ABSTRACT
While studies indicate increased recognition of the evidence base of biomedical care in the sub-Saharan African region, questions have been raised regarding the extent such outcomes are culturally sensitive and inclusive. On the other hand, while traditional and faith healers may play an important role in addressing mental health needs by offering culturally responsive treatments, these pathways are associated with the longest delay in reaching specialised services. To achieve therapeutic alliances and meet cultural expectations of outcome in these societies, health care providers must not insist on a linear or ‘logical’ Western approach which could strip away the local beliefs that provide buffers and safe harbour in the face of crises thus alienating sufferers. The call of the UN Permanent Forum on Indigenous Issues for a complementary approach to health care is pertinent. It envisages consultation with, referral to, or joint therapy with trained spiritual and traditional practitioners. Biomedical and alternative healers could help persons with mental illness by resolving different issues relating to the same illness. While the pragmatics of such an integrated model of care must be determined, training to promote improved cultural competency of local mental health professionals would be a good starting point towards a bottom-up approach that recognises the importance of local conceptualisations of mental health difficulties for more auspicious service delivery.
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