunity to mitigate existing challenges and meet the mental health needs in Rwanda, informed them on how they could develop a solution. Together with his team, Sezibera, a professor of Psychology at the University of Rwanda, College of Medicine and Health Sciences and Director of the Centre for Mental Health at the college, embarked on a project named “e-Ruhuka: An e-mental healthcare architecture as an innovative solution to promote an alternative and conventional support in Rwanda.” The project, according to Sezibera, is set out to examine the effectiveness of tele-mental health for both patients and professionals and is expected to improve universal access to quality health services and fight stigmatisation of mental diseases. “The overall aim of the study is to design an innovative and cost-effective e-mental health platform (e-Ruhuka), that will support mental health service delivery, and promote mental health literacy through online psychoeducation in Rwanda,” he said. In the first phase of the project, Sezibera and the team are set to develop the architecture of the e-Ruhuka platform that is intended to be tested, implemented, and scaled up during subsequent phases of the project. This, according to Sezibera, will increase and improve the efficacy and efficiency of clinical care on behalf of the users as well as mental health care practitioners. He added: “The platform is hypothesised to respond to the underlying evidence data gap and limited access to mental health service, by developing an online community mental health support program and to avail a monitoring and evaluation framework working alongside national mental health system with structures to address limitations encountered during provision of mental health services.” Talking about how the platform will be used in promoting mental health awareness, Sezibera said they will be hosting different campaigns to explain more about different mental disorders and illness, hence encouraging people to seek help. “Our platform is a combination of different features and components; tentative diagnosis of mental health disorders or illnesses and promoting mental health services. In addition, patients will be able to engage in counselling and prolonged psychotherapy, book appointments and decide whether to access the service physically or virtually,” said Sezibera, referring to how comprehensive their solution is compared to others that are available locally. The e-Ruhuka project recently secured $90,000 through phase 1 of the Rwanda Innovation Challenge for Academia-Industry Research and Development Collaboration Grant that is spearheaded by the National Council for Science and Technology. Sezibera said the team will use the money to implement the project for two years, adding that if they succeed, they would seek for a phase 2 Grant to scale up further by handing the platform over to the users including the Ministry of Health as well as private healthcare facilities. He mentioned that in project development, they worked with different industry organisations, tech companies and NGOs.
