Perceptions of Mental Disorders and Help-Seeking Behaviour for Mental Health Care Within the Maasai Community of Northern Tanzania: An Exploratory Qualitative Study.

BACKGROUND

Mental disorders are rapidly becoming more prevalent worldwide and are estimated to contribute up to 15% of the global burden of disease by 2020. In Africa, the help-seeking behaviour for mental health care is complex and is hindered by misconceptions and negative attitudes towards mental disorders. This study aimed to explore perceptions of mental disorders and help-seeking behaviour for mental health care within the Maasai community in northern Tanzania.

METHODS

This qualitative study enrolled a purposive sample of 41 participants from a Maasai community in Arusha Region, northern Tanzania. Participants included modern health-care providers, religious leaders, traditional practitioners, local government leaders, local Maasai leaders, and workers from nongovernmental organisations dealing with mental health. Local interviewers used interview guides to conduct in-depth interviews and focus group discussions in the local language, Kiswahili. The interviews were completed between April and May 2013. We used content analysis to analyse the qualitative data.

RESULTS

Study participants attributed mental disorders to supernatural causes, such as curses, witchcraft, demons, and God's will. A few participants also mentioned biological causes and risk behaviours, including perinatal insults, head injuries, and drug abuse. Furthermore, we found that the Maasai community seeks mental health care in a sequential and simultaneous manner from 3 sectors, namely, professional health-care providers, traditional healers, and religious leaders. Traditional healers and religious leaders were preferred over professional health-care providers for the treatment of mental disorders.

CONCLUSION

The Maasai have pluralistic help-seeking behaviour for mental health disorders. Integrating traditional healers in the modern health-care system may be beneficial to addressing mental health issues in this setting.