Knowledge Gap: This research study investigates the attitudes toward collaboration for mental health treatment among three types of providers in rural Uganda: Traditional Healers, Religious Leaders, and Biomedical Providers. Given the predominant focus on mental health in developed regions, this study aims to deepen our comprehension on the openness of these three providers to interdisciplinary approaches in rural communities. Using the Buyende district as a representative model, the study examines providers’ attitudes toward mental illness, effective strategies proposed for mental health care, and collaborative approaches for optimal patient outcomes.

Methods: The study involved a total of 53 one-on-one interviews and 8 focus group discussions with select participants: traditional healers, religious leaders and biomedical providers. Interviews conducted in the native language, Lusoga, were transcribed into English. Scripts were analyzed by a qualitative thematic framework.

Findings: Examining the findings revealed key insights into the perspectives and interactions among mental health care providers:

1. Belief disparities: While all providers recognized contemporary medical causes of mental illness, differences also emerged. Religious Leaders often attributed mental illness to divine punishment, while Traditional Healers tended to link mental illness to witchcraft.
2. Inter-provider Hesitations: Traditional Healers hesitated to collaborate with Religious Leaders, and vice versa, due to stigma and differing perspectives.
3. Biomedical Providers’ Views: Biomedical Providers were skeptical of Traditional Healers’ efficacy, but acknowledged cultural significance. They advocated for a combined approach, emphasizing medication and prayer.
4. Stigma and collaboration: A positive trend toward collaboration and minimal stigma toward mental illness was seen from all providers.
5. Accessibility Challenges: Findings indicate a lack of accessibility to care for patients due to the cost of medication, transport to facilities, and lack of available mental health providers.

Conclusions & Implications: In summary, the study highlights the importance of interprofessional collaboration in mental health care. Shared perspectives and nuanced differences among providers, coupled with the challenges in accessibility, suggest potential areas for intervention and collaboration in the holistic treatment of mental illness. Moreover, the study shows that helpful steps could be taken within the biomedical health care system to further incorporate Religious Leaders and Traditional Healers for a more comprehensive approach to patient care.

References and Resources

1. Burns, J. K., & Tomita, A. (2015). Traditional and religious healers in the pathway to care for people with mental disorders in Africa: a systematic review and meta-analysis. Social psychiatry and psychiatric epidemiology, 50(6), 867–877. https://doi.org/10.1007/s00127-014-0989-7.
2. Catherine Abbo (2011) Profiles and outcome of traditional healing practices for severe mental illnesses in two districts of Eastern Uganda, Global Health Action, 4:1, DOI: 10.3402/gha.v4i0.7117.
3. Joanna Teuton, Christopher Dowrick, Richard P. Bentall. How healers manage the pluralistic healing context: The perspective of indigenous, religious and allopathic healers in relation to psychosis in Uganda. Social Science & Medicine,Volume 65, Issue 6, 2007,Pages 1260-1273, https://doi.org/10.1016/j.socscimed.2007.03.055.
4. Sarikhani, Y., Bastani, P., Rafiee, M. et al. Key Barriers to the Provision and Utilization of Mental Health Services in Low-and Middle-Income Countries: A Scope Study. Community Ment Health J 57, 836–852 (2021). https://doi.org/10.1007/s10597-020-00619-2.
5. Shekhar Saxena, Graham Thornicroft, Martin Knapp, Harvey Whiteford. Resources for mental health: scarcity, inequity, and inefficiency. The Lancet, Volume 370, Issue 9590, 2007, Pages 878-889, https://doi.org/10.1016/S0140-6736(07)61239-2.