At least 60 per cent of members of the National Organisation of Users and Survivors of Psychiatry in Rwanda (NOUSPR) are experiencing loneliness with many facing social isolation, stigma and limited family support, according to the organisation.

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The extent of loneliness among people receiving psychiatric care was highlighted on Sunday, October 11, during the commemoration of World Mental Health Day.

Rose Umutesi, the chairperson of NOUSPR, said an assessment of its members found that at least 60 per cent had experienced loneliness, highlighting the mental health challenges faced by people with psychosocial disabilities.

The organisation, which has 6,861 members, advocates for people with psychosocial disabilities, who have long faced various challenges, including being unheard, feared and misunderstood, as well as being perceived as violent, possessed by evil spirits, dangerous, harmful or unproductive.

"People lock themselves in their houses. They do not want to join members of their communities and families. At least 60 per cent of our members we assessed have faced isolation effects,” Umutesi said.

She said some members were isolated by their families and communities, while others lacked basic necessities, further worsening their vulnerability.

"People with psychosocial disabilities often face stigma, discrimination and barriers to healthcare, employment and participation in community life,” she said.

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Umutesi said some members lacked basic necessities such as food and clothing and struggled to afford health insurance and medicines, while others found it difficult to participate in family decisions or access property.

Stigma and discrimination remain key barriers, she said, noting that even members with university degrees were often denied employment opportunities.

She called on the government to help vulnerable people with psychosocial disabilities afford health insurance and medicines, including by providing free treatment where possible.

She also urged the authorities to ensure that people with psychosocial disabilities could access ambulance services in emergencies, like other patients.

In addition, she said community health workers should be trained to support people with psychosocial disabilities.

Umutesi said the organisation&039;s priorities for the next five years included improving communication between mental health professionals and patients at district level, introducing identification cards to help members receive assistance during mental health crises, and advocating for legislation to protect people with psychosocial disabilities.

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For Cansilde Mukakabanda, a university graduate from Gakenke District, the challenges facing people with psychosocial disabilities extend beyond access to treatment.

Mukakabanda represents two associations comprising 65 members who have formed savings groups and started weaving baskets for sale to generate income and support one another.

"We realised that many people were facing similar challenges. We established savings groups and started weaving baskets to sell and earn money,” she said.

She said the members had also received training to understand their rights and support others experiencing mental health challenges.

However, she said stigma and discrimination remained major obstacles, with some people struggling to gain the trust of local leaders and participate fully in community activities.

She called for greater support for people with psychosocial disabilities who live on the streets, including efforts to reconnect them with their families and ensure they receive appropriate care.

She added that employment opportunities were needed to help members become financially independent, noting that stigma could prevent even educated people from securing jobs.

More than 230 peer supporters have been trained to assist members in their respective communities.

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The peer supporters help people understand their rights, navigate available services and connect with others facing similar challenges.

Jonathan Iradukunda from Bugesera District said that although he had observed improvements in how local authorities and service providers understood psychosocial disabilities, further capacity-building was needed.

"Local authorities need to understand how to support and serve people with psychosocial disabilities. Their knowledge and capacity need to be strengthened to serve these people more effectively,” he said.

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He called for improved access to mental healthcare, employment opportunities and social protection for people with psychosocial disabilities.

From one psychiatrist in 1995

In 1995, Rwanda had only one psychiatrist, according to the Ministry of Health. By 2025, the country had 14 psychiatrists, six neurologists and six neurosurgeons.

There were also 334 mental health nurses, 793 psychology practitioners and 208 social work practitioners.

The government's 4x4 reform, which aims to increase the number of medical personnel fourfold, has started to show results, with district hospitals now equipped to provide mental health services.

Mental healthcare has been integrated into the Health Sector Strategic Plan (HSSP) 2024–2029, the National Health Policy and the Healthcare Service Law.