Traditional healers are causing treatment delay among patients with psychosis in Hospital Kuala Lumpur: Fact or Fallacy?
- Author:
Cheng-Kar Phang
;
Marhani Midin
;
Salina Abdul Aziz
- Publication Type:Journal Article
- Keywords:
Traditional healer, duration of untreated psychosis (DUP), treatment delay
- From:ASEAN Journal of Psychiatry
2010;11(2):206-215
- CountryMalaysia
- Language:English
-
Abstract:
Objective: Mental health services in
Malaysia often face competition from
traditional healers especially among
patients with psychosis. The objective
of the study is to determine whether
patients who sought help earlier from
traditional healers had longer duration
of untreated psychosis (DUP), and more
adverse experiences in pathways to
psychiatric care. Methods: This is
a hospital-based cross-sectional
study of 50 inpatients with first-episode
psychosis in Hospital Kuala Lumpur.
Structured Clinical Interview for
DSM-IV (Diagnostic and statistical
manual, 4th edition) Clinical Version
for Axis I Disorders (SCID-CV) was
used for establishing diagnosis. Onset of
psychosis was defined as any one
positive symptom with a score of >3 on
the Positive and Negative Syndrome Scale (PANSS).
Socio-demographic data, information on
pathways and treatment delaying factors
were determined through face-to-face
interview and semi-structured questionnaire.
Results: Fifty-four percent of the
patients had at least one contact with
traditional healers prior to consulting
psychiatric service, and it was the most popular
first point of non-psychiatric help-seeking
contact (48%). Contact with traditional
healers was not associated with age,
gender, ethnic, education level,
longer DUP or treatment delay, and
admissions with violent behaviour
or police assistance. Of those who
had sought help from traditional
healers, one third were recommended
by at least one of their traditional
healers to seek medical help. Conclusion:
Consultation involving traditional healers
was a popular choice, and not associated
with treatment delay. Traditional healers
in an urban setting may be potential
collaborators in managing patients with first-episode psychosis.
Future research should explore the frontiers of
such collaborative work.