This summer, The Duke Center for Global Mental Health convened partners in Kigali, Rwanda, to strengthen long-standing collaborations, advance mental health capacity-building efforts, and lay the groundwork for new research and implementation initiatives across East Africa.
The Duke Center for Global Mental Health (CGMH) brought together clinicians, researchers, educators, and health leaders in Kigali, Rwanda for a series of meetings focused on strengthening mental health systems and expanding regional collaboration. Supported by two Duke Global Health Institute (DGHI) grants, the gathering included workshops exploring implementation of the World Health Organization’s Mental Health Gap Action Programme (mhGAP) in Rwanda, grant-writing workshops for Rwandan mental health professionals, and the third annual meeting of the East African Mental Health Collaborative, a regional network of clinician-researchers representing Kenya, Tanzania, Rwanda, and Uganda.
Why mhGAP in Rwanda
Following the 1994 genocide against the Tutsi, Rwanda built its mental health system from the ground up, and has since focused on decentralization, expanding mental health services beyond district and referral hospitals to encompass smaller health centers and clinics. This decentralization effort extends beyond health facilities to the health workforce itself. With an estimated one in five Rwandans living with a mental health disorder and only 16 psychiatrists and 6 neurologists serving a population of 14 million, Rwanda continues to face a need for both specialized training and task-shifting– the training of non-specialist providers, such as primary care physicians, nurses, or community health workers, to provide basic mental health care services and expand access to care. mhGAP was designed to address this challenge. Through evidence-based clinical guidance and training, mhGAP enables non-specialist health workers to assess, treat, and manage priority mental health conditions within primary care settings.
To explore how mhGAP could be adapted to Rwanda’s unique healthcare system, Duke partnered with the University of Global Health Equity (UGHE) for a multi-day workshop. Participants examined Rwanda’s current mental health landscape, reviewed ongoing implementation efforts, and learned from Kenya’s experience implementing mhGAP through colleagues from Moi Teaching and Referral Hospital (MTRH) in Kenya. Reflecting on their experience with the program, the Kenyan team spoke to the importance of ongoing mentorship, motivating local “champions,” and integrating programs into existing services rather than creating parallel programs.
Successful implementation depends not only on evidence-based tools, but on local champions, ongoing mentorship, and integration into existing health systems.
The workshop concluded with collaborative planning sessions that drew on these lessons to identify several priorities for implementation, including expanding task-sharing with community health workers and religious and traditional leaders, strengthening community-based mental health services, and developing universal, culturally adapted screening tools. Following the workshop, the next phase of collaboration will include a joint UGHE-Duke study designed to establish consensus priorities for strengthening Rwanda’s mental health system through consecutive surveys and expert interviews.
Regional Mental Health Collaboration
During the following week of meetings, many of CGMH’s longest-standing partners reconvened for the third annual meeting of the East African Mental Health Collaborative. The collaborative brings together leading researchers from institutions with established partnerships with Duke Global Health Institute (DGHI), including Moi Teaching and Referral Hospital (MTRH) in Kenya, Makerere University in Uganda, Kilimanjaro Christian Medical Center (KCMC) in Tanzania, and the University of Global Health Equity (UGHE) in Rwanda. Together, members contribute diverse expertise across a range of mental health research and implementation areas.
At this year’s gathering, collaborative members presented their current work, encompassing topics such as: substance use and tobacco cessation programs, transdiagnostic approaches to addressing mental health challenges of people living with HIV, peer-delivered and family-based adolescent mental health interventions, and epilepsy-related stigma.
The meeting concluded with a concrete pipeline of collaborative work, including several manuscripts nearing submission, a new comparative study of mental health financing across East African health systems, and a potential proposal for a multi-site mhGAP implementation grant. Members also committed to strengthening ongoing partnerships, through shared resources, including a shared measures library, a standing communication channel, and staff support to facilitate future research.
The future of global mental health depends on solutions that are locally led and regionally connected.
Building on these discussions, members also took part in a series of grant writing workshops, led by Dr. Emily Cherenack. The workshops provided Rwandan mental health providers with an overview of the research grant development process – from refining research ideas and writing specific aims pages to developing budgets and strengthening proposals already underway. Participants also had dedicated time to collaborate on drafts, develop research proposals, and refine ideas for advancing mental health knowledge and care.
Why This Matters to Global Mental Health
Strengthening mental health systems requires more than expanding infrastructure or increasing the number of providers—it requires investing in local leadership, research capacity, and regional collaboration
This requires equipping clinicians and researchers with the skills to identify locally relevant research questions, secure funding, and lead research and implementation efforts within their health system. Building this research capacity enables countries not only to adapt evidence-based practices such as mhGAP to their unique needs, but also to generate the evidence needed to improve mental health care within their own contexts. Through the model of the East African Mental Health Collaborative, neighboring countries facing similar constraints — including limited specialist availability, constrained funding, stigma, medicine stock-outs — can learn from one another rather than work in isolation. The Collaborative creates opportunities to share resources and knowledge beyond research findings, including infrastructure, training pipelines, and strategies for advancing mental health policy.
Long-standing partnerships create the foundation for sustainable regional mental health infrastructure through shared learning and local leadership.
For the Duke Center for Global Mental Health, the workshops reinforced the value and impact of long-standing partnerships. The collaborations strengthened in Kigali—with UGHE, Partners In Health, and research partners across the region—demonstrate the potential to build sustainable regional mental health infrastructure through shared learning, collaboration, and local leadership.
The mhGAP workshop and East African Mental Health Collaborative meeting were convened in Kigali, Rwanda, in partnership with the Rwanda Biomedical Centre, Partners In Health, the University of Global Health Equity, and the Duke Center for Global Mental Health.
Topics: Global mental health, Mental health systems, Capacity building, Implementation science, Health workforce, Research collaboration, Grant writing, mhGAP
Countries: Rwanda, Kenya, Uganda, Tanzania
People: Emily Cherenack, Brandon Knettel, Ryan Parker