SEATTLE, Washington — After decades of violence in the Democratic Republic of Congo, some of the most painful scars the Congolese people bear are invisible. In addition to causing untold physical violence, the ongoing conflict has had grievous impacts on mental health in the Democratic Republic of Congo.
When Congolese Asiya Kashindi was a teenager, she suffered a violent sexual assault and witnessed her father’s murder in one night, Noella Nyirabihogo reported. Though Kashindi experienced this attack in 2005, she still struggles with severe depression and chronic migraines as a result of her trauma. Yet, Kashindi has never sought treatment from a mental health care professional. For those living in the DRC, Kashindi’s story of trauma and a lack of mental health treatment represents a common experience.
Conflict and Mental Health in the Democratic Republic of Congo
The DRC has been embroiled in violent conflict since the 1990s when the 1994 genocide in neighboring Rwanda sparked the First Congo War. Shortly after, in 1998, continued tensions led to the outbreak of the Second Congo War, which officially ended in 2003 and caused millions of deaths. Following the wars, militant groups remained common throughout the country and continue to perpetrate violence in the DRC to this day.
As a result of these violent conflicts, many citizens have experienced trauma and struggle with mental health in the Democratic Republic of Congo. Violence and a lack of mental health infrastructure make it challenging to obtain statistics on mental health in the DRC. One 2010 survey of DRC residents conducted by an international research team, however, outlines some of the ways in which the conflict has impacted the Congolese people. The survey found that, since the start of the First Congo War, 39.7% of women and 23.6% of men had experienced sexual violence and 67% of the nation had experienced human rights abuses in connection with conflict, including harm to property and several types of violence.
Symptoms of mental health disorders were also common among participants, with about 41% matching symptom criteria for major depressive disorder and 50% meeting the criteria for post-traumatic stress disorder. In addition, more than one in four study participants reported experiencing suicidal ideation within the last year, at the time of the survey.
Barriers to Access
Despite the prevalence of violence and subsequent mental health problems, very few people in the DRC receive psychiatric care. Some of the obstacles preventing Congolese from accessing mental health care include a lack of education and cultural beliefs. Many Congolese people attribute the symptoms of psychiatric disorders to spiritual problems or black magic. As a result, the typical Congolese person would seek help for a psychiatric disorder from a traditional healer or a priest rather than a trained health care professional.
For those Congolese who do attempt to seek psychiatric help, though, resources are scarce. According to data from 2020, the DRC had just one inpatient mental hospital and one hospital providing outpatient mental health services. Data from 2017 shows that there are only 0.08 psychiatrists and 0.02 psychologists per 100,000 people in the DRC. In contrast, 2017 data indicates that in the United States, there are approximately 10.54 psychiatrists and 29.86 psychologists for every 100,000 people.
Financial limitations can also hinder Congolese peoples’ access to mental health care. The DRC government does not allocate any money for the mental health sector, so the cost of mental health treatments in the DRC care typically falls on individuals and their families. Poverty is prevalent in the DRC, with 73% of people surviving on less than $1.90 a day in 2018, according to the World Bank. With widespread poverty, few Congolese have the financial ability to access mental health care if they choose to seek it out.
Living Peace Institute
Though the current mental health situation of the Congolese people is dire, there are groups working to help Congolese people struggling with psychiatric disorders. Living Peace Institute (LPI), established in 2015, is a nonprofit working to reduce gender-based violence in the DRC with a particular focus on the Kivu region.
One of LPI’s efforts, teaching healthy coping mechanisms for dealing with trauma through group therapy, has reached more than 3,000 Congolese. Separately, one study found that group psychotherapy helped to improve mental health symptoms of survivors of sexual violence in the DRC. Given the scarcity of mental health care providers in the DRC, group therapy could be a powerful tool for helping Congolese people work through their experiences with violence and achieve better mental health in the absence of a high number of psychological professionals.
The nonprofit organization Heartland Alliance also works to improve mental health resources for Congolese people. Founded in the 19th century to support Americans living in poverty, Heartland Alliance now serves vulnerable populations in seven countries around the globe.
Since 2009, Heartland Alliance has been working to address issues of gender inequality, human trafficking and mental health in the DRC. To increase access to mental health services in the DRC, Heartland Alliance works with the Congolese government to place psychologists in more hospitals around the country and provide health care professionals with more information about mental health problems. Through these efforts, Heartland Alliance has helped provide mental health services to more than 8,000 Congolese people and participants who had experienced trauma reported “a 68% reduction in symptoms of PTSD, depression and/or anxiety.”
Though intertwined problems of violence and lack of access to psychiatric care have had devastating impacts on mental health in the Democratic Republic of Congo, simple therapies have the potential to help many Congolese overcome the trauma of conflict and violence.
– Anna Inghram