Perspectives of different stakeholders about mental health care services provided by traditional healers in Ghana and the possibility of the integration of traditional medicine into mental health care
Thesis (MPhil)--Stellenbosch University, 2016.
ENGLISH ABSTRACT: There is recognition that despite technological advancement and increase in expenditure in formal health care services, the popularity of traditional healing services has remained very high. This is demonstrated by the high utilisation of services of traditional healers, especially for the management of mental illnesses. This study undertook to explore perspectives of different stakeholders about mental health care services provided by traditional healers and the possibility of integrating traditional medicine into formal community mental health care in northern Ghana. It was a qualitative study where field data was collected using Key Informant Interviews and Focus Group Discussions with a range of stakeholders, made up of traditional healers, mental health service users and their primary carers formal community mental health workers, made up of mental health nurses and general health nurses, as well as district, regional and national level health policy officials and legislator. Analysis of the data was done using the thematic analysis framework of Braun and Clarke (2006). The findings of the study supported the high utilisation of traditional healing services in the treatment of mental illnesses and epilepsy. On the whole, views of stakeholders were that integration of traditional healers and their services into formal community mental health treatment services would enhance mental health services, scale up mental health care and reduce the mental health treatment gap in Ghana. On how such integration might work within the formal health system of Ghana. The finding clearly indicate that integration of services of traditional healers does not amount to their locating in public health facilities such as hospitals and clinics, with offices or working spaces to operate from. Traditional healers wold continue to be in their places of operation. Opportunities to bring about such inclusion of traditional healing services into formal community mental health care was that the study established that both traditional healers and community mental health workers being agreeable to working together. Also current national level efforts and the global momentum for increased attention to mental health has included mobilising all available resources to optimise mental health care service provision among the population, especially in low income settings. Ghana’s Mental Health Act, 2012 (Act 846) and association of traditional healers in mental health were other opportunities to take advantage of to maximise the services of traditional healers in community mental health care service provision. Challenges to the effective integration of traditional healing services into formal community mental health care included the different approaches and nosological perspectives of traditional healing and formal community mental health services, low literacy and numeracy levels of traditional healers, funding constraints and inadequate political commitment, as well as concerns with misuse of knowledge and attributions of the contribution of formal and traditional healing services to treatment and recovery of service users. It is recommended that a referral process be in place and traditional healers so identified to be treating mental illnesses of epilepsy located within proximity of community mental health service facility are engaged, through regular meetings and supportive visits, are encouraged to refer people who come to them with mental health care needs to the Community Psychiatric Units for treatment. They can be assured to have the patients to administer their prayers. The regular meetings between traditional healers and formal mental health practitioners should help diffuse the mutual suspicion between and among the two categories of health care practitioners. Guidelines detailing when to refer and minimum standards can be collectively agreed upon and regularly reviewed to ensure compliance. A system of monitoring and supervision of practices and activities of traditional healers should be in place to prevent excesses. The Mental Health Act, 2012 (Act 846) provides for such monitoring and supervision for compliance through the Visiting Committees and Mental Health Tribunals.
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