title: Traditional healers in the treatment of common mental disorders in South Africa.
abstract: There are few population-level insights into the use of traditional healers and other forms of alternative care for the treatment of common mental disorders in sub-Saharan Africa. We examined the extent to which alternative practitioners are consulted, and predictors of traditional healer visits. A national survey was conducted with 3651 adult South Africans between 2002 and 2004, using the World Health Organization Composite International Diagnostic Interview (CIDI) to generate DSM-IV diagnoses for common mood, anxiety, and substance use disorders. A minority of participants with a lifetime DSM-IV diagnosis obtained treatment from Western (29%) or alternative (20%) practitioners. Traditional healers were consulted by 9% of the respondents and 11% consulted a religious or spiritual advisor. Use of traditional healers in the full sample was predicted by older age, black race, unemployment, lower education, and having an anxiety or a substance use disorder. Alternative practitioners, including traditional healers and religious advisors, appear to play a notable role in the delivery of mental health care in South Africa.
authors.affiliation: Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa. katherine.sorsdahl@uct.ac.za
authors.forename: Katherine
authors.initials: K
authors.lastname: Sorsdahl
authors.forename: Dan J
authors.initials: DJ
authors.lastname: Stein
authors.forename: Anna
authors.initials: A
authors.lastname: Grimsrud
authors.forename: Soraya
authors.initials: S
authors.lastname: Seedat
authors.forename: Alan J
authors.initials: AJ
authors.lastname: Flisher
authors.forename: David R
authors.initials: DR
authors.lastname: Williams
authors.forename: Landon
authors.initials: L
authors.lastname: Myer
mesh_terms: D000293:Adolescent; D000328:Adult; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D016488:Medicine, African Traditional; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D015995:Prevalence; D012017:Referral and Consultation; D013019:South Africa / Q000453:epidemiology; D011795:Surveys and Questionnaires; D055815:Young Adult