Traditional healing practices and perspectives of mental health in Nagaland

Abstract

The 66th World Health Assembly adopted a comprehensive mental health action plan for 2013-2020 to strengthen effective leadership and governance for mental health by providing comprehensive, integrated, and responsive mental health and social care services in community-based settings. This would help the world almost 400 million indigenous people who have low standards of health, inadequate clinical care, and poor disease prevention services. Most indigenous populations prefer traditional medicine developed over generations before the era of modern medicine. Today, challenges lie ahead to integrate the best of the different healing traditions and modern mental health care to meet the needs of contemporary society, especially for mental disorders. Nagaland, one of the states of North Eastern India, has a large tribal population, high literacy rates but low health indicators. Based on an extensive critical review of published literature, a mixed-methods research approach was adopted using quantitative surveys of households and traditional healers in representative random samples of rural and urban Nagaland as well as a variety of qualitative research techniques. In-depth household interviews of a representative random sample of 510 rural households and 300 urban households on seeking traditional healing for mental health revealed that about half had some mental disorder, mostly depression, stress, anxiety and substance abuse. Overall, nearly 30% consulted a traditional healer, 34.8% in the rural and 16.5% in the urban, the difference statistically highly significant. The most common form of traditional healing used was psycho-spiritual intervention (49.0%). Of those who used traditional healing, 58.9% reported that the outcome was good. Excellent or good satisfaction was mentioned by slightly over 50% of rural respondents as compared to only 26% for urban but the differences barely reach statistical significance. Nearly 60% in the rural but only 24% in the urban felt that traditional healers are still popular for mental health, the difference statistically significant due to their strong faith that traditional healers have the diagnostic ability and because they adopt culturally acceptable methods. For a majority of people in Nagaland, traditional methods of healing mental disorders remain the first point of contact and pursued until the problem is alleviated. While traditional healers are still popular, their number is decreasing and also their capacity to deal with increased substance abuse, stress disorders, and younger client remained constant. It is concluded that the integration of traditional healing with modern allopathic psychiatric practices will significantly benefit the Nagaland population and appropriate counselling programs will be necessary.