Integrating Alternative and Traditional Treatments a Challenge in Global Mental Health

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It will be a challenge to develop and implement appropriate models for collaboration between conventional western psychiatry and alternative, traditional approaches to treating psychological crises that are popular in many low and middle-income countries, according to a literature review and commentary in The Lancet Psychiatry.

“Every healing modality assesses and categorises patients’ distress according to its own philosophy of illness, which is embedded in a larger world view,” noted the authors, a team of Nigerian and South African researchers. “Diagnostic systems differ and by necessity show differences in world views. Thus unsurprisingly, practitioners of traditional medicine, and most complementary and alternative medicine use diagnostic systems that are incompatible with conventional medicine.”

Every country and every situation, they wrote, might require a different type of integrative, collaborative or complementary solution. “For example, traditional medicine practitioners could administer psychotropic medication and brief psychotherapies to patients in rural areas, or be trained to deliver other psychiatric support. Although task-shifting might expand the reach of psychiatric services in countries with few resources, this approach makes little use of healers’ unique skills and specific advantages, which should instead be acknowledged and built on.”

“In a collaborative model,” the researchers continued, “traditional or conventional medicine practitioners remain autonomous and independent, but cooperate fully; for example, by referring patients to each other or consulting on complex cases. In a fully integrated model, traditional and conventional medicine health-care services would be blended into a new hybrid system such that patients need not choose one over the other. Treatment approaches would be integrated; for example, a culturally relevant explanation might be given for why someone is depressed, followed by the necessary ritual and a prescription for an antidepressant.”

“Just one model is unlikely to suit every situation,” they concluded, “so a region’s solution will need to be tailored to local circumstances and resources. This tailored approach should be based on a more detailed understanding of the dynamics of traditional medicine than we have at present.”

Gureje, Oye, Gareth Nortje, Victor Makanjuola, Bibilola D Oladeji, Soraya Seedat, and Rachel Jenkins. “The Role of Global Traditional and Complementary Systems of Medicine in the Treatment of Mental Health Disorders.” The Lancet Psychiatry 2, no. 2 (February 2015): 168–77. doi:10.1016/S2215-0366(15)00013-9. (Full text with free registration)

7 COMMENTS

  1. “models for collaboration between conventional western psychiatry and alternative, traditional approaches to treating psychological crises”
    I understand that Western psychiatrists will go to 3rd world countries to learn how they achieve much better long term results (according to WHO study) than we do, right?

    • Oh, I see that’s not what they mean…
      “For example, traditional medicine practitioners could administer psychotropic medication and brief psychotherapies”
      “a culturally relevant explanation might be given for why someone is depressed, followed by the necessary ritual and a prescription for an antidepressant.”
      Interesting…

      The mindset of these people is just so backwards. They can’t accept that the uneducated savages may be doing something better. The sick colonial mindset, the ignorance and the arrogance that comes with it – perfect for an average psychiatrist.

        • It is bizarre, especially since the DSM disorders have now been confessed to be completely “lacking in validity” by the head of the NIMH, and coercing or forcing these drugs onto people has now been declared “torture” by the UN. The hubris of the American psychiatric industry is staggering. They don’t seem capable of comprehending their behavior (defaming and torturing other human beings) is unacceptable.

  2. Collaboration is fine if everyone’s voice is equally weighed and every human being in that collaboration were treated with equal regard.

    Even in collaboration, however, there is someone who takes the lead and facilitates the collaboration. In all, it’s a collective endeavor, but there has to be at least one grounded and trustworthy voice of reason to bring balance and hold the space. Otherwise, I’ve no doubt that it would only be collaboration in conflict, chaos, and chronic irritation, leading us all further down the rabbit hole.

    Who ‘leads’ seems to be what a lot of conflict is over–and destructive competition–who is really in charge, here?

    I say to psychiatry, “Get off the throne. You (collectively) have proven to be dangerous as ‘leaders’ and ‘examples.’ Hard truth, yes, I know, and somehow, we’ve all been duped, you included. But it’s painfully obvious, just from all that I’ve read here on MIA over the last few years, that this is truth and your ‘authority’ over matters of the mind have heart have proven to be damaging and even lethal to so, so many. And you refuse to hear this. Time to wake up.”

    Psychiatry is not capable of setting the example of empathy, openness, and healing that we seek. I find their attempts to dialogue one-sided and confusing, filled with resistance. I am sorry to say this, but it’s a truth that bares speaking repeatedly, given the way things have been going, and we know why, to a large extent.

    So in this collaboration, I would suggest that psychiatry should be in the position of listening, learning, and following. Then, it would more than likely be a fruitful and effective collaboration, from which new information, solutions, and abundant clarity would come.

  3. Anti-psychotics drugs alone net the pharmaceutical industry at least $14.6bn dollars a year. Psycho-pharmaceuticals are the most profitable sector of the industry, which makes it one of the most profitable business sectors in the world. Americans are less than 5% of the world’s population, yet they consume 66% of the world’s psychological medications. http://www.theguardian.com/commentisfree/cifamerica/2011/mar/15/psychology-healthcare

    “Global Mental Health”

    They act like the world ‘needs’ this nonsense ! It’s all about profit and expanding the “pharmacaust” worldwide.

    • “Global Mental Health”

      China’s former drug and food safety watchdog chief was executed after being found guilty of corruption and dereliction of duty, Xinhua news agency said.

      http://www.chinadaily.com.cn/china/2007-07/10/content_5424937.htm

      Zheng was sentenced to death in May for taking bribes to approve an antibiotic blamed for at least 10 deaths and other substandard medicines. Cao was given a death sentence last month with a two-year reprieve for accepting bribes and dereliction of duty.

      China has been around for like 5000 years, no way are they going to let these western snake oil salesmen come in and poison their children for ADHD or the slimiest fraud ever “child bipolar” and the toxic hell called treatment that goes with that.

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