Abstract
ABSTRACTForensic psychiatry has often been neglected in nonwestern countries, including the African continent. Our aim was to assess the practices and needs for improvement in the field of forensic psychiatry in Rwanda. During a one-week visit conducted in October 2017, we interviewed key-informants working at decisional levels in the domains of health, justice and security. Two clinical workshops involving psychiatrists, psychologists and nurses were held in psychiatric facilities, including at Ndera, the main psychiatric hospital of the country. Three axes of development and improvement were identified: First there is a need for a clearer, more coherent and updated legislative framework. Second, the absence of a forensic secured unit, which compromises both quality of care for forensic patients and security of the other patients and staff, should be remediated. Third, the supervision and training in this specialized domain should be provided through international collaborations. Hopefully, Rwanda could become in the next few years a driving force for other African countries in the field of forensic psychiatry.
Highlights
Forensic psychology and forensic psychiatry are located at the interface of the sciences of the psyche and the law
The precise definition of forensic psychiatry varies from one country to another, due to different historical developments, mental health systems and legal traditions [1]
This subspecialty of psychiatry broadly deals with clinical expertise applied in the legal context, embracing civil, criminal, correctional or legislative matters, as defined by the American Board of Forensic Psychiatry [2]
Summary
Forensic psychology and forensic psychiatry are located at the interface of the sciences of the psyche and the law. The precise definition of forensic psychiatry varies from one country to another, due to different historical developments, mental health systems and legal traditions [1] This subspecialty of psychiatry broadly deals with clinical expertise applied in the legal context, embracing civil, criminal, correctional or legislative matters, as defined by the American Board of Forensic Psychiatry [2]. As Dr Frank Njenga, Founder President of Africa Association of Psychiatrists observed in 2006: ‘A visit to many of these institutions leads to despair about the state of human rights and dignity in our continent Those who are considered lucky are seen by a demoralized, poorly trained, and inadequately paid doctor who passes by the ward once every few weeks, to see only those patients who are most disturbed. It is against this backdrop of great need that the rest of society is served in the field of forensic psychiatry in sub-Saharan Africa’ [7]
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