Implications of healing power and positioning for collaboration between formal mental health services and traditional/alternative medicine: the case of Ghana

Abstract

Background: Many current debates about global mental health have increasingly called for collaboration between biomedical and traditional medical health systems. Despite these calls, not much has been written about the variables that would influence such collaboration. To a large extent, collaboration dialogues have considered biomedicine on the one hand, and a wide range of traditional and faith-based treatments on the other hand. However, this dualistic bifurcation does not reflect the plurality of healing systems in operation in many contexts, and the diverse investments that different non-biomedical healing approaches may have in their own power to heal. Objective: We set out to explore the diversity of different healers’ perceptions of power, and the relationship between that power and the perceived power of biomedical approaches. Methods: Through a qualitative design, and using the case of medical pluralism in urban Ghana as an example, we conducted interviews among different categories of traditional and alternative medicine (TAM) practitioners living and/or working in the Greater Accra Region of Ghana. Results: Through thematic analyses, differences in the notions about collaboration between the different categories of healers were identified. Their perceptions of whether collaboration would be beneficial seemed, from this study, to co-occur with their perceptions of their own power. Conclusions: We suggest that an important way to move debates forward about collaboration amongst different sectors is to examine the notions of power and positioning of different categories of TAM healers in relation to biomedicine, and the attendant implications of those notions for integrative mental healthcare.

An integrative review of potential enablers and barriers to accessing mental health services in Ghana

“…Some studies suggested that service users experience some challenges financing the cost of medication [ 31 , 33 , 35 , 49 , 50 , 52 ]. For instance, whilst the cost of mental health treatment is subsidised for service users [ 49 , 50 , 53 ], they are expected to purchase their own medication from a private pharmacist whenever there is shortage of such drugs at the psychiatric facilities.…”

Traditional healers’ and biomedical practitioners’ perceptions of collaborative mental healthcare in low- and middle-income countries: A systematic review

“…Research continues to explore traditional healers' understanding of mental illness and suicidal behaviour, yet the effectiveness of their prevention strategies remains largely untested (Bantjes, et al, 2018). Recent research has highlighted the huge diversity in traditional treatment methods; further research must explore the effectiveness and quality of these treatments before they can be recommended or formally integrated (Kpobi & Swartz, 2018).…”

“…Due to the complex nature of indigenous healing in each country, it is unlikely that one single best practice model will be developed that can be followed and implemented across all LMICs. A recent study by Kpobi and Swartz (2018) has emphasised this need for a nuanced approach to collaboration. They clearly demonstrated that different groups of traditional healers exhibit varying perceptions of their own power and ideological proximity to biomedicine; these factors may impact on their motivation for, and understanding of, collaboration; thus traditional healers should not be conceived as one homogeneous group (Kpobi & Swartz, 2018).…”

Biomedical drugs and traditional treatment in care seeking pathways for adults with epilepsy in Masindi district, Western Uganda: a household survey

“…A study in Malawi among people with epilepsy indicated that they sought both traditional and modern medicine to treat their condition [13]. Other countries in Africa face this multiplicity of health providers like in Ghana [14] South Africa [15] and Ethiopia [16,17]. It has been noted that biomedical treatment offered at health facilities is not adequate.…”