Contribution of traditional healers to the burden of mental health conditions in five African countries and England

Purpose Mental health conditions such as depression and anxiety, mental illnesses like schizophrenia and bipolar disorder, and alcohol use disorders are leading causes of disability and mortality worldwide. However, the understanding of the burden of these conditions varies across countries, as does the access to and utilisation of services for those who seek help. Many Africans depend on traditional healers as their primary source of mental health care due to cultural beliefs and easier accessibility compared to biomedical services. This study aimed to understand the burden of mental health conditions in selected countries, evaluate the contributions of traditional healers as a support source, and identify future directions for mental health and traditional healing research. Design/methodology/approach The study focused on five African countries (Burkina Faso, Ghana, South Africa, Uganda and Zimbabwe) and Black African communities in England. The study was primarily a desk review, complemented by a priority-setting exercise and a consensus-building workshop with traditional healers and mental health researchers to validate and strengthen the findings. A predefined template co-created during the priority-setting process was used to guide the non-systematic review mapping and covered three areas: 1) burden of these conditions, 2) contributions of traditional healers and 3) mental health policy and legislative frameworks. Data analysis from the non-systematic review was conducted descriptively. Cross-country similarities and differences, as well as future research directions, were collaboratively discussed during the consensus-building workshop. Findings In terms of the burden of conditions, the study revealed that depression was recognised as the most prevalent condition among all six countries. The contributions of traditional healers were more acknowledged in the African countries than in England, although their exact roles in providing mental health support across all six countries were not fully known or understood. In addition, mental health policies and legislation existed in all the African countries and recognised the presence of traditional healers, albeit to varying degrees. None of the mental health policies or legislation in England acknowledged the contributions of traditional healers. These findings and the consensus-building process led to the establishment of the Pan-African Mental Health Research Network to advance research on mental health and traditional healing in Black African societies. Research limitations/implications More research is needed on the role and contribution of traditional healers in mental health in sub-Saharan Africa and other parts of the world. Practical implications There is a need for active engagement with traditional healers to increase their visibility and potential contributions to mental health. Social implications Engagement of traditional healers as key stakeholders in decision making processes regarding mental health in communities is needed. Originality/value The burden of mental ill health varied across different countries, and the potential contribution of traditional healers in alleviating this problem in Africa and among African communities in England was not well understood. Active engagement with traditional healers is necessary to enhance their visibility and investigate their potential contribution to mental health support.