Family caregivers' perspectives of cultural beliefs and practices towards mental illness in Zambia: an interview-based qualitative study

Many elements of mental illness, including accessibility and utilization of mental health care, are influenced by societal cultural ideas. In Zambia, for example, traditional healers are not recognized, yet a large segment of the population continues to use their services due to their conviction. Despite this, studies on cultural beliefs and practices regarding mental illness in Zambia are scarce. Thus, this study is contextualized in Lusaka, Zambia, with the goal of filling a gap in the knowledge by exploring the cultural beliefs and practices surrounding mental illness as experienced by family caregivers caring for a next-of-kin with mental illness. Using a qualitative exploratory design, a purposeful sample of 15 family caregivers of next-of-kins diagnosed with mental illness were recruited. Data were collected via individual interviews, and analyzed using qualitative thematic analysis. The analysis revealed four main themes: (1) prevailing beliefs on cause of mental illness; (2) encountering social support and neglect; (3) recognizing the need of professional help; and (4) seeking culturally influenced help. Findings show that traditional attributions (for example, being bewitched, demon possession and sexual relations with uncleansed widows) are deeply embedded in beliefs and descriptions of what causes mental illness. These beliefs were found to influence not only help-seeking practices but also how people perceived and related to families. Given that beliefs influence caregiver help-seeking, these findings have implications for culturally sensitive practice. The study recommends that public health practitioners consider cultural beliefs and practices when developing health promotion programs, and public health messages.