title: Attitudes and beliefs about mental illness among church-based lay health workers: experience from a prevention of mother-to-child HIV transmission trial in Nigeria.
abstract: Common mental disorders are prevalent in Nigeria. Due to stigma and a limited number of trained specialists, only 10% of adults with mental illness in Nigeria receive any care. The Healthy Beginning Initiative is a community-based maternal/child health program that includes screening for perinatal depression and was implemented by lay, volunteer, church-based health advisors (CHAs). The aim of the study was to assess the beliefs and attitudes about mental illness among the CHAs. The study used a cross-sectional survey of 57 CHAs, who completed a 43-item, self-administered questionnaire that assessed their beliefs and attitudes about mental illness. The response rate was 71%. Respondents were mostly female (79%), married (83%) and aged 40-49 years (M= 41.16SD= 10.48). Most endorsed possession by evil spirits (84%), traumatic events (81%) and witchcraft (60%) as causes of mental illness. A majority (69%) believed that people with mental illness were a nuisance, and less than half (46%) believed that mental disorders were illnesses like any other illness. It is concluded that stigmatizing attitudes and beliefs about mental illness are common among the CHAs. Training for lay health workers in Nigeria should include education on the known bio-psycho-social basis of mental disorders and the role of social inclusion in recovery.
authors.affiliation: Department of Psychiatry, Yale University School of Medicine , New Haven , USA.
authors.forename: Theddeus
authors.initials: T
authors.lastname: Iheanacho
authors.affiliation: Avalon University School of Medicine , Girard , USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Kapadia
authors.affiliation: HealthySunrise Foundation , Las Vegas , USA.
authors.forename: Chinenye O
authors.initials: CO
authors.lastname: Ezeanolue
authors.affiliation: Prevention, Education, Treatment, Training and Research Global Solutions , Enugu , Nigeria.
authors.forename: Alice A
authors.initials: AA
authors.lastname: Osuji
authors.affiliation: Prevention, Education, Treatment, Training and Research Global Solutions , Enugu , Nigeria.
authors.forename: Amaka G
authors.initials: AG
authors.lastname: Ogidi
authors.affiliation: Prevention, Education, Treatment, Training and Research Global Solutions , Enugu , Nigeria.
authors.forename: Anulika
authors.initials: A
authors.lastname: Ike
authors.affiliation: HealthySunrise Foundation, Las Vegas, USA; University of Nevada School of Medicine, Las Vegas, USA.
authors.forename: Dina
authors.initials: D
authors.lastname: Patel
authors.affiliation: Department of Psychiatry, Yale University School of Medicine , New Haven , USA.
authors.forename: Elina
authors.initials: E
authors.lastname: Stefanovics
authors.affiliation: Department of Psychiatry, Yale University School of Medicine , New Haven , USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Rosenheck
authors.affiliation: HealthySunrise Foundation, Las Vegas, USA; Prevention, Education, Treatment, Training and Research Global Solutions, Enugu, Nigeria.
authors.forename: Michael
authors.initials: M
authors.lastname: Obiefune
authors.affiliation: HealthySunrise Foundation, Las Vegas, USA; University of Nevada School of Medicine, Las Vegas, USA.
authors.forename: Echezona E
authors.initials: EE
authors.lastname: Ezeanolue
keywords: Nigeria; attitudes; beliefs; lay health workers; mental illness; stigma