Helping hands: how communities can foster mental health

Alphonsine, a widowed mother of three adolescents, lives in Gasharara Village in the Northern province of Rwanda. In adolescence, Alphonsine began showing marked changes in behavior after her father left the family. She dropped out of school and could no longer carry out simple household chores or basic self-care. When she became increasingly agitated, she was admitted to NDERA Neuropsychiatric Hospital in Kigali for treatment.

Initially, Alphonsine’s mental health improved, but upon the death of her husband a few years later, her children observed a sudden return of symptoms. She became restless and aggressive and would often run back and forth in the street, take off her clothes, and leave the home in disarray. Her children were frightened and believed she was a victim of witchcraft. During this time, Alphonsine had ceased attending her monthly check-ups and taking medication for her mental illness as well as the anti-retroviral drugs for HIV/AIDS.

A community health worker who attended the mhGAP training provided by AVSI’s <a href=”https://www.fondationdharcourt.org/project/care-comprehensive-solutions-for-increased-access-to-mental-health-care-rooted-in-communities-and-enhancing-public-services”>CARE project</a> was able to get Alphonsine access to medical treatment and psychosocial support. In addition, she helped her children understand their mother’s illness and how it could be treated.

Day after day, the community health worker built a relationship of trust with Alphonsine and accompanied her to the local health facility.  Alphonsine was then invited to participate in psycho-educational groups where she learned the importance of continuing her medical care. She was never left alone along this challenging recovery path, receiving regular follow-up visits at home and continued support for both her and her family.

Today, Alphonsine takes better care of herself and her children, which makes them happy. She carries out household tasks and was granted cows which provide them with milk and manure for fertilizer. Alphonsine now goes to the health center on her own and takes her medicine regularly without any assistance. Most importantly, she continues to actively participate in the psycho-education sessions for people living with mental illness and shares her story to help others facing their recovery journey.