Mental health is still a subject that many Rwandans have little to no knowledge about. This lack of awareness gives room to a lot of misconceptions about the subject: some people think that any mental illness equates to inability to be an active member of the society and that one can never recover from that illness. Others tend to think that such illnesses are a consequence of the anger of their ancestors over their current malpractices whereas others think that mental illnesses are only for the weak ones which makes it difficult for people to come forward for treatment so that they may not be viewed as weak in a society that upholds bravery and strength naming but a few. Needless to mention the amount of stigma those misconceptions create.

“Ijoro ribara uwariraye” is a Kinyarwanda proverb which roughly translates to the tales of the dark can only be told by the night traveler which means that only a person with a mental illness can only be the one to tell what it really feels like to be a person living with a mental illness and the amount of stigma they face.

Alice (not her real name) was once an individual with mental illness, but you can’t really tell. In fact, unless she tells it to you, the idea of her having been a mental illness can never cross your mind. She lives with other people with mental illnesses whom she tries to give love that they couldn’t get in their respective homes nor from their families.

Before diving into the stigma individuals  with mental illnesses face, she began by telling us a story.

There is a story I can’t recall word by word but I have managed to transpose it to draw up the life of an individual with a mental illness within the society we live in.

A mental illness’s big risk factor is lack of affection and emotional support, for example someone suffering from trauma from the loss of his beloved ones in the 1994 Genocide against the Tutsi translates into loss of affection which the person with a mental illness ought to have had if they would still be alive. Lack of affection and emotional support placed this person in a psychiatric hospital but also the same affection and emotional support can be a great protective factor that may prevent that individual from relapsing.

On a beautiful sunset at Kabeza mountain where the only alarms people wake up to are the birds’ morning hymns, this woman called Daphrose woke up early and as usual she went to fetch water at a village well. On her way, she passes through a banana plantation where she spots a young lady who almost seems lost and this scares Daphrose a little bit, because she has just met a stranger at such wee hours of the morning. But like any mother, Daphrose tries to approach the young lady to investigate what is happening to her. As Daphrose is trying to get to her, the young lady immediately takes off screaming: “Isakeee irandya” translating to a rooster wants to feast on me. Daphrose checks around for a rooster but there is none. Nonetheless Daphrose doesn’t dismiss the young lady’s fright, for she is clearly running from something; perhaps there is a rooster nearby, she thinks. Daphrose immediately runs after the frightened young lady at the same time imploring for help of nearby standers to catch her.

Upon catching her, the young lady is still in fight mode and still screaming “Isakeee”. Joseph, the boy who has just caught her then asks her why she keeps repeating the word “rooster” over and over, to which she responds: “I have seen a rooster and it wants to feast on me.”

They then try to calm her assuring her that there are no roosters nearby therefore she is in total security. When they ask for her name, she answers only one word: “Clarence”. They then comfort her and Daphrose even invites her to her house after having reassured her that there are no roosters nearby and that she would be in total security.

Joseph helps Daphrose to take Clarence home and upon reaching the gate, they spot Daphrose’s neighbour’s flock in Daphrose’s compound. Clarence doesn’t take long to pick out the rooster and starts screaming again that the rooster is going to eat her. Daphrose’s neighbour (the owner of the flock) is awakened by the noise and rushes to them to understand why the young lady is calling for help against a rooster. A few minutes later, he suggests to the group to inquire from Clarence why she thinks the rooster wants to eat her which they did after trying to calm her down. “I am a worm; that’s why the rooster wants to feast on me,” Clarence calmly responds. The group tries to talk her out of the idea but with no success, and that’s when the neighbour comes up with another idea to take her to a psychiatric hospital since the clues keep pointing at a mental health issue. At this point, Clarence doesn’t know her origins and she is restless.

They arrive at the hospital and recount everything that has happened since that morning and the young lady is immediately admitted. 

Clarence is going to begin another journey with the doctor to help her get some rest first- for everytime she has attempted to do so, she keeps seeing a rooster coming to eat her- and secondly, to help her understand that she is not a worm. With the doctor’s experience, this is not something new, the doctor has all the tools and skills to handle such a case.

A few months later, Clarence has undergone all the necessary treatment procedures; she is conscious, she can now rest well and knows her origins that she has even told the doctor.

