Integration of mental health services in the Democratic Republique of Congo (DRC)
Between 2012 and 2015, the Ministry of Public Health of the DRC and several other international and local stakeholders joint efforts in an attempt to integrate a package of mental health services into the basic health care system of the district Lubero in the DRC.
In 2019, local stakeholders such as the Institut Supérieur des Techniques Médicales de Kananga, and the National Program of Mental Health of the DRC came with an initiative to conduct an evaluation of this specific project in order to document lessons learned . This information might inform policy makers and other stakeholders how to continue and expand these efforts while ensuring increased access to and use of available services that in the end should lead to better mental health and increased feelings of well-being among the population of the DRC.
Culture 4 Change participated in the analysis and documentation of lessons learned.
Results of the pilot project in Lubero were positive in the sense that it has been possible to introduce a basic package of mental health services within a health care system of a so called fragile country. 18 supervisors and 52 health care providers have been trained in the provision of mental health care related services; these people were also able to support the 44 community health workers that were active in their communities. Between 2012 and 2015, 3.941 people that suffered from a mental health condition visited the different health centres or district hospital of Lubero in order to get help for their mental health related problems. Despite these positive results, many challenges have been observed.
After analysis, the relatively low number of people that visited the health centres for mental health care appears to be the result of: a lack of community based actors (non-medical persons) that were informed about the existence of available services; the lack of access to the mental health services in place (distance, infrastructure, fear of stigma) and a failing health system in general that appears to be a major precondition for the integration of mental health service in any health care system.
A major recommendation after the analysis of results is the implication of a heterogeneous group of local agents of change responsible for the implementation of interventions and actions that are not necessarily medical oriented and to implicate religious leaders, traditional healers and other social actors that play an important role in the dissemination of messages and best practices at local level.