The Challenge of Indigenous Healing for Global Mental Health

Psychiatry and anthropology have a long relationship, and it is worth examining aspects of how that relation is carried over into the developing field of Global Mental Health (GMH). One place at which the two disciplines overlap significantly is in addressing religious phenomena and ritual performance in relation to mental health, and one of the greatest challenges for GMH is how productively to take into account forms of indigenous healing based on religion and ritual. In this paper I compare recent texts in GMH written from the standpoint of psychiatry and anthropology, observing that the psychiatric texts emphasize evidence-based determination of treatment efficacy, while the anthropological texts emphasize ethnographic understanding of treatment experience. Reconciling these two emphases constitutes a challenge to the field, attending to contextual variations in treatment events, illness episodes, phenomenological factors both endogenous and intersubjective, and sociopolitical factors both interpersonal and structural. In addressing this challenge, I propose an approach to therapeutic process that on the empirical level can facilitate comparison across the diversity of healing forms, and on the conceptual level can constitute a bridge between efficacy and experience. This approach is predicated on a rhetorical model of therapeutic process including components of disposition, experience of the sacred, elaboration of alternatives, and actualization of change that highlights experiential specificity and incremental change. Deploying this model can help meet the challenge of understanding efficacy and experience in indigenous healing, and prepare the ground for the further challenge of how practitioners of GMH relate to and interact with such forms of healing.

Edutainment pedagogies in education, a textual analysis.

Edutainment shows promise as an alternative and complementary pedagogy, in autistic education, in this paper we evaluate a textual analysis of a movie Inner Healing on the edutainment and infotainment Fire Stick ++ terminal, also serving as a dock station to student keyboards and laptops, the textual analysis of this important media, in education proves the neurodiversity viewpoint in the indigenous healing diaspora, proving autism as transcending a minority culture in a viewpoint of a gift and hence a strength with the acceptance of the whole, the diversity of the self in meltdowns, irrationality, rage and anger, all as part of a gift and an acceptance of oneself, the inner healing. This edutainment is a broad deviation from current western thought streams in autism interventions as proves the holistic and alternative viewpoints.

A study protocol for a quasi-experimental community trial evaluating the integration of indigenous healing practices and a harm reduction approach with principles of seeking safety in an indigenous residential treatment program in Northern Ontario

Background Indigenous communities in Canada face significant challenges with intergenerational trauma, which manifests in substance use disorders. There is consensus that connecting treatment approaches to culture, land, community, and spiritual practices is a pathway to healing trauma and substance use disorders for Indigenous peoples. Indigenous residential addiction treatment programs have been established as the primary intervention to provide healing for Indigenous peoples with substance use disorders and intergenerational trauma. However, there is limited evidence demonstrating the effectiveness of these programs. In collaboration with the Benbowopka Treatment Centre, this paper describes a study protocol which aims to evaluate the effectiveness of blending Indigenous Healing Practices and Seeking Safety for the treatment of Indigenous patients with intergenerational trauma and substance use disorders. Methods We will conduct a pre/post Quasi Experimental Community trial, to compare historical treatment outcomes for patients following the implementation of Indigenous Healing and Seeking Safety. We will conduct quantitative and qualitative analyses to understand the differences before and after the intervention is implemented. The pre- Indigenous Healing and Seeking Safety intervention study window will span from 2013 to 2016; n = 343, and the post-Indigenous Healing and Seeking Safety intervention study window from 2018 to 2020; n > 300. All participants will be enrolled in the Benbowopka residential treatment for the first time during the study periods. All data will be anonymized at the time of data entry. Propensity matching will be undertaken for patient characteristics, including sex/gender, age, and substance use type. Results and conclusions The study findings could be used to inform intergenerational trauma and substance use disorders residential treatment programming for Indigenous communities across Canada. Our work will contribute to the field of community-based intergenerational trauma and substance use disorders programming by addressing objectives that consider: (a) the patient perspective, (b) the program perspective, and (c) the community perspective. The study findings may validate an innovative approach for evaluating the effectiveness of residential addiction treatment and particularly the effective and appropriate care for Indigenous patients with intergenerational trauma and substance use disorders.

Curing Madness?

