Mental health literacy : conceptions and attitudes toward mental disorders and beliefs about treatment among African residents of Sisonke district in KwaZulu-Natal.

Doctor of Philosophy in Clinical Psychology. University of KwaZulu-Natal, Durban 2016.Nearly 1 in 10 people have a mental disorder worldwide, and there are many people with chronic or severe mental disorders who are unaware that they have a diagnosable disorder or that effective treatment is available. This may lead to delays in appropriate help-seeking and negative attitudes toward patients with mental illness. It is plausible that this is largely because of the public’s non-alignment of biomedical understanding of mental illness which may imply lack of mental health literacy. Such assumptions, however, do not take into consideration the fact that various societies draw their knowledge from different worldviews, which in turn informs their conceptualisation of mental illness. This study investigated conceptions and attitudes toward three mental disorders, namely, depression, schizophrenia, and alcohol dependency, and beliefs about their treatment among African residents of Sisonke District in KwaZulu-Natal. The sample was drawn from two municipalities of Sisonke District (Kokstad and Kwa Sani) using a survey. In total, 787 African participants of both genders were randomly recruited, and they completed a self-administered questionnaire. Data was analysed using Statistical Package for Social Sciences for Windows, Version 24.0. The results show an endorsement of multiple explanatory models of illness, thus suggesting an embracement of both Western and indigenous influences in conceptualisation of mental illness. This study found that participants did not use standard psychological nomenclature to describe mental illness, but instead used very broad, over-encompassing terms which may be indicative of their worldview. Of the three disorders investigated, depression was mainly conceptualised using psychological and medical terms, and schizophrenia and alcohol dependency were conceptualised in psychological and social terms. In addition, only schizophrenia, among the three disorders investigated was conceptualised using supernatural descriptions such as bewitchment and ukuthwasa. The results also show that conceptualisation of mental illness is not haphazard; but is viewed as holistic and as encompassing social, psychological and physical factors. The results of the current study also revealed that participants’ conceptions of mental illness are significantly related to their aetiological beliefs. The results of this study highlighted the strong preference among the respondents for professional help-seeking, particularly from social workers and medical practitioners, for the treatment of depression and alcohol dependency. However, traditional healing was seen as more helpful for treating schizophrenia. Furthermore, the results indicate that vitamins, minerals and tonics, pain relievers, antibiotics as well as tranquilisers were considered more helpful for the treatment of depression. Regarding attitudes towards mental illness, the key findings in this study indicate that negative attitudes towards people with mental illness are widely maintained. Of the three disorders investigated in this study, most of the participants attributed stigmatising attitudes more toward alcohol dependency. Furthermore, the results suggest a general willingness to have a closer social distance with mentally ill individuals, especially when the relationship is perceived as less intimate. However, this finding was converse when the relationship was perceived to be more intimate. The results of this study highlight the importance of awareness campaigns that take into consideration and respect the cultural differences of the people, collaboration between traditional and medical practitioners. Suggestions for future research, emphasising the use of discourse analysis to further explore indigenous communities’ constructions of mental illness and their beliefs about its causes and treatment are recommended