Urban and rural perceptions of mental illness in Ethiopia

Abstract

This study explores the impact of social environment on perceptions of mental illness in Ethiopia. Specifically, urban and rural Ethiopians’ attitudes, beliefs and practices associated with the symptoms, causes and treatment of mental illness were compared. One hundred and fifteen participants were interviewed using a semi-structured questionnaire to explore their perceptions of depression, anxiety and psychosis. Qualitative analysis of the interview responses indicated a number of similarities, as well as important differences in urban and rural beliefs about the recognition and etiology of mental illness. Responses were categorized as focusing on spiritual, psycho-cultural or socio-economic explanations of mental illness. Rural residents emphasized spiritual and socio-economic indicators of mental illness, while urban residents highlighted culturally inappropriate and disruptive behaviors as signs of mental illness. Both groups overwhelmingly indicated modern psychiatric treatment was the best option to treat mental illness. However, rural residents were more likely to endorse traditional treatment and urban residents were more likely to cite a combination of modern and traditional treatment. Implications for clinical assessment and policy planning are discussed.