Pathways to mental healthcare in south-eastern Nigeria

In sub-Saharan Africa, traditional and faith healers provide competing services alongside biomedical professionals. This may be associated with delays in reaching specialised mental health services, and hence with longer duration of untreated illness. As first line care constitutes a crucial stage in accessing of psychiatric care, investigating pathways to mental healthcare can highlight help-seeking choices. This study explored the pathways to care for mental illness preferred by a non-clinical sample of the population in south-eastern Nigeria. Multistage sampling was used to select participants (N = 706) who completed questionnaires on help-seeking. Results showed a significant preference for biomedical (90.8%) compared to spiritual (57.8%) and traditional (33.2%) pathways. Higher education predicted preference for the biomedical model, while low education was associated with traditional and spiritual pathways. Protestants preferred the spiritual pathway more than did Catholics. The use of biomedical care is potentially undermined by poor mental health infrastructure, a lack of fit between the culture of biomedical care and the deep-seated cultural/religious worldviews of the people, stigma surrounding mental illness, and the likelihood of a social desirability bias in responses. A complementary model of care is proposed

Psychological distress and its associated socio-demographic factors among amputees in an orthopaedic hospital in south-eastern Nigeria

Early detection and treatment of psychological morbidity have been associated with reduction in long-term disability and increase in total well-being of amputees. However, much attention have been focused on the management of the physical disability with little interest on differences in distress on account of socio-demographic factors such as gender. This cross-sectional study examined psychological distress in 86 orthopaedic patients with limb amputation participated in the study. They were assessed with the Symptom Distress Checklist-90 (SCL-90) and socio-demographic questionnaire. Results showed that about sixty-four percent (64.4%) of the participants manifested distress in at least one domain of the Symptom Distress Checklist. None of the socio-demographic variables (e.g., gender) differentiated the participants in their self-reported psychological distress. Considering the high prevalence of psychological distress among amputees, mental health professionals should be involved in the management of these patients prior to and after amputation in order to enhance and promote prevention, early detection and treatment of psychological morbidity among amputees.Keywords: Amputation, Gender, Mental Health, Psychological distress, Psychotherap