Psychiatric-Mental Health Nursing

Biography

Biography: Ugo Ikwuka

Abstract

In the 'free market' model of mental healthcare characteristic of sub-Saharan Africa, traditional and faith healers provide competing services alongside biomedical professionals. This may be associated with delays in reaching specialized mental health services, and hence with longer duration of untreated illness. As first line care constitutes a crucial stage in psychiatric care, investigating pathways to mental healthcare can highlight choices that might have critical implications for eventual outcome. However, most research on pathways to mental healthcare in the region dealt with clinical samples at conventional psychiatric facilities where the customary pathway culminates. This creates a gap in knowledge since the pathways of many distressed persons do not lead to or end at such facilities. To fill this gap, this study explored the pathways to care for mental illness preferred by a non-clinical cross-section of the south-eastern Nigerian population. Convenience sampling was used to select participants (N = 706) who completed questionnaires on help-seeking. Contrary to expectation, results showed a significant preference for the biomedical (90.8%) to the spiritual (57.8%) and traditional (33.2%) pathways. Higher education predicted preference for the biomedical model while low education was associated with traditional and spiritual pathways. Protestants preferred the spiritual pathway more than did Catholics. The high potential patronage of biomedical care suggested by the findings is undermined by poor mental health infrastructure, a lack of fit between the cultures of biomedical and traditional care, the deep-seated cultural/religious worldviews of the people, the conceptualisation of mental illness, stigma surrounding mental illness, and the likelihood of a social desirability bias in responses. A complementary model of care is proposed.