A Scoping Review of Service Users' and Caregivers' Perceptions of Collaborative Mental Healthcare in Low and Middle Income Countries

Abstract

Background: Collaboration between biomedical practitioners (BHPs) and traditional and faith healers (TFHs) in treating mental disorders has been promoted as improving access to biomedical care and preventing human rights abuses. In many low- and middle-income countries, TFHs outnumber BHPs, and are the first contact for people with lived experience of mental illness (PLEs). While there are many papers exploring collaboration from the view of healers and BMPs, there is a lack of research that explores the views of PLEs and caregivers.

Aims: This scoping review aims to identify the literature investigating perspectives on collaboration for mental health care between BHPs and TFHs from the perspectives of PLEs and caregivers.

Methods: The Joanna Briggs Institute (JBI) protocol was used for this scoping review. Search terms were identified and agreed by team members and an initial search was conducted on four databases – CINAHL, AMED, PsychInfo and Medline. Identified articles were extracted and abstracts were screened independently by both researchers using Rayyan software. Conflicting papers were resolved, duplicates removed, and full texts retrieved for screening. Full texts and reference lists of selected papers were screened independently by two researchers. The selected articles were summarised in a charting table and coded thematically using NVivo.

Results: Eleven articles met the inclusion criteria. Five themes were explored – acceptability and perceived benefits of collaboration, perceived barriers to collaboration, potential harms and recommendations. Perceptions were generally positive towards collaboration and benefits were identified. However, some important barriers and harms were also highlighted, which may hinder effective partnership.

Conclusion: Overall, PLEs/caregivers were receptive to the idea of collaboration but had concerns such as lack of access to biomedicine or efficacy and trustworthiness of TFHs. Research that collected primary data was lacking stressing the need to focus on the perspectives of PLEs and caregivers in respect to collaboration between traditional and biomedical systems, as they have the most to benefit or lose from this partnership.