Mental health services transform life for orphaned teenager

By Anne Stevenson

Just over a year ago, the Family Strengthening Intervention research team at Partners In Health-Rwanda encountered a depressed teenage boy during the course of its research. Since then, the boy’s life has been transformed thanks to follow up by the Family Strengthening Intervention team and the Social Work department at PIH.

	FSI mental health clinicians Christina Mushashi and Charles Ingabire discuss Placide's care.

Placide* was only 13 years old when his mother abandoned the family in 2010, leaving him as the head of the household and sole caretaker for his five younger siblings. In April 2011, team members from the Family Strengthening Intervention (FSI) project—a mental health research initiative conducted by the Harvard School of Public Health/FXB Center in collaboration with Inshuti Mu Buzima (IMB), Partner’s in Health’s sister organization in Rwanda—happened to interview Placide during the course of their research. At the time, the project was using structured diagnostic interviews and local measurement tools to assess mental health problems in the children in the community. When they encountered Placide, the staff was alarmed by the boy’s critical levels of depression, loneliness, and hopelessness.

Despite his dire need for mental health services, Placide refused to visit the hospital’s mental health team for additional follow-up. And when FSI staff and IMB social workers tried to visit him at home, he ran away.  

But FSI and IMB staff persisted. Finally, after many attempts to contact him, Placide agreed to speak with the concerned team. He shared that he had been abandoned by his mother one year earlier. The children were struggling to eat, and none of them was in school.

	IMB Social Worker Virginie Mukakayijuka gives a food packet to a child near Rwinkwavu Hospital.

The IMB social work team and FSI took Placide’s case in hand. They enrolled the family in IMB’s supplemental food program, which supplies regular food packages of sugar, beans, cooking oil, and cereal. And Placide began seeing a mental health clinician at the hospital.

In December 2011, several months after services for Placide’s family were initiated, a social worker, community health worker, and FSI team member drove to Placide’s house to check up on him and to deliver a donated mattress to the family.

When they arrived, Placide’s sister called him in from the field. The young man had changed. Instead of running away, Placide came over and gave each of the visitors a hug. When they asked him how he was doing, Placide laughed and smiled and said that things were better. He shared that IMB had helped enroll three of his younger siblings into a boarding school nearby and that the school would provide for all of the siblings’ needs going forward. IMB had also enrolled his 11 year-old sister in primary school. And they helped Placide and his sister enroll in vocational school.

“I helped follow up on Placide’s care and I saw his life changing day by day," says Christina Mushashi, a mental health clinician and one of the Program Coordinators on the FSI project. "He is smiling much more than before and I can see the impact of our work on the family. All of the children are now in school and the burden on Placide has been reduced.” 

Placide and his family continue to receive food packages from IMB and to check in with the social work department in Rwinkwavu. 

Placide’s story is a powerful example of how research and services work together at IMB. Innovative projects like FSI are pioneering new strategies and tools for assessing unmet needs in the community, and strong services systems at IMB are able to provide comprehensive support to new referrals.

In Placide’s case, channels existed to provide the family with food, education, mental health care, and social support. With all of these systems working well and in coordination with one another, and with the dedicated perseverance of research and services staff, a boy’s life and the lives of his siblings were dramatically transformed for the better.

“By being in this study, the boy’s family was able to benefit from services that PIH can offer," Christina Mushashi adds. "The family members are no longer isolated and they have hope for the future.”

* The boy’s name has been changed to preserve confidentiality.

Anne Stevenson is a Program Manager at the Harvard School of Public Health. She is currently working with PIH’s sister organization Inshuti Mu Buzima (IMB) in Rwanda.