Traditional and religious healers in the pathway to care for people with mental disorders in Africa: a systematic review and meta-analysis

Burns, Jonathan K.; Tomita, Andrew

doi:10.1007/s00127-014-0989-7

Cited by 143 publications

(153 citation statements)

References 40 publications

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“…Approximately half of individuals seeking formal health care for mental disorders in LMICs, choose traditional and religious healers as their first care provider, and this choice is associated with delays in accessing formal mental health services. 320 Based on lessons from Uganda, 321 strategies should involve, among others, improving clinicians' understanding of traditional healers' explanatory models for illness, and vice versa. Secondly, trust between the two categories of providers needs to be enhanced to improve interaction between the two sectors, which currently operate in isolation.…”

Section: Harnessing Collaborations and Task Sharingmentioning

confidence: 99%

The Lancet Psychiatry Commission: a blueprint for protecting physical health in people with mental illness

Firth

Siddiqi

Koyanagi

et al. 2019

The Lancet Psychiatry

973

1,093

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Executive SummaryThe poor physical health of people with mental illness is a multi-faceted, transdiagnostic, and global problem. Physical health disparities are observed across the entire spectrum of mental illnesses, in low, middle-and high-income countries. This stems from both a heightened risk of physical diseases in people with mental illness, along with their reduced access to adequate healthcare. The high rates of physical comorbidities (and typically-poor clinical management of this) drastically reduces life expectancy, and also increases the personal, social and economic burden of illness across the lifespan.This Commission has brought together an international team of researchers, clinicians, and key stakeholders from various backgrounds and professionally / personally-relevant experience, in order to summarize advances in understanding on this topic, and present clear directions for health promotion, clinical care and future research. The breadth and multifactorial nature of physical health disparities across the range of mental health diagnoses poses an almost limitless number of potential considerations. Therefore, rather than attempting to cover all of the different possible combinations of physical-mental comorbidities individually, the aim of this Commission was to: (i) establish highlypertinent aspects of physical health-related morbidity and mortality which apply transdiagnostically, (ii) highlight the common modifiable factors driving these disparities, (iii) present actions and initiatives for health policy and clinical services to address these issues, and (iv) identify promising areas for future research towards discovering novel solutions. This was addressed across 5 different Parts of the Commission: Parts 1 and 2 determined the scope, priorities and key targets for physical health improvement across multiple mental illnesses. Parts 3, 4 and 5 discussed emerging strategies and produced recommendations for improving physical health outcomes in people with mental illness. Leaders and contributors for each Part are shown in the Appendix (pg.1) . Part 1: 'Its more than premature mortality'Part 1 identified almost 100 systematic reviews/meta-analyses examining the prevalence of physical comorbidities in mental illness. Around 70% of the meta-research focused on cardiometabolic diseases; consistently reporting that mental illnesses were associated with 1.4-to 2-fold increased risk for obesity, diabetes and cardiovascular diseases compared to the general population. Although mostly studied in 'severe mental illness' ('SMI', and particularly psychotic disorders), the prevalence of cardiometabolic diseases was similarly elevated across a broad range of other diagnoses, including substance use disorders (SUDs), and 'common mental disorders' ('CMDs', such as depression and anxiety). Part 2: Key modifiable factors in health behaviours and health servicesPart 2 built on the findings of Part 1 with a hierarchal evidence synthesis of modifiable risk factors for physical diseases in mental illness. The bu...

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Section: Harnessing Collaborations and Task Sharingmentioning

confidence: 99%

The Lancet Psychiatry Commission: a blueprint for protecting physical health in people with mental illness

Firth

Siddiqi

Koyanagi

et al. 2019

The Lancet Psychiatry

973

1,093

View full text Add to dashboard Cite

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“…For Gureje et al [35], research is still required to clearly delineate the boundaries of such collaboration and to test the effectiveness in treating mental illness in different contexts. Burns and Tomita [36] have proposed recommendations to include innovative programmes to foster collaboration between the different stakeholders in order to improve mental health care in Africa. As Musyimi et al [31, p. 7] conclude:…”

Section: Rural Mental Health In South Africamentioning

confidence: 99%

From global-to-local: rural mental health in South Africa

Vergunst

2018

Global Health Action

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In this paper, the current situation regarding rural mental health in South Africa is explored. The current status is presented, followed by an attempt to provide approaches and ideas to improve the situation in order to make it more context appropriate and relevant. Issues of staffing, task shifting or sharing, and formal vs informal health care systems are considered and discussed as possible future approaches to improve rural mental health care in South Africa.

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“…It has also been widely believed that patients' use of traditional healers simply reflected a lack of an alternative. However, recent research shows they are used even when psychiatric facilities and medication are readily available and it is now generally accepted that the appeal of healers lies in their ability to understand patients' illness experience within their cultural framework (Read, 2012;Burns, 2015;Heaton, 2013). This is particularly true of mental illness, where social and cultural determinants play a heightened role in psychopathology.…”

Section: Introductionmentioning

confidence: 99%

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

Green

Colucci

2020

Transcult Psychiatry

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Access to mental healthcare in low- and middle-income countries (LMICs) is one of the greatest challenges in public health today. One suggestion for improving accessibility is through collaboration between biomedical practitioners and traditional healers. This paper reviews studies of traditional healers’ and biomedical practitioners’ perceptions of collaboration. We conducted a systematic review of online databases, selected journals, and reference lists for relevant studies. Eligible papers were assessed using a tool designed for this review for quality and study characteristics, and qualitative data demonstrating participants’ views were extracted. A total of 14 papers from seven countries were included. The published literature on this topic is relatively homogenous and studies are of variable quality. The findings suggest that, despite differing conceptualisations of mental illness causation, both traditional healers and biomedical practitioners recognise that patients can benefit from a combination of both practices and demonstrate a clear willingness to work together. There are concerns about patients’ safety and human rights regarding traditional methods and some healers are sceptical about the effectiveness of Western psychiatric medication. Despite keeping the inclusion criteria open to all LMICs, 13 of the studies were conducted in Africa, seven of which were in South Africa. This limits the applicability of the findings of this review to the wider LMIC context. The paper concludes with recommendations for research and practice.

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Traditional and religious healers in the pathway to care for people with mental disorders in Africa: a systematic review and meta-analysis

Cited by 143 publications

References 40 publications

The Lancet Psychiatry Commission: a blueprint for protecting physical health in people with mental illness

The Lancet Psychiatry Commission: a blueprint for protecting physical health in people with mental illness

From global-to-local: rural mental health in South Africa

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

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