Perceptions of Mental Disorders and Help-Seeking Behaviour for Mental Health Care Within the Maasai Community of Northern Tanzania: An Exploratory Qualitative Study

BACKGROUND: Mental disorders are rapidly becoming more prevalent worldwide and are estimated to contribute up to 15% of the global burden of disease by 2020. In Africa, the help-seeking behaviour for mental health care is complex and is hindered by misconceptions and negative attitudes towards mental disorders. This study aimed to explore perceptions of mental disorders and help-seeking behaviour for mental health care within the Maasai community in northern Tanzania. METHODS: This qualitative study enrolled a purposive sample of 41 participants from a Maasai community in Arusha Region, northern Tanzania. Participants included modern health-care providers, religious leaders, traditional practitioners, local government leaders, local Maasai leaders, and workers from nongovernmental organisations dealing with mental health. Local interviewers used interview guides to conduct in-depth interviews and focus group discussions in the local language, Kiswahili. The interviews were completed between April and May 2013. We used content analysis to analyse the qualitative data. RESULTS: Study participants attributed mental disorders to supernatural causes, such as curses, witchcraft, demons, and God's will. A few participants also mentioned biological causes and risk behaviours, including perinatal insults, head injuries, and drug abuse. Furthermore, we found that the Maasai community seeks mental health care in a sequential and simultaneous manner from 3 sectors, namely, professional health-care providers, traditional healers, and religious leaders. Traditional healers and religious leaders were preferred over professional health-care providers for the treatment of mental disorders. CONCLUSION: The Maasai have pluralistic help-seeking behaviour for mental health disorders. Integrating traditional healers in the modern health-care system may be beneficial to addressing mental health issues in this setting.