ATTRIBUTIONS FOR ADMISSION TO ZOMBA MENTAL-HOSPITAL - IMPLICATIONS FOR THE DEVELOPMENT OF MENTAL-HEALTH-SERVICES IN MALAWI

Within Malawi, as in many other African countries, a variety of tradit ional and modern attributions exist regarding the cause of a person's mental disturbance, or their admission to a 'mental' hospital. It is a rgued that a good mental health service should consider the beliefs of the patients it seeks to serve. Consequently we studied 103 consecuti ve admissions to Zomba Mental Hospital in order to find out how patien ts explained their own admission to the hospital. Traditional attribut ions were the most common, followed by medical and then psychological attributions. Some patients explained their admission to the hospital by combining traditional, medical or psychological ideas. Content anal ysis of traditional attributions identified examples of ''Tropical Tol erance'' and the ''Pull Down'' phenomenon. The possible interactive na ture of traditional, medical and psychological processes is discussed and it is suggested that traditional healers should be incorporated in to 'modern' Malawian mental health services.