This paper considers several aspects of the evolution, organization and current status of the mental health system of Rwanda. The centerpiece of the Rwandan mental health system is the neuropsychiatric hospital in Ndera. Resource constraints preclude development of an extensive system of specialty mental health care. The World Health Organization has proposed that mental health services can best be delivered in developing countries through decentralization and integration with primary health care services. The accomplishments and problems encountered in implementing this model in Rwanda are described and, based on this experience, some recommendations are offered for other developing countries.

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