Perceptions of mental illness among Muslim general practitioners in South Africa

Abstract

BACKGROUND: Mental health literacy on the part of medical practitioners is an important component of mental healthcare. General practitioners (GPs) are typically the first doctors consulted by a person who is ill. Exploration of their perceptions regarding mental illness, aetiological issues and treatment is important. OBJECTIVE: To investigate perceptions of mental illness in a sample of 10 South African Muslim GPs (five male, five female) in the Lenasia area (Johannesburg, South Africa). METHODS: Using a qualitative approach, semi-structured interviews were conducted with each GP. The questionnaire encompassed 37 questions relating to the context in which the GPs practised, perceptions of mental illness, understanding of religion and culture, and treatment of mental illness (including aspects of spiritual illness). Thematic content analysis was used to analyse the data. RESULTS: Six dominant themes were identified, namely GPs' understanding of mental illness and its causation; stigma, secrecy and somatisation; the beneficial effects of religion in mental illnesses; perceptions of spiritual illnesses; collaboration with traditional healers; and collaboration with psychiatrists and psychologists. CONCLUSION: Greater awareness regarding the stigmatisation of mental illness is needed. Furthermore, it is important that healthcare professionals have an understanding of religious and cultural taxonomies of illness and the use of traditional healing as a mode of treatment. Participants identified a need for increased collaboration between healthcare professionals, including traditional healers. Local and international research consistently emphasises the importance of mental health literacy on the part of healthcare professionals and community members. Mental health literacy extends beyond the biopsychosocial sphere and calls for a greater awareness of religious and cultural values that can influence healthcare professionals and their patients. General practitioners (GPs) are often the first point of entry when people seek medical treatment, and their perceptions of mental illness, aetiological issues and treatment are important. An examination of current research in the South African (SA) context indicates that research has focused on the prevalence of mental illness generally and across different groups.[1] It has also focused on assessing the role of traditional healers and traditional healing in relation to more conventional care.[2] Issues of mental health literacy[3] and explanatory models of mental illness[4] have been addressed. This research has mainly been quantitative. Qualitative studies have examined perceptions of mental illness in samples of traditional healers, volunteer counsellors, community members, psychologists and psychiatrists, but not among GPs.[5,6] The GP, often the family physician and the community doctor, is typically the first professional from whom a person who is ill seeks treatment and healthcare advice. According to Ng,[7] culture can often influence mental illness in terms of perception, conception, experience of symptoms, classification, treatment, recognition, labelling and the course of mental illness. This is particularly the case in the SA context, where supernatural, religious, magical and moralistic approaches to mental illness exist.[5-7] Spiritual punishment or sorcery is often identified as a cause of illness.[5,7] It is therefore essential that GPs' perceptions of mental illness be explored, as they deal with patients from various cultures and religions and are well positioned to inform research on mental illness in SA.