Abstract
Mental disorders are rapidly becoming more prevalent worldwide and are estimated to contribute up to 15% of the global burden of disease by 2020. In Africa, the help-seeking behaviour for mental health care is complex and is hindered by misconceptions and negative attitudes towards mental disorders. This study aimed to explore perceptions of mental disorders and help-seeking behaviour for mental health care within the Maasai community in northern Tanzania.This qualitative study enrolled a purposive sample of 41 participants from a Maasai community in Arusha Region, northern Tanzania. Participants included modern health-care providers, religious leaders, traditional practitioners, local government leaders, local Maasai leaders, and workers from nongovernmental organisations dealing with mental health. Local interviewers used interview guides to conduct in-depth interviews and focus group discussions in the local language, Kiswahili. The interviews were completed between April and May 2013. We used content analysis to analyse the qualitative data.Study participants attributed mental disorders to supernatural causes, such as curses, witchcraft, demons, and God's will. A few participants also mentioned biological causes and risk behaviours, including perinatal insults, head injuries, and drug abuse. Furthermore, we found that the Maasai community seeks mental health care in a sequential and simultaneous manner from 3 sectors, namely, professional health-care providers, traditional healers, and religious leaders. Traditional healers and religious leaders were preferred over professional health-care providers for the treatment of mental disorders.The Maasai have pluralistic help-seeking behaviour for mental health disorders. Integrating traditional healers in the modern health-care system may be beneficial to addressing mental health issues in this setting.
Highlights
Mental disorders, defined as a combination of abnormal thoughts, emotions, behaviour, and relationships with others, contribute about 12% of the global burden of disease, and this proportion is expected to rise to 15% by 2020.1,2 According to the World Health Organization, more than 450 million people worldwide suffer from some form of mental disorder, most of whom live in developing countries.[2,3] Evidence from studies conducted in different settings has shown that the contribution of mental disorders on the burden of disease differs from country to country
We found that the Maasai community seeks mental health care in a sequential and simultaneous manner from 3 sectors, namely, professional health-care providers, traditional healers, and religious leaders
Integrating traditional healers in the modern health-care system may be beneficial to addressing mental health issues in this setting
Summary
Mental disorders, defined as a combination of abnormal thoughts, emotions, behaviour, and relationships with others, contribute about 12% of the global burden of disease, and this proportion is expected to rise to 15% by 2020.1,2 According to the World Health Organization, more than 450 million people worldwide suffer from some form of mental disorder, most of whom live in developing countries.[2,3] Evidence from studies conducted in different settings has shown that the contribution of mental disorders on the burden of disease differs from country to country. In Namibia, mental disorders are estimated to contribute 6.9% of the burden of disease, compared to 6.6% in Togo and 5.2% in Mali.[3] In Tanzania, mental disorders contribute about 5.3% of the disease burden.[3] The Tanzanian Ministry of Health, Community Development, Gender, Elderly, and Children has integrated mental health in all levels of health-care service.[5,6,7] in the Tanzanian setting, biomedical as well as traditional healers provide primary healthcare services.[8,9] Previous studies have estimated that.
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