Perceptions held by traditional health practitioners regarding patients'use traditional mental health services in Burgersfort, Sekhukhune District, Limpopo Province, South Africa

Abstract

Empirical research highlights that black Africans continue to rely on the traditional health care system despite governments failing to regulate the sector. Located within the interpretivist paradigm and using the hermeneutic phenomenological design, the study explored perceptions held by Traditional Health Practitioners (THPs) on the use of their services by mental health patients. The study was undertaken in the Sekhukhune District, Burgersfort area. Participating practitioners were selected using the purposive and snowball sampling strategies. The sample consisted of ten Diviner THPs. Data were collected using semi-structured interviews and analysed through Interpretive Phenomenological Analysis (IPA). Themes pertaining to the demographic and clinical profiles of patients that are serviced by THPs were generated. Factors that hinder and/or promote the use of traditional health care services by mental health care users also emerged and are presented in line with the Theoretical Domains framework (TDF). Out of the fourteen (14) TDF domains, only eleven were supported by the findings, and these included Domain 2: Limitations associated with mainstream mental health care services; Domain 3: Social/professional role and identity; Domain 4: Dishonesty about spiritual healing capabilities and skills; Domain 7: Reinforcement; Domain 8: Determining individual life direction; Domain 9: Use of effective natural medications; Domain 10: Memory, attention, and decision processes; Domain 11: Environmental context and resources; Domain 12: Social influence; Domain 13: Emotions, and (k) Domain 14: Behavioural regulation. Service use enabling factors varied from showing great interpersonal skills, low costs of services, efficiency of natural herbs, maintenance of hygiene by healers, and alignment between the healer-patient belief systems. In contrast, service use disabling factors included the perceived rise in spiritual charlatans and the lack of integrity by some THPs, consequently leading to the public’s lack of trust in healers and their methods. The findings imply that ethical practice and collaborative efforts between healers are imperatives for attracting mental health users. Theoretical, interventional, and policy-related implications are suggested