# Advancing forensic psychiatry in Rwanda: lessons learned and challenges

## TL;DR

Rwanda's forensic psychiatry training program helps address mental health and legal needs after the 1994 genocide.

## Contribution

A forensic psychiatry training program in Rwanda is presented as a model for post-conflict mental health capacity building.

## Key findings

- Forensic psychiatry expertise is essential for managing mental health and legal challenges in post-traumatic settings.
- Rwanda's training program focuses on risk assessments, court-ordered treatments, and trauma sensitivity.
- The program could serve as a model for other post-conflict African countries.

## Abstract

Following the 1994 genocide against the Tutsi, Rwanda showed remarkable resilience in rebuilding its institutions, particularly within the health sector. The genocide against Tutsi left lasting emotional and psychological trauma, highlighting the urgent need to prioritize mental health in national recovery efforts.

The aim of this article is to present the curricula, outcomes and lessons learned from a forensic psychiatry training in Rwanda.

Since 1997, a partnership between the University of Kigali and Geneva University Hospitals has supported this goal by co-developing training programs and professional capacity building. A focus of this collaboration has been forensic psychiatry, a field that bridges mental health and the justice system.

During this training major aspects of forensic psychiatry have been addressed: expert evaluations and risk assessments, court-ordered treatments and ethical and legal considerations. Trauma sensitivity has been central as well. The importance of forensic psychiatry extends beyond legal cases, contributing to the management of gender-based violence, substance abuse, and post-traumatic stress disorders. These issues remain significant given Rwanda’s history of genocide against Tutsi and its long-lasting psychological effects.

Continuing the training is essential to strengthen the skills of local professionals in managing complex legal and medical cases, ensuring they are confident in their interactions with the justice system and supporting its effective and ethical functioning. It is essential to strengthen these competencies and the collaboration between local authorities and academic institutions.

Main findings: Expertise in forensic psychiatry is crucial in post-traumatic settings and specific training is required to address the complex mental health and legal needs of affected populations.Added knowledge: In Rwanda, a forensic psychiatry training program is underway to strengthen professional competencies and develop a specialized national curriculum.Global health impact for policy and action: The Rwandan experience may serve as a valuable model for other African countries, particularly those with post-conflict or traumatic histories, to guide the development of forensic mental health capacity.

Main findings: Expertise in forensic psychiatry is crucial in post-traumatic settings and specific training is required to address the complex mental health and legal needs of affected populations.

Added knowledge: In Rwanda, a forensic psychiatry training program is underway to strengthen professional competencies and develop a specialized national curriculum.

Global health impact for policy and action: The Rwandan experience may serve as a valuable model for other African countries, particularly those with post-conflict or traumatic histories, to guide the development of forensic mental health capacity.