Longitudinal Analysis of Barriers to Mental Healthcare Access for Gender-Based Violence Survivors in Goma's Displacement Camps, Democratic Republic of Congo

Gender-based violence is a pervasive public health crisis in conflict-affected regions, with survivors facing severe mental health consequences. Displacement camps in Goma, Democratic Republic of Congo, represent a critical setting where access to mental healthcare is severely constrained. Longitudinal evidence on the specific barriers faced by survivors in this context remains limited. This longitudinal study aimed to identify and analyse the persistent barriers to accessing mental health services for gender-based violence survivors in Goma’s displacement camps. It sought to understand how these barriers evolved and interacted across personal, social, and systemic levels over time. A longitudinal qualitative study was conducted. A cohort of gender-based violence survivors was recruited from multiple displacement camps and participated in repeated in-depth interviews and focus group discussions over an extended period. Data were analysed using a thematic framework approach. Key barriers were structural and socio-cultural. A predominant and persistent theme was the chronic shortage of trained mental health professionals within the camps. This was compounded by fears of stigma and community rejection, economic dependence on perpetrators, and a lack of safe, confidential spaces for service provision. These barriers remained largely unchanged throughout the study period. Barriers to mental healthcare for gender-based violence survivors in these settings are deeply entrenched and systemic. They create a significant blockade to recovery and limit the effectiveness of broader humanitarian assistance. Immediate scale-up of task-shifting programmes to train community health workers in psychological first aid. Integration of mental health services into primary healthcare and gender-based violence response protocols within the camps. Design and implementation of community-led anti-stigma campaigns to foster safer environments for survivors seeking help. Gender-based violence, mental health access, displacement camps, Democratic Republic of Congo, longitudinal study, qualitative research This study provides longitudinal evidence on the systemic and persistent nature of barriers to mental healthcare for a highly vulnerable population, informing the design of more effective, integrated humanitarian health interventions in protracted displacement settings.