Traditional herbalists’ methods of treating mental disorders in Ghana

2018 ◽  
Vol 56 (1) ◽  
pp. 250-266 ◽  
Author(s):  
Lily N. A. Kpobi ◽  
Leslie Swartz ◽  
Cephas N. Omenyo
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Traditional Medicine ◽  
Mental Health Professionals ◽  
Specific Treatment ◽  
Mental Healthcare ◽  
Traditional Healers ◽  
Structured Interviews ◽  
Middle Income ◽  
Traditional Herbalists

The use of traditional medicine for the treatment of various disorders is not a new practice. Indeed, various categories of traditional healers form a large part of the healthcare workforce in many low- and middle-income countries, and given the paucity of mental health professionals in these countries, traditional and complementary medicine practitioners are utilised even more so for mental disorders. In Ghana, efforts have been made to formalise and standardise the work of traditional medicine practitioners. This goal is still mostly unmet, partly due to the lack of scientific knowledge of their beliefs, methods, and practices in mental healthcare. Very few studies have documented this knowledge. In this article, we report on some of the methods that are used by traditional Ghanaian herbalists in treating mental disorders. Eight herbalists working within the Greater Accra Region, who specialised in mental health, were interviewed through individual semi-structured interviews. Thematic analysis showed that traditional herbalists’ work in treating mental disorders revolved around four key themes: the method of diagnosis; the treatment methods used; the mode of administering the treatment; and the purpose of the specific treatment. These themes are discussed with reference to their potential implications for patients’ care and outcomes.

scholarly journals Brain drain: a challenge to global mental health

2016 ◽  
Vol 13 (3) ◽  
pp. 61-63 ◽  
Author(s):  
Bibilola D. Oladeji ◽  
Oye Gureje
Keyword(s):  
Mental Health ◽  
Mental Health Professionals ◽  
Brain Drain ◽  
Global Mental Health ◽  
Scale Up ◽  
Mental Healthcare ◽  
Psychiatric Training ◽  
Skilled Workers ◽  
African Countries ◽  
Middle Income

The brain drain of medical professionals from lower-income to higher-income countries contributes to the current inequity that characterises access to mental healthcare by those in need across the world and hinders efforts to scale up mental health services in resource-constrained settings, especially in Nigeria and other West African countries. The migration of skilled workers is driven by a combination of the globalisation of the labour market and the ability of highly resourced countries to attract and retain specialists from poorer countries. If we are to ameliorate the worldwide shortage of mental health professionals, we need to find innovative ways of attracting young doctors into psychiatric training in all countries. We must also introduce measures to improve health worker retention in low- and middle-income countries.

‘That is how the real mad people behave’: Beliefs about and treatment of mental disorders by traditional medicine-men in Accra, Ghana

2018 ◽  
Vol 64 (4) ◽  
pp. 309-316 ◽  
Author(s):  
Lily Kpobi ◽  
Leslie Swartz
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Illness ◽  
Mental Disorders ◽  
Mental Health Care ◽  
Traditional Medicine ◽  
Traditional Healers ◽  
Causal Beliefs ◽  
Treatment Methods ◽  
Medicine Men

Background: Traditional healing methods are considered central to mental health care in low-income countries such as Ghana, because they are perceived to be more easily accessible, more affordable and generally ascribe similar causal beliefs to those of the patients. However, not much is known about the work of traditional healers largely because their methods are shrouded in mysticism and secrecy. There is a need to understand the ideology and beliefs of traditional healers surrounding mental disorders, including knowledge about their practices in mental health care. Aims: In this article, we discuss the causal beliefs and treatment methods of traditional medicine-men from Accra, Ghana. We also describe their diagnostic and treatment methods for mental disorders. Methods: Eight medicine-men, indigenous to the Greater Accra Region, were interviewed through individual semi-structured interviews. The data were analysed through thematic analysis. Results: The medicine-men’s beliefs about mental illness were dominated by supernatural ideas. Mental illness was also seen as a form of punishment or resulting from envy, and there was a strong reliance on spiritual direction from the gods for diagnosis and treatment. Conclusion: These themes are discussed with emphasis on their potential implications for patients, as well as for collaborative efforts.

scholarly journals Challenges Encountered by Mental Health Workers in Rwanda; Current Situation and Future Needs

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Nkundimana Balthazar
Keyword(s):  
Mental Health ◽  
Data Analysis ◽  
Mental Health Professionals ◽  
Qualitative Data ◽  
Health Workers ◽  
Demographic Data ◽  
Mental Healthcare ◽  
Mental Health Workers ◽  
Mental Health Training ◽  
Middle Income

