Explanatory models of mental disorders and treatment practices among traditional healers in Mpumulanga, South Africa

RESUMO

Objective: In many traditional belief systems in Africa; including South Africa; mental health problems may be attributed to the influence of ancestors or to bewitchment. Traditional healers are viewed as having the expertise to address these causes. However; there is limited information on their explanatory models and consequent treatment practices. The present study examines traditional healers' explanatory models (EMs) and treatment practices for psychotic and non-psychotic mental illnesses. Method: 4 focus group discussions (8 healers in each group) and 18 in-depth interviews were conducted. Four vignettes were presented (schizophrenia; depression; panic and somatization) and traditional healers' views on the nature of the problem; cause; consequence; treatment and patient expectations were elicited. Results: Traditional healers held multiple explanatory models for psychotic and non-psychotic disorders. Psychotic illnesses appear to be the main exemplar of mental illness and were treated with traditional medicine; while nonpsychotic illnesses were not viewed as a mental illness at all. Additionally; traditional healers do not only use herbs and substances solely from ""traditional"" sources but rather have incorporated into their treatment practices modern ingredients that are potentially toxic. Conclusion: Interventions aimed at increasing the mental health literacy of traditional healers are essential. In addition; investigations of the effectiveness of traditional healer treatment for psychiatric disorders should be conducted