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Traditional Healers Play Significant Role in Mental Health
With one-third[i] of South Africans experiencing a mental disorder in their lifetime, and limited access to psychiatric treatment in the public health sector, traditional healers can play an important role in the front-line of treatment for depression, anxiety and substance abuse.
Speaking ahead of African Traditional Medicine Day on 31 August, specialist psychiatrist Dr Lerato Dikobe-Kalane, a member of the South African Society of Psychiatrists (SASOP) called for greater cooperation between conventional Western medicine and traditional health practitioners to improve access to mental health care.
South Africa currently has 915[ii] practising psychiatrists, the majority of those in the private sector and in urban areas, and 75%[iii] of people in South Africa with mental health disorders do not receive the treatment they need, she said.
“We have an estimated 200,000[iv] traditional healers in South Africa – they have intimate knowledge of traditional medicine and cultural and spiritual practices and beliefs. They are respected in the community and their advice is sought out and respected, and they are able to offer culturally appropriate treatment.
“There is evidence that the psychosocial role of traditional healers – informal counselling and support in improving family, community or work relationships – can help to relieve distress and mild symptoms of common mental disorders like depression and anxiety. Given our limited public sector psychiatric facilities, traditional healers can play an important role in assisting people with mental health issues at a primary healthcare level,” Dr Dikobe-Kalane said.
Traditional healers play an influential role in providing health information, in both rural and urban settings, and greater collaboration between conventional, Western health practitioners and traditional healers can educate traditional healers on common mental disorders, treatment options and to refer people for more specialist treatment, she said.
The South African Stress and Health Study in 2009[v], the first nationally-representative research into mental disorders, showed that alternative, or traditional, medicine is widely used by South Africans, and that those suffering from anxiety or a substance abuse disorder were likely to consult traditional healers.
Dr Dikobe-Kalane said the wide use of alternative medicine suggested that educating traditional healers on common mental disorders and treatment options could make a significant impact for people living with untreated mental health problems.
“There is little evidence that traditional healers have an impact on treatment for severe mental illnesses such as bipolar and psychotic disorders. This is why collaboration between traditional and Western practitioners is needed – to ensure that they understand each other’s roles and cultures, and are able to refer treatment-resistant patients to alternative modes,” she said.
African Traditional Medicine Day is an initiative of the World Health Organisation (WHO) as part of their advocacy of recognition of traditional health practitioners and the integration of traditional medicine in national health systems.
[i] SA Stress and Health (SASH) Study. http://www.samj.org.za/index.php/samj/article/view/3374
[ii] Health Professions Council of South Africa (HPCSA) register http://isystems.hpcsa.co.za/iregister/ accessed 25 August 2019.
[iii] SA Stress and Health (SASH) Study. http://www.samj.org.za/index.php/samj/article/view/3374
[iv] Widely quoted figure.
[v] SA Stress and Health (SASH) Study. http://www.samj.org.za/index.php/samj/article/view/3061/2367