Pathways to mental healthcare in south-eastern Nigeria

Ugo Ikwuka, Niall Galbraith, Ken Manktelow, Josephine Chen-Wilson, Femi Oyebode, Rosemary Chizobam Muomah, Anulika Igboaka

Research output: Contribution to JournalArticlepeer-review


In sub-Saharan Africa, traditional and faith healers provide competing services alongside biomedical professionals. This may be associated with delays in reaching specialised mental health services, and hence with longer duration of untreated illness. As first line care constitutes a crucial stage in accessing of psychiatric care, investigating pathways to mental healthcare can highlight help-seeking choices. This study explored the pathways to care for mental illness preferred by a non-clinical sample of the population in south-eastern Nigeria. Multistage sampling was used to select participants (N = 706) who completed questionnaires on help-seeking. Results showed a significant preference for biomedical (90.8%) compared to spiritual (57.8%) and traditional (33.2%) pathways. Higher education predicted preference for the biomedical model, while low education was associated with traditional and spiritual pathways. Protestants preferred the spiritual pathway more than did Catholics. The use of biomedical care is potentially undermined by poor mental health infrastructure, a lack of fit between the culture of biomedical care and the deep-seated cultural/religious worldviews of the people, stigma surrounding mental illness, and the likelihood of a social desirability bias in responses. A complementary model of care is proposed.
Original languageEnglish
Pages (from-to)574-594
Number of pages21
JournalTranscultural Psychiatry
Issue number5
Early online date26 Jul 2016
Publication statusE-pub ahead of print - 26 Jul 2016


  • Pathways to health care
  • Indigenous Populations
  • Mental Health Services
  • Biomedicine
  • Biomedical model
  • Faith Healing
  • Nigeria
  • Spiritual
  • Cultural factor
  • Demography
  • Educational status
  • Female
  • Help seeking behaviour
  • Human
  • Male
  • Religion
  • Social desirability
  • Social status
  • Stigma


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