Curing Madness? focuses on the institutional and non-institutional histories of madness in colonial north India. ‘Madness’ and ‘cure’ are explored as shifting categories which travelled across cultural, medical, national, and regional boundaries, thereby moving beyond asylum-centric histories. It is based on extensive research of archival materials gathered from various repositories in India and abroad. The book focusses on governmental policies, legal processes, everyday patterns of treatment, discipline and resistance behind the walls, and individual case histories. It also brings to fore the non-institutional histories of madness. While few ended up in asylums, most people suffering from insanity were cared for by their families and the local vidyas, ojhas, shamans, and pundits. Western medicine denigrated indigenous healing traditions forcing them to reconceptualize and reinvent themselves. The spread and dissemination of Western medical knowledge led to the reshaping of some of the Ayurvedic concepts of mental illness. Based on an examination of Hindi medical advice literature which primarily includes books, pamphlets, and periodicals, the study locates the history of madness within and beyond the asylum walls.

Fakes and chemicals: indigenous medicine in contemporary Kenya and implications for health equity

Background Access to effective biomedical treatments for humans and livestock in Kenya is far from universal. Indigenous healing has a significant role to play in contemporary society in Kenya, yet access is not the only reason for this. Beliefs surrounding the composition of biomedicines, people’s experiences of biomedical care, and issues of counterfeit biomedicines sold over the counter have led to patients seeking care outside of biomedical institutions. Methods This study explores local realities of treatment seeking in one rural and one urban study site, for both humans and their livestock, including when, where and how people access certain types of medicines. Using an ethnographic approach to interviews, focus groups and observations, I explore the role that indigenous healing, both herbal and occasionally spiritual, plays within this context with healers and community members. Results Indigenous healing remains important for many people due to their mistrust and suspicion of biomedicine and big pharma. Their interactions with the healer or doctor, and the equity of these interactions, influence their decisions whether to access herbal or biomedical care, or a combination of the two. Indigenous healing bridges the gap many people experience when they are unable to access biomedical treatments and effectively creates a broader, more equitable coverage for healthcare. The plurality of reasons surrounding decision making is complex, but it is clear that many people often use indigenous healing, improvements in the regulation of both formulas and practice would assist people to access more effective treatment. Conclusions Indigenous healing is an important way in which Kenyans in rural and urban areas access healthcare for themselves and their animals. Issues of counterfeit biomedicines have led to broad mistrust and people favour indigenous healing, depending on the illness or severity of symptoms. Indigenous healing is a vital way in which people in underserved rural and urban populations access care. Herbal medicines and indigenous healing are trusted due to the greater transparency in their creation, and the more equitable relationship between indigenous doctor and patient. The study demonstrates that a pluralistic system is appropriate to increasing equity in access to healthcare in both urban and rural settings, as well as the importance of biomedical care providers respecting indigenous healing and viewing it with legitimacy. By taking a One Health perspective to understand the intersection of humans, livestock and the environment, we can better understand critical aspects affecting decision making for treatment and implications for healthcare equity in a rapidly changing world.

Culture, Sexuality and Indigenous Healing in Pakistan: Exploring Sexual Health Care through Hakeems and Herbalists

Objective: This paper aims to understand the relationship between sexuality, culture, and male sexual health through the role of hakeems as an indigenous healing framework in Pakistan. Study Design: Participant observation (by first author) and personal practice (by second author). Place and Duration of Study: At a matab where second author practices hikmat is located in Islamabad. The fieldwork in the form of collaborative learning has been going on since September 2019 to date. Materials and Methods: This research is based on the participant observation at the matab where people come to seek herbal medicine and consultancy from the hakeem. Narrative account of anthropologist and practice of certified hakeem, through an interactive exchange of ideas about questions of the study, was employed. The study has taken information in the form of semi-structured interviews from the patients who either gave consent or asked to remain anonymous. Results: Results have shown that the nature of the relation between sexuality and cultural order have compelled people to seek hikmat as indigenous healing on a long-term basis. The framework of indigenous healers has helped to understand the cultural logic of sexuality, which is embedded more closely in the practice of hakeems than the biomedical regime. Conclusion: Cultural competence, in this case the same cultural background of the hakeem and patients, adds to our understanding of the indigenous healing framework, sexuality, and culture.