Profiles and outcome of traditional healing practices for severe mental illnesses in two districts of Eastern Uganda

Catherine Abbo

doi:10.3402/gha.v4i0.7117

Abstract

Background: The WHO estimates that more than 80% of African populations attend traditional healers for health reasons and that 40%–60% of these have some kind of mental illness. However, little is known about the profiles and outcome of this traditional approach to treatment.Objective: The purpose of this study was to describe the profiles and outcome of traditional healing practices for severe mental illnesses in Jinja and Iganga districts in the Busoga region of Eastern Uganda.Methods: Four studies were conducted. Study I used focus group discussions (FGDs) with case vignettes with local community members and traditional healers to explore the lay concepts of psychosis. Studies II and III concerned a cross-sectional survey of patients above 18 years at the traditional healer's shrines and study IV was made on a prospective cohort of patients diagnosed with psychosis in study III. Manual content analysis was used in study I; quantitative data in studies II, III, and IV were analyzed at univariate, bivariate, and multivariate levels to determine the association between psychological distress and socio-demographic factors; for study IV, factors associated with outcome were analyzed. One-way ANOVA for independent samples was the analysis used in Study IV.Results: The community gave indigenous names to psychoses (mania, schizophrenia, and psychotic depression) and had multiple explanatory models for them. Thus multiple solutions for these problems were sought. Of the 387 respondents, the prevalence of psychological distress was 65.1%, where 60.2% had diagnosable current mental illness, and 16.3% had had one disorder in their lifetime. Over 80% of patients with psychosis used both biomedical and traditional healing systems. Those who combined these two systems seemed to have a better outcome. All the symptom scales showed a percentage reduction of more than 20% at the 3- and 6-month follow-ups.Conclusion: Traditional healers shoulder a large burden of care of patients with mental health problems. This calls for all those who share the goal of improving the mental health of individuals to engage with traditional healers.

Highlights

The WHO estimates that more than 80% of African populations attend traditional healers for health reasons
Manual content analysis was used in study I; quantitative data in studies II, III and IV were analyzed at Univariate, Bivariate and Multivariate levels to determine the association between psychological distress and sociodemographic factors; for study IV, factors associated with outcome were analyzed
This study explored lay concepts of psychosis among people in the study area and investigated the profiles and treatment outcomes of traditional healing practices for severe mental illnesses as measured by standard instruments

Summary

Introduction

The WHO estimates that more than 80% of African populations attend traditional healers for health reasons. Patients with moderate to severe symptoms were more likely to use both biomedical services and traditional healers (III). Western Europe and other developed regions, an increasing number of patients are seeking out CAM practitioners for mental health care [1, 6] Studies done in this region report that the use of CAM approaches among individuals who meet DSM-IV criteria for some psychiatric disorder is significantly greater than in the general population [6, 7]. A common finding was that traditional healers could recognize symptoms of severe illness, but that they expressed strong belief in supernatural factors as ultimate causes of mental illness and this influenced the treatments they gave [10, 11]

Methods

Results

Discussion

Conclusion