A student who hasn’t slept well for weeks, a market vendor whose friendly smile hides a racing heart, a father numbed by alcohol after months without work. All these stories, and more, are so common that few people recognize them for what they truly are: signs of mental illness. ALSO READ: From one psychiatrist in 1995, Rwanda's mental healthcare comes of age Although we tend to underrate mental health as a minor accessory to our well-being, it is as vital as blood pressure checks, the treatment of malaria, or brain surgery to remove a cancerous tumour. ALSO READ: Study reveals alarming mental health cases in domestic workers According to the World Health Organization (WHO), mental health conditions affect one in eight people globally, adding up to 970 million people. The most common conditions are anxiety and depressive disorder. Annually, over 280 million people suffer from depression, and over 700,000 people die by suicide linked to depression. These numbers represent friends, colleagues, students, coworkers, waiters and waitresses, police officers, family members, or loved ones who suffer, mostly in silence. ALSO READ: Early alcohol, cannabis use linked to teen mental health struggles in Rwanda Rwanda's picture is just as critical. According to a 2018 national mental health survey, 20.5% (one in five) Rwandans had a mental disorder. The most common conditions were major depressive episode (12.0%), panic disorder (8.1%), and post-traumatic stress disorder (PTSD) (3.6%). The burden was heavier among survivors of the 1994 Genocide against the Tutsi – depression at 35%, PTSD at 27.9%, and panic disorder at 26.8%. Furthermore, despite awareness of available mental health services, only 5.3% of those who needed them actually sought after care – a gap in access and stigma that we should address. How do mental conditions present in daily life? A person with depression usually has persistent sadness, fatigue, and drowsiness, loss of interest in what they typically enjoy, inability to concentrate, and suicidal thoughts. They might seem lazy, but it's a disease that needs medical attention. Anxiety disorders show unending worry that disrupts work, school, or interaction. A person with anxiety might be restless, irritable, unable to sleep, or tense. Post-traumatic stress disorder follows traumatic events, triggering disturbing memories. People with post-traumatic stress disorder are hyper-vigilant, easily irritated, and avoid reminders of their trauma. Ironically, silence to avoid triggers makes it worse. Caring for mental health requires everyone's – parents, teachers, churches, health workers, and leaders – help. Each can make a small difference by listening, talking, and helping people seek care without fear. The change starts when we stop treating mental health as something hidden and begin seeing it as part of daily life that impacts or affects all of us in one way or another. What can we do now? First, we should treat mental health as important as physical health. If someone with hypertension deserves routine follow-up, so does a teen with panic attacks or a mother with postpartum depression. This starts in primary health care. We should train nurses and community health workers to recognize symptoms, offer first-line support, and refer early. It's low cost and kinder than waiting for a crisis. Second, we should make schools safe for the mind. Most youth spend the majority of their time in school. Therefore, they should have access to mental health services through school counsellors, peer-support clubs, and open referral channels. This is not a luxury—it protects learning and shapes futures. Third, we should facilitate community conversations. Youth leaders, educators, religious leaders, and local media, can help replace harmful labels like weak, crazy, and cursed with words that promote recovery and compassion. We did this when confronting HIV stigma. We can do it again with mental health. Fourth, we should empower young people to use digital mental health resources effectively. Confidential, culturally appropriate platforms can help them access support without fear of being caught. Digital health isn't a miracle by itself, but it becomes a lifeline when combined with trusted community structures. Fifth, we should invest in mental health because it pays off. Mental health services, training, and awareness reduce school dropouts, violence, and lost productivity. The burden is significant both globally and locally, and the return on early, humane care is even greater. As a medical doctor and public health advocate, I've seen this up close. A few honest questions, such as How have you been sleeping? or Have you lost interest in the things you enjoy?, can change the course of a doctor's consultation. A referral can change a year. Compassion, shown consistently, can change a life. Mental health is as important as physical health, not some day, but right now. Treating it that way doesn't just alleviate suffering; we build stronger families, healthier workplaces, and greater national resilience. That is the promise of public health, and it belongs to all of us. The author is a medical doctor and passionate public health advocate.
