Indigenous knowledge systems and mental health
A recent report by the Global Burden of Diseases (GBD) 2019 Mental Disorders Collaborators (2022) indicates that mental disorders have remained among the top ten leading causes of burden worldwide since 1990. The recent outbreak of the COVID-19 pandemic has exacerbated this situation with some studies suggesting that people’s mental health has worsened during the pandemic (COVID-19 Mental Disorders Collaborators, 2021). The high levels of mental disorders call for innovative ways to provide mental health services, especially in many under-resourced countries and minority communities in the developed world. This themed Issue aims to present a collection of articles that examine how knowledge systems connected to different cultures and belief systems contribute to our understanding of mental health conditions and how they are managed. The contributions focus mainly on three themes: mental health support experienced by black and minority ethnic (BME) groups in different contexts and responses to a range of challenges; traditional healing and mental health; and relationships between traditional practice and mainstream mental health services.
The first three articles address the theme of mental health support experienced by BME groups in different contexts and responses to various challenges. The first article by King and Devonish reports on a survey that explored the perceptions of 450 Black Barbadian residents regarding their challenges during the COVID-19 pandemic. One of the study’s key findings is that Barbadians were generally mild in their mental ill-health on the somatic symptoms, social dysfunction and severe depression dimensions but were at least moderately strained on the anxiety and insomnia dimensions of the General Health Questionnaire (GHQ)-28. Another interesting finding was that younger and unemployed participants in the study reported more adverse mental health outcomes when compared to respondents in the older age groups and those employed full-time. One of the study's key recommendations is that consideration should be given to developing a robust mental health policy and disseminating information on mental health through platforms such as social media, television, print media and radio to reach the wider population in this Caribbean community. King and Devonish study’s uniqueness is that this is the first research to empirically examine the relationship between COVID-19 perceptions of Afro-Caribbean people and the associated mental health outcomes.
Also focusing on COVID-19 and mental health, Jean-Charles, McGee, Jean-Baptiste, Joseph and Rouzier report on the development and implementation of the first telepsychology initiative in Haiti to provide psychoeducational and emotional support to community members and frontline health workers in the wake of the COVID-19 pandemic. The authors used a multi-stakeholder approach to collect programme data and implement the initiative across four regions of Haiti, namely, Nord, Artibonite, Reste-Quest and Sud. The initial data from the study suggests that telepsychology is a potentially acceptable service and is most likely to increase access to mental health services by communities in Haiti. In concluding their article, the authors recommend that on-going telepsychology be provided to consider logistical concerns and the Haitian cultural context. What is remarkable about this telepsychology initiative is that it is the first in Haiti. The initiative is commendable because it provides valuable lessons to other countries with limited mental health resources.
The third article that focuses on the theme of mental health support as experienced by the BME groups in different contexts and response to various challenges is by Rogers, Churchill, Shahid, Davis and Mandojana-Ducot. The five authors did a content analysis of research published from 2000 to 2018 about supportive factors that contribute to the academic success of American Indian students. The study was prompted by the authors’ observation that no previous studies have highlighted the existing research about supportive factors that contribute to the success of schooling for American Indians. The authors used a Community Cultural Wealth approach as a conceptual lens to understand the cultural capital embedded in the lived experiences and social environments of American Indian students. The analysis of the published research revealed that the most common supports for the American Indian students included culturally sensitive schooling and personal/intrinsic qualities with family and social support. One of the key recommendations made by the authors is that school psychologists could assist students by reaching out and building relationships with American Indian families and the larger tribal community. Furthermore, school psychologists could play a significant role in finding mentors and helping students establish relationships with teachers and faculty.
With regard to the second theme (i.e. traditional healing and mental health), Makgahlela, Mabidilala, Lesolang, Jidong and Monera-Penduka report on the results of a phenomenological study that investigated the experiences of traditional healers in the use of African indigenous methods to manage traumatic memories in bereavement. Nineteen traditional healers drawn from the Northern Sotho speaking community in South Africa were requested to share their experiences and insights in using a herb known as bolebatša to manage complicated bereavement. One of the study’s key findings was that traditional healers administer bolebatša to induce forgetfulness of painful memories and enhance coping in clients who struggle with complicated bereavement and trauma-related memories. The results of the study by Makgahlela and his colleagues amplify the calls that have already been made about the need to pay closer attention to the potential role that traditional healers can play in mental health delivery. In line with these pronouncements, the authors conclude their study by calling for closer collaboration between western-oriented researchers, mental health practitioners and traditional healers.
The need for some form of collaboration between western-oriented mental health practitioners and traditional healers is further expressed by Hoskins and Platt in their contribution which addresses the third theme (i.e. relationships between traditional practice and mainstream mental health services) of this Special Issue. These two authors explored the experiences of a group of psychotherapists (social workers = 2; marriage and family therapists = 3; psychologists = 3) who have collaborated with curanderxs in managing clients of Mexican descent in the state of California (USA). One of the critical findings of the study is that few mental health training programmes in the USA provide basic information on curanderismo or on how clinicians might integrate concepts related to indigenous healing approaches into their practices or collaborate with traditional healers. The implication here is that western-oriented psychotherapists have little understanding of the role that curanderxs play in mental health promotion. The significant contribution of this study is the collaborative framework or integrative model that is proposed to guide western-oriented health care providers who may like to collaborate with traditional healers and the clients who consult traditional healers for physical, psychological and spiritual healing. Based on their findings, Hoskins and Platt give recommendations that could have significant educational, clinical and public policy implications.
In conclusion, the articles in this themed Issue highlight the importance of continuing to explore how different knowledge systems can contribute to developing contemporary responses to mental ill health that reflect global advances in understanding. In the light of wider agendas relating to decolonisation we hope that this collection of articles will encourage western-oriented mental health professionals to learn about other knowledge systems and context-specific approaches that promote the mental health of individuals and communities in other parts of the world. It has indeed been a great honour and privilege for guest editors to put together this themed Issue.
