Survey of early predictive signs of poor mental health and socio-cultural beliefs about mental illness in Enugu state, Nigeria

Abstract

BACKGROUND : The rising prevalence of mental disorder and the enormous emotional, financial, socio-economic and developmental burden is a source of concern and challenge to the global community. This study assessed the prevalence of major warning signs of poor mental health and socio-cultural beliefs about the mental illness among the urban and rural dwellers in Enugu State, Nigeria. METHODS : This was a descriptive, cross sectional study, using multistage sampling to recruit a total of 724 respondents, 371 from urban and 353 from rural Local Government Areas. A researcher constructed and pre-tested semi-structured questionnaire was the instrument of data collection used. William C. Menninger's questions for assessing warning signs of poor mental health was modified and adapted. Data was analysed using Epi-info version 3.5.3. Chi-square test and Student T-test statistics were used. Level of significant was set at p ≤0.05. RESULTS : Socio-cultural factors mostly believed to cause mental illness were evil spirits (51.8% Urban: 34.28% rural, X2 = 22.51, p= 0.000) and native charm (47.7% urban: 43.1% rural; X2 = 1.58, p = 0.209). Major alternative treatments recommended for the mentally ill were prayer/deliverance (59.8% urban: 54.7% rural, p=0.160) and herbal drugs/ traditional healers (31.0% urban: 35.7% rural, p=0.180). Mean scores of the signs of poor mental health among the urban and rural dwellers were 80.82±41.66 and 119.55±37.06 (t=13.19, p= 0.000); and prevalence of early warning signals of poor mental health were 21.7% for the urban and 33.87% for the rural respondents. CONCLUSION : Traditional beliefs about mental illness are still prevalent in the 21st century Nigeria. The rural dwellers have more warning signs of poor mental health than their urban counterparts. In-depth psychiatric evaluation, mental health education and counselling are advocated. Key Words: beliefs, mental health, mental illness, rural, signs, urban