Despite passing laws to ban the use of physical restraints on people with mental health problems, coercive practices such as the use of chains, shackles and cages and enforced fasting, remain commonplace in Ghana and Indonesia. This has prompted international concerns over human rights abuses of people with mental illness in these regions.
Research has suggested that partnerships between traditional and faith-based healers and mental health workers could help to prevent human rights abuses, reduce stigma surrounding mental illness and enable access to treatment and care. For example, families may turn to healers when there is perceived to be a risk of violence or self-harm, often resulting in the use of physical restraints. Instead healers could direct families to mental health services and, when the crisis is over, health workers could refer patients back to healers in order to support their spiritual needs.
However, mental health workers face resource challenges, such as shortages of medication, and lack of transport, when carrying out community-based interventions. Added to this, there are differences in healing traditions and mental health systems between and within countries. Approaches to the treatment of mental illness by healers and mental health services can conflict and healers can be left feeling that their knowledge and experience is not recognised.
A new project from King’s may be taking a step towards resolving some of these issues. With funding from the Economic and Social Research Council (ESRC) and the Arts and Humanities Research Council (AHRC), the project will explore the experiences of people with mental illness and their families in these two countries. They will seek to identify the reasons why restraints are used and what attempts have been made by health workers to connect with healers and improve treatment and care for people with mental illness.
Dr Ursula Read from the Department of Global Health and Social Medicine at King’s College London will be leading the research in Ghana, having previously conducted research on mental health and human rights in the country, including looking into social inclusion for persons with experiences of mental illness.
Dr Erminia Colucci, the Principal Investigator from the Middlesex University, will lead the research in Indonesia, and together they will be working collaboratively with the University of Ghana, the University of Gadjah Mada in Indonesia and local mental health advocacy groups and arts organisations.
“Ritual and spiritual practices remain highly valued in addressing mental illness in both countries, despite increased availability of mental health services,” said Dr Read.
“This project will use filmed interviews and observations and participatory methods to investigate how mental health workers establish collaborations with faith-based and traditional healers in particular settings and how these can prevent the use of coercion and improve care for individuals affected by mental illness.”
The use of visual methods aims to make the project accessible to people with personal experience of mental illness, from different socio-economic backgrounds, levels of educational achievement and languages.
The project will also build a network to share experiences and examples of best practice to reduce the use of coercion and restraint, and improve access to care for people with mental illness.
The ESRC and the AHRC have awarded £4.9 million in funding for seven projects across three continents in the effort to address and prevent poor mental health – pillars that unpin several United Nations Sustainable Development Goals.