Experiences and perspectives on traditional and faith healers' involvement in the care of people with severe mental health conditions in Ethiopia: A scoping review

Background Traditional and faith healers (TFHs) play a prominent role in the care of people with severe mental health conditions (MHCs) in many countries. Consequently, there have been calls for closer collaboration between TFHs and mental health care practitioners. This scoping review aimed to map the literature on the experiences of, and perspectives on, traditional and faith healing for people with severe MHCs in Ethiopia. Methods The review was conducted in accordance with the Joanna Briggs Institute methodology for scoping reviews. Pubmed, Embase, CINAHL, Scopus, Web of Science, and PsycINFO databases were searched from inception until May 2024. Online student MSc/PhD theses and catalogued Ethiopian publications up to 2015 were also searched. Studies were included if they were in English and of any study design using primary data collection. Narrative synthesis was chosen for data synthesis. Results Of the 3,824 records identified, 31 were included. There were 17 qualitative, 12 quantitative, and two mixed methods studies, conducted in most regions in Ethiopia but with more focus on urban than rural settings. Findings were synthesised under the following themes: perceived causes of MHCs; pathways to care and help-seeking preferences; identification and intervention methods used by TFHs; experience of treatment, satisfaction with care, gaps, and barriers; and collaboration between TFHs and mental health practitioners. People with severe MHCs commonly accessed TFHs first and alongside biomedical care. A substantial range of healers was identified but they were not accessible or acceptable to all communities equally. TFH interventions were diverse and some of their practices were reported to be harmful. However, there were few in-depth studies of TFH care processes. Furthermore, there was little evidence about the experience of care from the perspective of people with severe MHCs. Efforts toward collaboration emphasised the need to develop relationships within which differences could be negotiated. Conclusion Although much is known about the place of TFHs within care pathways for people with MHCs in Ethiopia, there are evidence gaps in relation to the perspectives of people with MHCs and rich contextual understanding of healing processes, both of which are needed for meaningful collaboration to occur.