# Prevalence and Factors Associated with Repeat Mental Health Service Utilization During Rwanda’s Genocide Commemoration Week

## TL;DR

During Rwanda’s genocide commemoration week, most mental health service users are repeat visitors, with age and lack of insurance being key factors.

## Contribution

The study identifies demographic and socioeconomic factors linked to repeat mental health service use during a sensitive commemorative period in Rwanda.

## Key findings

- 76% of individuals accessing mental health services during the 2024 genocide commemoration week were repeat users.
- Middle-aged individuals (31–50 years) and those without insurance were significantly more likely to be repeat users.
- Improving access for the uninsured and middle-aged could enhance mental health service delivery during the commemoration period.

## Abstract

The genocide commemoration week in Rwanda often triggers heightened mental health (MH) needs, necessitating targeted support. Understanding factors influencing repeat MH service utilization is essential for effective interventions. This cross-sectional study analyzed data from individuals seeking MH services during the 2024 Rwandan genocide commemoration week, distinguishing between first-time and repeat users. Descriptive and logistic regression analyses examined factors associated with repeat utilization. Of the 825 individuals who accessed MH services during Rwanda’s 2024 genocide memorial week, 76% were repeat users. Bivariate analysis showed that age and insurance coverage were significantly associated with repeat service utilization, while gender and province were not. Logistic regression revealed that individuals aged 31–50 (AOR = 2.29, 95% CI: 1.13–4.64, p = 0.022) and those without insurance coverage (AOR = 3.31, 95% CI: 1.78–6.18, p < 0.001) were more likely to be repeat users compared to the reference groups (18–30 years old and those with insurance, respectively). Gender and province remained nonsignificant in the adjusted model. Improving MH access, particularly for middle-aged individuals and the uninsured, is crucial. Addressing barriers to care could enhance service delivery during the commemoration period.