Moreover, Clarence is fully aware that she is a human being but not a worm. No one has come to pick her, she is discharged and going home by herself. On her way not far from the hospital, Clarence sees a rooster on the sidewalks crossing her path and she begins to scream “isakeeee” right away.

Due to being accustomed to cases of patients escaping the psychiatric hospital, people within the psychiatric hospital’s neighbourhood know that when they see a person showing symptoms of a mental health illness, they must take him back to the hospital to be treated.

Bystanders who are watching Clarence screaming have to respond to the call of duty-of taking that patient who has just escaped back to the hospital- but Clarence is in denial and fighting them because she has just been discharged and she is fully aware that she is a normal person. On the other hand, she is still frightened by the rooster. Nonetheless, they manage to take her back to the hospital and when the doctor lays eyes on her, he furiously asks: “What have you come to do here again, haven’t I just cleared you to continue your daily life?” People who have brought her then weigh in explaining what has just happened and then leave.

Left alone with the doctor, Clarence then repeats the same word “Isake”.

“Clarence didn’t we agree that you are not a worm?” asks the doctor. “Yes, I understand that perfectly,” she replies. 

Let’s pause the story a little bit. At this point, one may wonder, what has brought back Clarence to the hospital? Wasn’t she fully healed? If yes, why is she still frightened by the rooster? Or is any of the parties involved not telling the truth? Did the hospital’s neighbours act right to take her back to the doctor? Did Clarence really see a rooster? The list goes on.

Let’s get back to the story. 

In reality, Clarence is healed and did see a rooster but the doctor’s fury of her return is founded and understandable, for he treated a patient and a few minutes after being discharged, she is back with the same problem which may depict the professional’s incompetence.

As Clarence keeps on screaming “isake”, the doctor gets angrier. He finally asks her, “Didn’t we agree that you’re no longer a worm?”. Mind you, this second time that Clarence has been screaming “isake”, she has not yet spoke about being a worm.

Afterwards, the doctor decides to calm down and ask nicely. “Please tell me, what has brought you back?” asks the doctor as he slowly sat next to her. Clarence then sighs and looks at the doctor then says: “Doctor, you did an amazing job in making me fully aware that I am not a worm, but does that rooster really know that I am no longer a worm?”

Basing on the story, the doctor only treated Clarence but for her to feel secure, the rooster also needs to be told that Clarence has become a normal human being.

I was once a patient of mental health illness and during my time at the psychiatric hospital I have met many Clarences.

The roosters we’re talking about are the people surrounding that patient especially in his/ her daily life. The reality is that a mental health patient when treated, (s)he recovers fully but the society still views him/ her as the same person during his/her mental health crisis.

Clarence’s last question is the same as the patient asking the doctor: “Even though you’re discharging me, does my family and siblings know that I have fully recovered? Or when I get home my 69-year-old mum will be going to fetch water miles away leaving me seated and closes the kitchen behind her thinking that I might destroy or burn the house down?”

Unfortunately, that’s how the society still views a person with mental illness. Psychiatric institutions have been doing an amazing job in treating the people they have within their premises but have done very little to sensitize and raise awareness in preparation of the homes, families and the society at large that are going to welcome the treated and fully recovered patient without stigmatizing him/her.

Psychiatric institutions still need to conduct campaigns at places of mass gatherings such as churches, markets, schools to name but a few, in a bid to keep raising awareness about mental health issues but mostly in fighting the stigma that individuals struggling with mental health illness face especially within our community.

From these campaigns everyone questions themselves about their role in helping the person battling with mental illness to live happily.

Mental health care requires community’s participation in addition to the professional’s duties.

The people they thought to be sick, have been treated and have recovered. Let’s treat them with support and acceptance, let’s allow them to take responsibilities and play their role in building our society. Let’s give them time and space to showcase what they can do.

It is important to note that mental health episodes do not occur every single day; the society tends to perceive people with mental illness like they’re always in crisis hence denying them the right to be functional members of the society.

Every individual battling mental illness needs help not death, discrimination, or stigma because when given time they have a lot to offer and with a much better standard of quality because they want to erase the bad image that our society has for long pinned on them.

Disclaimer: This letter was written in collaboration with Rwanda We Want (RWW) a youth organisation that aims to train and harness skills among the youth which will help them exploit their full potential and become pillars of sustainable peace and development.