Research view


Title: The role of culture and faith healers in the treatment of mood disorders in rural versus urban areas in United Arab Emirates
Author: Khalid S. Sherra, Mohamed Shahda and Dalia M. Khali
Background Culture plays a major role in healthcare delivery. The majority of mentally ill patients prefer to attend nonmedical practitioners such as traditional healers. Practical clinical application of the research in cultural competency can enable physicians to decide whether folk traditional healing practices are harmful or benign. Like other cultures, the Arab culture transmits a number of beliefs, which are locally shared, although considered unlikely or even objectively disprovable by others outside the culture. Aim In this paper, we examine the view of mood disorders as seen by the patients and the role of faith healers in the treatment of such disorders with regard to urban versus rural areas. Patients and methods We assessed 416 United Arab Emirates national patients with Bipolar Affective Disorder (BAD) (279 urban and 137 rural) after confirmation of diagnosis with Diagnostic and Statistical Manual of Mental Disorders, 4th ed., text revised. These patients underwent Mini International Neuropsychiatric Interview, Help-Seeking Pattern, and Experience Questionnaire, which stressed on the attitude of the patient toward psychiatric illness, belief in healer management, line and result of traditional management, and the frequency of seeking traditional healers. Results The current study showed that about 60% of patients of both populations had visited faith healers before seeking medical services. Rural population usually shows no commitment to treatment and resorts to traditional therapy more often compared with the urban population (24 vs. 17.5% and 33.7 vs. 19%, respectively). Rural patients were more credulous toward faith management compared with urban patients (35.1 and 18.4%, respectively), whereas a merge of the two beliefs, psychiatric and faith management, was more common in the urban population than in the rural population (31.6% compared with 9.6%, respectively). An overall 39.5% of the families of urban cases and 9.6% of the families of rural cases considered mental illness a real disease as any other organic disease. In faith healing, different diagnoses, which included touch, evil eye, witchcraft, and jinn possession, were evenly distributed among patients with varying percentages among rural and urban populations. Conclusion This study shows that the majority of patients suffering from mental illness, especially in rural populations, prefer to approach faith healers first, which may delay entry to psychiatric care and thereby negatively impact the prognosis of BAD. Therefore, we should improve the orientation of the general practitioners (GPs) and broaden the destigmatization program about psychiatric disorders, especially mood disorders. This highlights the importance of mental health education, developing a positive collaborative relationship with traditional healers, and highlighting the role of cultural beliefs in both the evaluation and the management of mental disorders. Keywords: BAD, cultural beliefs, faith healer, rural versus urban
Distributor: Egypt J Psychiatr 38:79–89