Pathways to mental health services across local health systems in sub-Saharan Africa: Findings from a Systematic Review

Abstract

AbstractMental illnesses significantly affect patients, families, and their communities. The different pathways to care, both formal and informal, influenced the timing and appropriate care. This literature review identifies pathways to access mental health services and suggests a collaborative model for mental health care across sub-Saharan Africa. We systematically searched multiple databases for studies reporting on primary qualitative and quantitative studies on pathways to mental healthcare services across Sub-Saharan Africa. Descriptive analysis of pathway stages was done according to Goldberg and Huxley’s ’model of Levels and Filters’. Overall, twenty-nine We included 29 studies in the final review. Biomedical services were the preferred treatment option. The majority (70%) used traditional and religious healers as the first point of mental health care. The median duration for the delay in seeking treatment in a health facility was six and fifty-four months. Patients who sought care from traditional and faith healers were found to have experienced the most prolonged delay without treatment. This study emphasizes that the call for collaboration between the two care systems can no longer be ignored. A proposed new model for collaboration between biomedical and traditional /faith healers that focuses on education and adopting a new referral framework.