The burden of mental health has become a great concern for public health as the diseases caused by mental health is ranking second worldwide. According to the HWO countries of Low- and Middle-Income Countries (LMICs) don’t allocate enough financial means to mental healthcare. The lack of will or interest in mental health in these countries causes different challenges in this sector. Rwanda as one of LMICs is not served on the challenges although it might have its particularities. This study aimed to explore the challenges encountered by Rwandan local mental health workers within and outside of their demanding work. Method: An interpretative qualitative mixed with quantitative design. The self-administrated questionnaire with open-ended questions, demographic data as well as qualitative data was systematically prepared, explained, and given to respondents. The questionnaire was completed by sixty mental health workers from various institutions with mental health in Rwanda. SPSS was used in quantitative data analysis while the main part of data used Thematic analysis for qualitative data analysis. Results: The main results immersed in themes that consist of the shortage of; salary, poverty of mental health seekers, culture, and beliefs toward mental health, training, and professional development of mental health works. The study concluded with a better understanding of challenges in mental health practice in Rwanda and the outcome could be used to decrease challenges for mental health professionals and sustain of the mental healthcare system in Rwanda.

Mapping mental health professionals’ perspectives and practices regarding the implementation of Digital Mental Health: a qualitative study (Preprint)

2021 ◽  
Author(s):  
Cristina Mendes-Santos ◽  
Francisco Nunes ◽  
Elisabete Weiderpass ◽  
Rui Santana ◽  
Gerhard Andersson
Keyword(s):  
Mental Health ◽  
Qualitative Study ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Mental Healthcare ◽  
Cost Effective ◽  
Clinical Settings ◽  
Structured Interviews ◽  
Intervention Delivery ◽  
Training Programmes

BACKGROUND Despite Digital Mental Health’s potential to provide cost-effective mental healthcare, its adoption in clinical settings is limited and little is known about the perspectives and practices of mental health professionals regarding its implementation or the factors influencing such perspectives and practices. OBJECTIVE The current study aimed at characterizing in-depth the perspectives and practices of mental health professionals regarding the implementation of Digital Mental Health and exploring the factors impacting such perspectives and practices. METHODS A qualitative study using in-depth semi-structured interviews with Portuguese mental health professionals (N=13) - psychologists and psychiatrists – was conducted. Transcribed interviews were thematically analysed. RESULTS Mental health professionals deemed important or engaged in the following practices during the implementation of Digital Mental Health: i) Indication evaluation; ii) Therapeutic contract negotiation; iii) Digital psychological assessment; iv) Technology setup and management; and v) Intervention delivery and follow-up. Low threshold accessibility and professionals' perceived duty to provide support to their clients facilitated the implementation of Digital Mental Health. Conversely, the lack of structured intervention frameworks; the unavailability of usable, validated, and affordable technology; and the absence of structured training programmes, inhibited Digital Mental Health’s implementation by mental health professionals. CONCLUSIONS The publication of practice frameworks, the development of evidence-based technology, and the delivery of structured training seem key to expedite implementation and encourage the sustained adoption of Digital Mental Health by mental health professionals.

scholarly journals Common Mental Disorders

2012 ◽  
Vol 9 (3) ◽  
pp. 213-217
Author(s):  
A Risal
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Mental Disorders ◽  
Mental Health Care ◽  
Mental Health Professionals ◽  
Common Mental Disorders ◽  
Economic Status ◽  
Pathways To Care ◽  
Middle Income

Common mental disorders are a group of distress states manifesting with anxiety, depressive and unexplained somatic symptoms typically encountered in community and primary care settings. Risk factors for these disorders are mainly lower socio-economic status, psychological illnesses, poor reproductive health, gender disadvantage and physical ill-health. WHO has recommended that treatment of all these disorders should be based in primary care to be more effective and accessible to all the community people. The structure of mental health care in primary care is generally understood in terms of the “pathways to care” model and it plays a major role in countries like ours where community-based mental health services do not exist. Both the psychological and pharmacological therapies are found to be equally effective for treating these disorders. Integration of mental health into primary care can be considered as the stepping stone in the way forward to tackle the barriers and problems in effective management of common mental disorders in the community. The acute shortage of mental health professionals and the relatively low levels of awareness about mental disorders make it mandatory that primary health care should remain the single largest sector for mental health care in low and middle income countries like ours.DOI: http://dx.doi.org/10.3126/kumj.v9i3.6308 Kathmandu Univ Med J 2011;9(3):213-7  

scholarly journals Mental healthcare clinician engagement with point of care testing; a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Joseph Butler ◽  
Simone de Cassan ◽  
Phil Turner ◽  
Belinda Lennox ◽  
Gail Hayward ◽  
...  
Keyword(s):  
Mental Health ◽  
Clinical Practice ◽  
Mental Health Professionals ◽  
Positive Impact ◽  
Point Of Care ◽  
Mental Healthcare ◽  
Successful Implementation ◽  
Point Of Care Testing ◽  
Structured Interviews ◽  
The Impact

