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加纳基于信仰和传统治疗中心的精神疾病治疗:服务使用者和治疗师的观点。

The treatment of mental illness in faith-based and traditional healing centres in Ghana: perspectives of service users and healers.

作者信息

Lambert Jessica E, Nantogmah Fred, Dokurugu Adam Yahaya, Alhassan Hanan, Azuure Sandow Stanislaus, Yaro Peter Badimak, Kørner Jeanette

机构信息

Dignity- Danish Institute Against Torture, Kobenhavn, Denmark.

BasicNeeds-Ghana, Accra, Ghana.

出版信息

Glob Ment Health (Camb). 2020 Oct 14;7:e28. doi: 10.1017/gmh.2020.21. eCollection 2020.

Abstract

BACKGROUND

The maltreatment of people with mental illness in Ghana's traditional and faith-based healing centres, including shackling, flogging, and forced fasting, has been documented by numerous sources. Such treatment is potentially traumatising and may exacerbate mental health problems. Despite widespread use, few studies have focused on experiences and characteristics of people who seek traditional healing for mental illness or healers' perspectives treatment of these conditions.

METHOD

Purposeful sampling was used to recruit 82 individuals who were treated in healing centres and 40 traditional healers; all took part in semi-structured interviews. Those treated were asked about experiences in centres and assessed for prior trauma exposure, posttraumatic stress, and functional impairment. Healers were asked about beliefs and practices related to the treatment of mental illness.

RESULTS

Individuals treated in centres and healers generally believed that mental illness has a spiritual cause. Approximately 30.5% of those treated in centres were exposed to maltreatment; despite this, half would return. Individuals with a history of trauma were more likely to report maltreatment in the centre and had higher symptoms of posttraumatic stress. Most participants had impaired functioning. Healers who used practices like shackling believed they were necessary. Most healers were willing to collaborate with the official health structure.

CONCLUSION

Results provide insight into the treatment of mental illness by traditional healers in Ghana and the need for trauma-informed mental health services. Findings also highlight the importance of considering cultural beliefs when attempting to implement mental health interventions in the region.

摘要

背景

众多资料记载了加纳传统及宗教治疗中心对精神疾病患者的虐待行为,包括枷锁束缚、鞭打和强制禁食。这种治疗方式可能造成创伤,还可能加剧心理健康问题。尽管传统治疗被广泛使用,但很少有研究关注寻求传统精神疾病治疗者的经历和特征,或治疗师对这些病症的治疗观点。

方法

采用立意抽样法招募了82名在治疗中心接受过治疗的个体和40名传统治疗师;所有人都参与了半结构化访谈。接受治疗者被问及在治疗中心的经历,并接受先前创伤暴露、创伤后应激和功能损害评估。治疗师被问及与精神疾病治疗相关的信念和做法。

结果

在治疗中心接受治疗的个体和治疗师普遍认为精神疾病有精神方面的病因。在治疗中心接受治疗的人中约30.5%遭受过虐待;尽管如此,仍有半数会回去继续治疗。有创伤史的个体更有可能报告在治疗中心遭受虐待,且创伤后应激症状更严重。大多数参与者功能受损。使用枷锁束缚等做法的治疗师认为这些做法是必要的。大多数治疗师愿意与官方卫生机构合作。

结论

研究结果为了解加纳传统治疗师对精神疾病的治疗以及提供有创伤意识的心理健康服务的必要性提供了见解。研究结果还凸显了在该地区尝试实施心理健康干预措施时考虑文化信仰的重要性。

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