Mental Health Diagnostic Frameworks, Imputed Causes of Mental Illness, and Alternative Treatments in Northern Tanzania: Exploring Mental Health Providers' Perspectives.

Journal: Culture, medicine and psychiatry

Volume: 42

Issue: 3

Year of Publication: 2018

Affiliated Institutions:  Duke Global Health Institute, Trent Drive, Box , Durham, NC, , USA. Brandon.Knettel@gmail.com. Department of Psychology, University of Johannesburg, Johannesburg, South Africa. Yale University, New Haven, CT, USA.

Abstract summary 

In Tanzania, a nation with a large mental health treatment gap, local stakeholders' perspectives are critical for informing effective treatment. The practice-based perspectives of mental health providers may be particularly instructive. Existing foundational literature on the professional population in this region is scarce. We conducted semi-structured interviews with 29 mental health providers in northern Tanzania. Interviews focused on three topics: use of international diagnostic frameworks for mental illness, beliefs about causes of mental health concerns, and alternative treatments sought by clients. Interview data were coded and analyzed using consensual qualitative research and the constant comparative method. Usage of diagnostic frameworks varied widely. Providers believed frameworks accurately described many patients but neglected somatic symptoms and contained diagnoses that they had never witnessed. Providers described supernatural and spiritual attributions of mental illness as substantially impacting treatment decisions. Other notable attributions included physical illness, drug/alcohol use, and heredity. Providers reported their clients routinely sought treatment from traditional and spiritual healers prior to seeking care in the formal health system. This study builds a foundation for the ongoing development of the mental health system in northern Tanzania. Findings also support exploration of integrative models of care and task-shifting to incorporate traditional and spiritual beliefs.

Authors & Co-authors:  Knettel Brandon A BA Rugira Janvier J Cornett Joseph A JA

Study Outcome 

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Statistics
Citations :  Psychotherapy (Chic). 2006 Winter;43(4):531-48
Authors :  3
Identifiers
Doi : 10.1007/s11013-018-9565-z
SSN : 1573-076X
Study Population
Male,Female
Mesh Terms
Adult
Other Terms
Attribution;East Africa;Global mental health;Lay beliefs;Lay theories of mental illness
Study Design
Cross Sectional Study
Study Approach
Qualitative
Country of Study
Tanzania
Publication Country
Netherlands