Emergency psychiatric care in North Kivu in the Democratic Republic of the Congo

People with psychiatric disorders in humanitarian emergencies are primarily neglected and lack appropriate treatment. This results in unnecessary suffering, stigmatisation, loss of dignity and increased mortality. This paper describes the experience of Médecins Sans Frontières in providing emergency psychiatric treatment as a component of a busy medical programme in Mweso, a conflict affected region of North Kivu, the Democratic Republic of the Congo. Interventions included treatment with psychotropic medications by non specialist physicians and counselling by lay counsellors. Most patients were treated for psychotic disorders with good results. Our experience shows that generalist medical doctors can be trained to diagnose and treat psychiatric disorders. Introduction of emergency psychiatric care in humanitarian emergencies is needed and feasible, despite multiple competing priorities. Key issues to consider are contingency planning for programme interruptions due to security issues, simplification of protocols and shared care with mental health counsellors.