South African traditional healers’ approaches to mental illness: conceptualisation, diagnosis, and treatment: A scoping review

Abstract

Nearly 80% of Black South Africans consult traditional healers, mainly for mental illness. Geographical accessibility and cultural compatibility are the main reasons for this trend. Consolidation of research on traditional healers’ approaches to mental illness in South Africa is lacking. This review aimed to systematically map existing literature on traditional healers’ approaches to mental illness in South Africa between the years 2004 and 2024. The review used Arksey and O’Malley’s framework and the PRISMA-ScR guidelines. Selected databases, namely Academic Search Ultimate, APA PsycInfo, CINAHL Plus with Full Text, Global Health, MEDLINE, and APA PsycArticles, were searched to identify relevant studies. To cross-reference the identified studies, manual searches on Google and Google Scholar were performed. Thematic analysis was used to analyse the data. The findings revealed that the conceptualisation of mental illness by traditional healers encompassed three broad domains: the supernatural and spiritual, the biological and psychological, and the physical and environmental. Traditional healers commonly used divination bones and ancestral consultation for diagnosis. The preferred treatment was medicinal concoctions. However, additional research is necessary to determine the effectiveness of traditional healing treatments. The study contributes to the discourse on how traditional healers in South Africa approach mental illness. Mapping existing research and perspectives systematically provides insights that could help policymakers, healthcare professionals, and researchers shape the formal integration of traditional healing into mental healthcare. Furthermore, the results could aid in promoting collaboration between traditional and biomedical healing systems, thereby fostering more inclusive and culturally sensitive mental health services.