B. A. Robertson

Patient and Family Experiences of Psychiatric Services and African Indigenous Healers

The experiences and satisfaction of African psychiatric patients and their families with services rendered by indigenous healers and psychiatric facilities were explored in Cape Town, South Africa. Illness conceptualization and its impact on satisfaction were also investigated. Sixty-two African patients and their families were interviewed using an adapted version of Weiss’s Explanatory Model Interview Catalogue (EMIC). While respondents were satisfied with herbalists and faith healers, they reported negative experiences with diviners. Respondents expressed less dissatisfaction with psychiatric services than was expected. The study provides further evidence that indigenous names are used as explanatory categories which include the consideration of psychosocial and other explanations, and that the use of indigenous names does not preclude satisfaction with conventional psychiatric services.

Performance of the Diagnostic Interview Schedule for Children Version 2.3 (DISC-2.3) in an informal settlement area in South Africa.

OBJECTIVE To investigate the performance of the Xhosa Diagnostic Interview Schedule for Children Version 2.3 (DISC-2.3) in a community study of African children and adolescents in Khayelitsha, a largely informal settlement area in Cape Town, South Africa. METHOD A cross-sectional community study of 500 youths aged 6 to 16 years was undertaken using a systematic sampling strategy based on random starting points in the community. Three trained Xhosa-speaking lay interviewers administered the DISC-2.3 to youths and their parents in their homes. Additional questions included degree of impairment, selected risk factors, and service use. RESULTS The administration of the Xhosa DISC-2.3 in an informal settlement area was both feasible and acceptable to respondents. Psychiatric disorder with impairment was recorded for 76 (15.2%) of the children and adolescents. Consultation had been sought in only 20 cases, mostly from medical doctors, except for 3 who had attended indigenous healers. Rates of disorder were significantly higher among respondents who were living in unserviced areas or who came from homes where food was needed. CONCLUSIONS The DISC is a potentially useful instrument even in the presence of major constraints on conducting epidemiological research.