Practices of Congolese Mental Health and Psychosocial Support Providers: A Qualitative Study on Gaps and Obstacles

Mental health and psychosocial support (MHPSS) services, including services related to sexual and reproductive health problems, are highly unaddressed in the Eastern Democratic Republic of Congo. We present findings of a qualitative study that reveals three gaps related to the knowledge and skills of staff in the Eastern Democratic Republic of Congo (DRC) to provide proper MHPSS, with integrated care for sexual and reproductive health. These gaps relate to reliance on western imposed approaches that only partly fit the local context, to a strong focus on medication, and to a lack of training. Further, the data show two main obstacles to improve current practices: persistent cultural taboos and misconceptions about what mental health and sexual health problems are and how they come to exist, and a very limited referral system. The gaps and obstacles illustrate the complex context in Eastern DRC, they highlight the importance of locally tailored education and training, and they stress the need for system changes to improve access to and quality of MHPSS. From a national and regional perspective, the results seem to call for a paradigm shift as to how mental health is approached and embedded in educational systems and society.