Effectiveness of traditional healers in treating mental disorders: a systematic review

Nortje, Gareth; Oladeji, Bibilola D.; Gureje, Oye; Seedat, Soraya

doi:10.1016/s2215-0366(15)00515-5

Cited by 143 publications

(159 citation statements)

References 84 publications

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“…In some cultures, pharmacotherapy prescriptions might be affected by traditional medicinal treatments and potential conflicts with traditional healers, which must receive particular attention from the psychiatrist. 19 The cultural aspects of all components of the psychiatric care system should receive much more emphasis in the coming decade, with resources devoted to training, research, and clinical system development aimed to better equip clinicians to provide excellent culturally competent care.20,21…”

Section: Culture and Psychiatric Treatmentmentioning

confidence: 99%

The WPA- Lancet Psychiatry Commission on the Future of Psychiatry

Bhugra

Tasman

Pathare

et al. 2017

The Lancet Psychiatry

328

187

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Executive Summary BackgroundThis Commission addresses several priority areas for psychiatry over the next decade, and into the 21st century. These represent challenges and opportunities for the profession to sustain and develop itself to secure the best possible future for the millions of people worldwide who will face life with mental illness. Part 1: The patient and treatmentWho will psychiatrists help? The patient population of the future will reflect general demographic shifts towards older, more urban, and migrant populations. While technical advances such as the development of biomarkers will potentially alter diagnosis and treatment, and digital tech-nology will facilitate assessment of remote populations, the human elements of practice such as cultural sensitivity and the ability to form a strong therapeutic alliance with the patient will remain central. Part 2: Psychiatry and health-care systemsDelivering mental health services to those who need them will require reform of the traditional structure of services. Few existing models have evidence of clinical effectiveness and acceptability to service users. Services of the future should consider stepped care, increased use of multidisciplinary teamwork, more of a public health approach, and the integration of mental and physical health care. These services will need to fit into the cultural and economic framework of a diverse range of settings in high-income, low-income, and middle-income countries. Part 3: Psychiatry and societyIncreased emphasis on social interventions and engagement with societal expectations might be an important a ea fo ps hiat s de elop e t. This ould e o pass ad o a fo the ights of individuals living with mental illnesses, political involvement concerning the social risk factors for mental illness, and, on a smaller scale, work with families and local social networks and communities. Psychiatrists should therefore possess communication skills and knowledge of the social sciences as well as the basic biological sciences. Part 4: The future of mental health lawMental health law worldwide tends to be based on concerns about risk rather than the protection of the rights of individuals experiencing mental illness. The United Nations Convention on the Rights of Persons with Disabilities, which states that compulsion based in whole or in part on mental disability is discriminatory, is a landmark document that should inform the future formulation and reform of mental health laws. An evidence-based approach needs to be taken: mental health legislation should mandate mental health training for all health professionals; ensure access to good-quality care; and cover wider societal issues, particularly access to housing, resources, and employment. All governments should include a mental health impact assessment when drafting relevant legislation. Part 5: Digital psychiatry-enhancing the future of mental healthDigital technology might offer psychiatry the potential for radical change in terms of service delivery and the development of new treatm...

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Section: Culture and Psychiatric Treatmentmentioning

confidence: 99%

The WPA- Lancet Psychiatry Commission on the Future of Psychiatry

Bhugra

Tasman

Pathare

et al. 2017

The Lancet Psychiatry

328

187

View full text Add to dashboard Cite

show abstract

“…A lack of training of health-care professionals in a number of LMICs, the stigma associated with mental disorders exacerbated by preconceptions and cultural issues as well as a lack of clear referral systems and support to treat mental disorders, all negatively impact on care provision alongside concerns with access to care and appropriate treatment [3,4,12,16,23,[37][38][39][40][41][42][43][44][45][46][47][48][49]. There is also considerable use of traditional medicines and faith healers in a number of LMICs which may also have a negative impact on patient outcomes; however, this may not always be the case [50][51][52]. With respect to stigma, in Botswana patients with mental disorders can often be seen as untrustworthy and cognitively impaired; consequently, they can be discriminated against in their working environment [53].…”

Section: Generalmentioning

confidence: 99%

Pharmacotherapeutic interventions for bipolar disorder type II: addressing multiple symptoms and approaches with a particular emphasis on strategies in lower and middle-income countries

Godman

Grobler

Van-De-Lisle

et al. 2019

Expert Opinion on Pharmacotherapy

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Introduction: Appropriately managing mental disorders is a growing priority across countries in view of the impact on morbidity and mortality. This includes patients with bipolar disorders (BD). Management of BD is a concern as this is a complex disease with often misdiagnosis, which is a major issue in lower and middleincome countries (LMICs) with typically a limited number of trained personnel and resources. This needs to be addressed. Areas covered: Medicines are the cornerstone of managing patients with Bipolar II across countries including LMICs. The choice of medicines, especially antipsychotics, is important in LMICs with high rates of diabetes and HIV. However, care is currently compromised in LMICs by issues such as the stigma, cultural beliefs, a limited number of trained professionals and high patient co-payments. Expert opinion: Encouragingly, some LMICs have introduced guidelines for patients with BD; however, this is very variable. Strategies for the future include addressing the lack of national guidelines for patients with BD, improving resources for mental disorders including personnel, improving medicine availability and patients' rights, and monitoring prescribing against agreed guidelines. A number of strategies have been identified to improve the treatment of patients with Bipolar II in LMICs, and will be followed up.

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“…Some innovative ways to strengthen the health workforce would be: (1) to encourage retention and motivation of current workers through better, safer work environments; (2) to build leadership capacity in the workforce, potentially by mobilizing the Zimbabwean health diaspora to engage in training and skill-building among the current workforce [3]; and (3) to place a greater reliance on mid-level and non-specialist providers [32] and on community members including community health workers (CHWs) [33–36] and traditional healers [37–40]. …”

Section: Strengthen the Health Workforcementioning

confidence: 99%

The future of health in Zimbabwe

Kidia¹

2018

Global Health Action

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In November 2017, following a military intervention, Robert Mugabe was forced to resign as president of Zimbabwe – where he had ruthlessly ruled since 1980. Mugabe’s regime was responsible for destroying the country’s excellent health system. I argue that this is a unique moment for health reform in Zimbabwe. This reform should focus on three areas: (1) repairing relationships with the international community by focusing on human rights and eliminating corruption, (2) strengthening the health workforce through retention strategies, training, and non-specialist providers, and (3) community engagement. The future of Zimbabwe’s health system is in limbo, and now is a unique opportunity to make positive change.

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Effectiveness of traditional healers in treating mental disorders: a systematic review

Cited by 143 publications

References 84 publications

The WPA- Lancet Psychiatry Commission on the Future of Psychiatry

The WPA- Lancet Psychiatry Commission on the Future of Psychiatry

Pharmacotherapeutic interventions for bipolar disorder type II: addressing multiple symptoms and approaches with a particular emphasis on strategies in lower and middle-income countries

The future of health in Zimbabwe

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