Mental disorders are highly prevalent worldwide, yet mental health care is scarce or inappropriate, especially in developing countries. The majority of the 450 million patients with mental disorders around the world are not receiving even the most basic mental health care. In developing countries, 76.3-85.4% of serious cases receive no treatment. Unfortunately, the unnecessary suffering is likely to worsen, as the global burden of disease attributable to psychiatric and substance use disorders is expected to rise in the coming decade.This chapter unveils some important traditional healers' contributions. Among them are the following: (i) the role their psychosocial and clinical skills have played in the implementation of community and public health treatment programs for physical illness; (ii) their facilitation of culturally competent clinical care; and (iii) their limited, although effective, participation in unique collaborations with psychiatric treatment personnel. It also highlights their role in diminishing stigma related to mental illness and the reintegration of prison inmates and children soldiers into their communities.This chapter urges that the contributions of traditional healers should be welcomed in a world characterized by serious biomedical workforce shortages, limited funding, global mental health service inequalities and enormous unmet needs for mental health services.
THE GLOBAL BURDEN OF MENTAL ILLNESSDuring the past two decades, research on illness prevalence in countries around the world has shown that mental disorders are highly prevalent worldwide, and mental health care is Psychiatrists and Traditional Healers Edited by Mario Incayawar, Ronald Wintrob and Lise Bouchard Ó 2009 John Wiley & Sons, Ltd scarce or inappropriate, especially in developing countries (Alarcon, 2003;Desjarlais et al., 1995). Until recently, the true magnitude and social impact of mental disorders was literally unknown. The landmark Global Burden of Disease study, conducted by the World Health Organization, and the World Bank, in conjunction with Harvard University, (Murray et al., 1996) found that four of the ten leading causes of disability through the world, for persons age five and older, are mental disorders. Together, mental disorders (including suicide) account for 15.4% of the overall burden of disease from all causes; second only to cardiovascular conditions (18.6%) and slightly more than the burden associated with all forms of cancer (15%). Respiratory conditions (4.8%) and even infectious and parasitic diseases (2.8%) are far behind. However, despite the worldwide public health importance of psychiatric disorders and their associated higher rates of disability, they are undertreated compared with physical illnesses in high-, low-and middle-income countries alike (Ormel et al., 2008).The four most pervasive psychiatric disorders worldwide are unipolar major depression, bipolar disorder, schizophrenia and obsessive-compulsive disorder. The main message of the Global Burden of Disease study is that the impa...