Community reactions to mental disorders – A KEY INFORMANT STUDY IN THREE DEVELOPING COUNTRIES

Abstract

Attitudes towards mental disorders have been studied in rural areas of Sudan and Northern India and an urban area of the Philippines using standardized interviews with key informants. On average each informant knew by name 3.6 individuals who corresponded to descriptions provided of common mental disorders. The conditions most frequently identified were mental retardation (in all three areas), alcohol and drug related problems (in the Sudanese and Philippines areas) and acute psychosis (in the Indian area). In the Philippines area, the majority of informants indicated traditional healers as the primary source of help for psychological symptoms; in all areas people were judged to be more likely to seek help for psychological than for physical symptoms from traditional healers. Perceptions of mental illness and their consequences have been presented in graphic form through “attitude profiles”. These reveal differences in responses to the seven mental disorders presented to the key informants through vignettes. More negative and pessimistic attitudes were found in the Indian area than in the other two areas. The study has been carried out within a programme to introduce community based mental health care as part of primary health care in developing countries. The results have already been used in selecting priorities and designing interventions to promote community involvement. Their eventual use in evaluating the effectiveness of new forms of mental health care is also described.

Estimation of the prevalence of epilepsy in the Benin region of Zinvié using the capture-recapture method

“…A prevalence of 18.2 per 1000 was found using the cluster sampling method while the key-informant method estimated epilepsy to be 3.6 per 1000. Other studies using key informants to find patients were done by Thorburn et al 31 and Wig et al 32 with similar conclusions to Kaamugisha et al 25 The NMS source in our study found a prevalence of 7.9 per 1000 using a similar approach. This is double the prevalence found by Kaamugisha et al 25 based on key informants, while the DTD found a prevalence ratio (16.0 per 1000) quite close to their result by cluster sampling method which found 18.2 per 1000.…”

Mental disorders in primary health care: a study of their frequency and diagnosis in four developing countries

“…Indeed, so few psychotic patients were detected in the screening exercise that it is not possible to draw conclusions about the health workers' ability to diagnose such patients. The disinclination of psychotic patients to seek help at primary health facilities is clearly related to the attitudes and perceptions of mental illness which we have studied in a community survey, reported elsewhere (Wig et al 1980). Reaching psychotic patients who do not present spontaneously at primary health care facilities calls for active case finding by primary health workers in the community.…”

“…The results are being published separately (Giel et al in preparation). A survey of community attitudes and perceptions has also been carried out (Wig et al 1980 …”

Assessment of need for a school-based mental health programme in Nigeria: Perspectives of school administrators

“…This entails interviewing individuals whose social positions make them influential and bring them into contact with a large number of people. For example, Wig et al, (1980) carried out a key informant study in three developing countries to study the perceptions of mental illness and their consequences in the community. The results were used to select priorities and design interventions to promote community involvement.…”