Exploring Pathways to Care in the Zimbabwean Mental Health Sector

Abstract

This study investigated pathways to care in mental health treatment in Zimbabwe. Survey method was used to gather data through interviews and focus group discussions. For a period spanning over one year, the researcher randomly interviewed service providers, clinic staff, patients, caregivers/parents and community leaders. 20 Patients and 40 parents/caregivers were randomly selected as they seek services while 80 urban clinic staff, 50 from farm clinics, 50 from peri-urban clinics. 20 major referral hospital staff and 10 ATR practitioners, 30 FBO practitioners were purposively sampled making a total number of 300 participants. Results from these encounters revealed that people seeking mental health services use more than one treatment mode. Others use two while the majority use all three. There are varying factors contributing to their choice of pathway to care. Some notable factors revealed were that demographic and socioeconomic characteristics as well as health status shape how one enters mental health care and the subsequent perceptions of the effectiveness of that chosen path. additionally, the pathway to mental health care is associated with perceptions about the effectiveness of treatment. Additionally, severity of a mental illness has a strong bearing on the choice of pathway to treatment. Findings also revealed that only the medical pathway is used during daylight while half consulted faith based healers during daytime. For ATR the majority visit clandestinely after consulting hospitals during the day. It was concluded that mental health service in Zimbabwe is provided by three means which constitute pathways to care. These are the medical model, the traditional healers and the faith based practitioners. Results were inconclusive as to the efficacy of these pathways to care since some are concurrently used. From the above conclusions, the following recommendations are proposed: multi sectoral collaboration should be encouraged, evidence based practices to be enforced and further research into FBOs and ATR efficacy as well as the correlation between these pathways to care.