Abstract Background Point of Care Testing (POCT) is being increasingly used to augment the delivery of physical health care in a variety of settings, but their use in mental health has been limited. Research into understanding the barriers faced for successful implementation of POCT in these settings is lacking. We aimed to identify factors affecting engagement and implementation of POCT within mental health teams by exploring the attitudes to POCT, and the perceived impact POCT has on the practice of mental healthcare clinicians. Methods Alongside a study evaluating the impact of a point of care device in Community Mental Health Teams (CMHTs), qualitative interviews were carried out with CMHT clinicians using POCT as part of annual physical checks for patients with severe and enduring mental illness. Data were collected using semi-structured interviews and analysed using thematic analysis. Results Fifteen clinicians were interviewed across a range of professional backgrounds. Clinicians identified usability of the technology, positive impact on their patient’s experience and improved self-efficacy as drivers for successful implementation of POCT into their clinical practice. Issues with device functioning and the potential for a negative effect on the therapeutic relationship with their patients were identified as barriers. Level of physical heath training was not found to be a barrier by mental health professionals to using POCT. Conclusions Understanding barriers and drivers for engagement is important to allow co-production of POCT and guidelines to facilitate introduction of POCT into routine clinical practice.

scholarly journals Types of Ethical Problems and Expertise in Clinical Ethics Consultation in Psychiatry – Insights From a Qualitative Empirical Ethics Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Joschka Haltaufderheide ◽  
Jakov Gather ◽  
Georg Juckel ◽  
Jan Schildmann ◽  
Jochen Vollmann
Keyword(s):  
Mental Health ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Clinical Ethics ◽  
Mental Healthcare ◽  
Ethics Consultation ◽  
Third Party ◽  
Practical Training ◽  
Structured Interviews ◽  
Ethical Problems

Background: Ethics consultation has been advocated as a valuable tool in ethically challenging clinical situations in healthcare. It is paramount for the development and implementation of clinical ethics support services (CESS) in psychiatry that interventions can address the moral needs of mental health professionals adequately and communicate the nature of the services clearly. This study explores types of ethical problems and concepts of ethical expertise as core elements of CESS in mental healthcare with the aim of contributing to the further development of ethical support in psychiatry.Methods: We conducted 13 semi-structured interviews with mental health professionals and CESS members and triangulated them with four non-participant observations of ethical case consultations in psychiatry. Data were analyzed according to principles of grounded theory and are discussed from a normative perspective.Results: The analysis of the empirical data reveals a typology of three different ethical problems professionals want to refer to CESS: (1) Dyadic problems based on the relationship between patients and professionals, (2) triangular problems, where a third party is involved and affected as a side effect, and (3) problems on a systemic level. However, CESS members focus largely on types (1) and (2), while the third remains unrecognized or members do not feel responsible for these problems. Furthermore, they reflect a strong inner tension connected to their role as ethical experts which can be depicted as a dilemma. On the one hand, as ethically trained people, they reject the idea that their judgments have expert status. On the other hand, they feel that mental health professionals reach out for them to obtain guidance and that it is their responsibility to offer it.Conclusion: CESS members and professionals in mental healthcare have different ideas of the scope of responsibility of CESS. This contains the risk of misunderstandings and misconceptions and may affect the quality of consultations. It is necessary to adapt concepts of problem solving to practitioners' needs to overcome these problems. Secondly, CESS members struggle with their role as ethical experts. CESS members in psychiatry need to develop a stable professional identity. Theoretical clarification and practical training are needed.

scholarly journals The current state of mental healthcare in Bangladesh: part 1 – an updated country profile

2021 ◽  
pp. 1-5
Author(s):  
M. Tasdik Hasan ◽  
Tasnim Anwar ◽  
Enryka Christopher ◽  
Sahadat Hossain ◽  
Md Mahbub Hossain ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Mental Health Professionals ◽  
Psychiatric Patients ◽  
Synthesis Method ◽  
Mental Healthcare ◽  
Public Mental Health ◽  
Public Health Issue ◽  
Research Attention ◽  
Mental Health Expenditure

