Table 6. 3 Summary of findings for the current research project Main themes Summary of findings
1.Understanding and conceptualisation
a) Mental illness: most participants understood and conceptualised emotional distress in relation to behaviour, sociocultural norms and thinking processes. For instance, a person who is mentally ill, was conceptualised and understood to have disturbances in the thinking process, inability to act congruently and unconscious; inability to behave in a normal and acceptable way in the sociocultural setting.
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b) Psychological wellbeing: many participants conceptualised psychological wellbeing as being in congruence with life, behaving in an acceptable and appropriate way, and being conscious and having a normal state of mind. Additionally, the person who is mentally well was believed to have a sound relationship with their ancestors; world;
and their environment
2.Beliefs about the cause of mental illnesses
a) Beliefs about the causes of mental illness: the results from the study suggest that many participants have certain beliefs about the aetiology of psychological maladjustment, and these beliefs were mostly related to explanatory theories of mental illness and health.
The beliefs about the causes of mental illnesses included animistic, magical, and mystical theories. Nonetheless, there were few participants who indicated and believed that certain psychological abnormalities can be caused by psychosocial factors such as drug and alcohol abuse; dysfunctional families; childbirth;
unemployment etc.
b) The link between the beliefs about the aetiology &conception of mental illnesses: the results from the study clearly suggest that there is a relationship between the participant’s beliefs about the causes of mental illnesses and their conceptualisation of psychological distress. The participants, who mostly believed that mental illnesses are caused by African related factors, had an understanding of mental illness that is related to the African worldview. For instance, this understanding was associated with a broken relationship with the ancestors; angry ancestors; the need to do certain traditional rituals; ancestral calling and more. In the case of the participants who also had a Western related believes about the etiology of mental illnesses, there was as well a strong link in terms of how they understood and conceptualised mental illness, this included the thinking process, consciousness, and behavior.
100 3.African traditional
interventions for psychological distress
a) African traditional medicine: the findings suggest that African traditional healers utilise indigenous plants and herbs to make traditional mixtures. This was suggested by many participants as a method that traditional healers use to help people who are ill, including those who have psychological abnormalities.
b) African traditional divination: many participants including the traditional healers stated traditional divination as one of the methods they use in the treatment process. This process was said to be very important as it brings about answers as to why a person is sick; and who made them sick and more.
c) African traditional rituals: a number of participants suggested that traditional healers use traditional rituals as one of the methods to healing. The traditional rituals are guided and directed by the indigenous healer under the authority and guidance of the ancestors. Participants stated that these rituals are may include slaughtering a goat to appease to the ancestors; ukuthwasa ritual;
incision to protect the person from witchcraft; cleansing ceremony; and many more.
4.Perception about the role of traditional
healers in treatment of mental illnesses
a) The role of traditional healers: numerous participants believed that traditional healers have and important and enormous role in the treatment of mental illnesses. The role is related to advising and guiding the treatment process, in addition to that divining and helping with the reasons for the illnesses and more. Nevertheless, there were participants who had a contradictory view about the role of traditional healers. These participants believed that indigenous healers have no role to play in the treatment of mental illness and would therefore recommend mental health professionals to intervene in this process unless the aetiology of the illness is a caused by traditional related matters.
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b) The role of the ancestors: most participants believed that the ancestors have a huge and vital role to play in the treatment process; infact the participants believed that the treatment process is guided and led by the ancestors. Therefore, the traditional healers need to seek guidance and communicate with them before anything.
5.The issues related to helpseeking
a) Access to mental health care: most participants in their responses stated that, it is difficult for many people who are in rural areas to access mental health institutions because there are no mental hospitals in their areas. Consequently, many people from these settings loiter around the streets without any form of help; the participants also stated that this was the case in their community. Furthermore, in the surrounding or close urban areas it becomes difficult and sometimes impossible for them to go to those institutions as a result of transport costs and other related factors.
c) Other barriers related to mental health care: several participants suggested that there are many other barriers which lead to not seeking help for mental problems, these included but are not limited to language; different worldview and sociocultural beliefs between the client and mental health professional.