"Medical treatments are also part of God’s gift”: Holy water attendants’ perspectives on a collaboration between spiritual and psychiatric treatment for mental illness in Ethiopia

Asher, Laura; Birhanu, Ribka; Baheretibeb, Yonas; Fekadu, Abebaw

Abstract

Introduction: In Ethiopia, traditional and spiritual treatments, such as holy water, are used by people with mental disorders instead of, or alongside, psychiatric services. Collaborations between traditional and psychiatric providers may increase access to evidence-based treatments and address human rights abuses. This study aimed to explore the perspectives of holy water attendants on a novel collaboration between holy water and psychiatric care, at St Mary’s Clinic, Entoto, Ethiopia and to characterize the users of this service.

Methods: Semi-structured interviews were conducted with 14 holy water attendants, who run group houses for holy water residents and are paid by family members. A thematic analysis was conducted. Socio-demographic and clinical data were extracted from the records of all patients who had attended the clinic.

Results: A total of 174 individuals have attended the clinic in the three years since it opened. The majority were diagnosed with schizophrenia. Holy water attendants provide a partial gatekeeping role to psychiatric care, selecting which of their clients they think will benefit and, for these individuals, facilitating attendance to the clinic and anti-psychotic medication adherence. Psychiatric care was felt to be compatible with holy water by some, but not all, attendants. However, family members often had the ‘final say’ in individuals attending the clinic, in some cases putting up strong resistance to using psychiatric care.

Conclusion: A novel collaboration is acceptable to some holy water attendants and may increase access to psychiatric care amongst people with mental illness living at a holy water site in Ethiopia.

Citation

Asher, L., Birhanu, R., Baheretibeb, Y., & Fekadu, A. (2021). "Medical treatments are also part of God’s gift”: Holy water attendants’ perspectives on a collaboration between spiritual and psychiatric treatment for mental illness in Ethiopia. Transcultural Psychiatry, 58(4), 585-599. https://doi.org/10.1177/13634615211015082

• Journal Article Type: Article
• Acceptance Date: Sep 11, 2020
• Online Publication Date: May 25, 2021
• Publication Date: Aug 1, 2021
• Deposit Date: Sep 15, 2020
• Publicly Available Date: May 25, 2021
• Journal: Transcultural Psychiatry
• Print ISSN: 1363-4615
• Electronic ISSN: 1461-7471
• Peer Reviewed: Peer Reviewed
• Volume: 58
• Issue: 4
• Pages: 585-599
• DOI: https://doi.org/10.1177/13634615211015082
• Keywords: Health(social science); Psychiatry and Mental health
• Public URL: https://nottingham-repository.worktribe.com/output/4903813
• Publisher URL: https://journals.sagepub.com/doi/abs/10.1177/13634615211015082