Mental health is a significant factor for a sound and productive life; nevertheless, mental disorders do not often receive adequate research attention and are not addressed as a serious public health issue in countries such as Bangladesh. Part 1 of this two-part profile describes the current situation of mental health in Bangladesh in its wider sociocultural context, outlining existing policies and highlighting mental illness as a neglected healthcare problem in the country using a narrative synthesis method. The prevalence of mental disorders is very high and augmented in nature among different population groups in Bangladesh. A lack of public mental health facilities, scarcity of skilled mental health professionals, insufficient financial resource distribution, inadequately stewarded mental health policies and stigma contribute to making current mental healthcare significantly inadequate in Bangladesh. The country has few community care facilities for psychiatric patients. Furthermore, the current mental health expenditure by the Bangladeshi government is only 0.44% of the total health budget. Less than 0.11% of the population has access to free essential psychotropic medications.

scholarly journals Patterns of care and dropout rates from outpatient mental healthcare in low-, middle- and high-income countries from the World Health Organization's World Mental Health Survey Initiative

2020 ◽  
pp. 1-13
Author(s):  
Daniel Fernández ◽  
Daniel Vigo ◽  
Nancy A. Sampson ◽  
Irving Hwang ◽  
Sergio Aguilar-Gaxiola ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Mental Healthcare ◽  
High Income ◽  
Drop Out ◽  
World Health ◽  
Dropout Rates ◽  
Financial Protection ◽  
Middle Income ◽  
Training Support

Abstract Background There is a substantial proportion of patients who drop out of treatment before they receive minimally adequate care. They tend to have worse health outcomes than those who complete treatment. Our main goal is to describe the frequency and determinants of dropout from treatment for mental disorders in low-, middle-, and high-income countries. Methods Respondents from 13 low- or middle-income countries (N = 60 224) and 15 in high-income countries (N = 77 303) were screened for mental and substance use disorders. Cross-tabulations were used to examine the distribution of treatment and dropout rates for those who screened positive. The timing of dropout was examined using Kaplan–Meier curves. Predictors of dropout were examined with survival analysis using a logistic link function. Results Dropout rates are high, both in high-income (30%) and low/middle-income (45%) countries. Dropout mostly occurs during the first two visits. It is higher in general medical rather than in specialist settings (nearly 60% v. 20% in lower income settings). It is also higher for mild and moderate than for severe presentations. The lack of financial protection for mental health services is associated with overall increased dropout from care. Conclusions Extending financial protection and coverage for mental disorders may reduce dropout. Efficiency can be improved by managing the milder clinical presentations at the entry point to the mental health system, providing adequate training, support and specialist supervision for non-specialists, and streamlining referral to psychiatrists for more severe cases.

scholarly journals Towards a better understanding of attitudes and beliefs held by traditional healers and recipients of traditional medicine concerning mental health conditions in post-conflict Liberia: a qualitative investigation

2021 ◽  
Vol 21 (3) ◽  
pp. 1396-1409
Author(s):  
Samuel J Pullen ◽  
Augusta R Herman ◽  
Brittany CL Lange ◽  
Nicole Christian-Brathwaite ◽  
Melissa Ulloa ◽  
...  
Keyword(s):  
Mental Health ◽  
Traditional Medicine ◽  
Social Factors ◽  
Mental Health Problems ◽  
Mental Healthcare ◽  
Health Problems ◽  
Traditional Healers ◽  
Health Conditions ◽  
Attitudes And Beliefs ◽  
Modern Health Care

Background: A better understanding of attitudes and beliefs held by traditional healers and utilizers of traditional medicine concerning mental health conditions in Liberia is important as Liberia seeks to improve its delivery of mental healthcare in the context of scarce resources and recovery from civil war. Methods: A qualitative research design was used to collect data from 24 Liberian traditional healers, and 11 utilizers of Liberian traditional medicine. Participants were queried about mental health problems in Liberia, treatments, and attitudes towards modern healthcare. Qualitative data were probed and aggregated using content analysis. Results: Mental health problems described by study participants included: Open Mole, African Science, Epilepsy, Depres- sion and Mental Illness (trauma/substance use). Mental health problems were often associated with socioeconomic distress, and participants described their attitudes and beliefs concerning mental healthcare, traditional medicine, and modern health- care. Conclusion: Traditional medicine is an important part of mental healthcare in Africa. Mental illness, social factors, and healthcare access were important problems in Liberia. Mental health problems blended local cultural beliefs with Western- ized nosology and social factors. Traditional healer’s attitudes towards Western medicine reflected ambivalence. There is a desire for collaboration with ‘modern’ health care providers, but this will require reciprocal trust-building. Keywords: Traditional healer; mental healthcare; Liberia; qualitative research.

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