Baheretibeb Yonas, Wondimagegn Dawit, Law Samuel
Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Ethiopia.
Department of Psychiatry, Faculty of Medicine, University of Toronto, Canada.
BJPsych Open. 2021 May 5;7(3):e92. doi: 10.1192/bjo.2021.56.
Religious and traditional healers remain the main providers of mental healthcare in much of Africa. Collaboration between biomedical and traditional treatment modalities is an underutilised approach, with potential to scale up mental healthcare.
To report the process and feasibility of establishing a collaboration between religious healers and psychiatrists in Addis Ababa, Ethiopia. To gain insight into the collaboration through studies of patient demographics, help-seeking patterns, nature of illness and receptivity of the project.
This case study describes the process and challenges in establishing a collaborative psychiatric clinic for patients who are simultaneously receiving treatment with holy water, including an examination of basic clinical records of 1888 patients over a 7-year period.
The collaboration is feasible and has been successfully implemented for 8 years. A majority (54%) of the clinic's patients were seeing biomedical services for the first time. Patients were brought in largely by families (54%); 26% were referred directly by priest healers. Most patients had severe mental illness, including schizophrenia (40%), substance misuse (24%) and mood disorders (30%). A vast majority (92.2%) of patients reported comfort in receiving treatment with holy water and prayers simultaneously with medication, and 73.6% believed their illness was caused by evil spirit possession.
A cross-system collaborative model is a feasible and potentially valuable model to address biomedical resource limitations. Provider collaboration and mutual learning are ultimately beneficial to patients with severe mental illness. Open-minded acceptance of cultural benefits and strengths of traditional healing is a prerequisite. Further study on outcomes and implementation are warranted.
在非洲大部分地区，宗教和传统治疗师仍是精神卫生保健的主要提供者。生物医学与传统治疗方式之间的合作是一种未得到充分利用的方法，具有扩大精神卫生保健规模的潜力。
报告在埃塞俄比亚亚的斯亚贝巴建立宗教治疗师与精神科医生合作关系的过程和可行性。通过对患者人口统计学、求助模式、疾病性质和项目接受度的研究，深入了解这种合作关系。
本案例研究描述了为同时接受圣水治疗的患者建立合作性精神科诊所的过程和挑战，包括对1888名患者7年期间的基本临床记录进行审查。
这种合作是可行的，并且已经成功实施了8年。该诊所的大多数患者（54%）是首次接受生物医学服务。患者大多由家人送来（54%）；26%是由牧师治疗师直接转诊的。大多数患者患有严重精神疾病，包括精神分裂症（40%）、药物滥用（24%）和情绪障碍（30%）。绝大多数患者（92.2%）表示在接受药物治疗的同时接受圣水和祈祷治疗感到安心，73.6%的患者认为他们的疾病是由恶灵附身引起的。
跨系统合作模式是解决生物医学资源限制的一种可行且潜在有价值的模式。提供者之间的合作和相互学习最终有利于患有严重精神疾病的患者。开放地接受传统治疗的文化益处和优势是前提条件。有必要对结果和实施情况进行进一步研究。
