The prevalence, classification and treatment of mental disorders among attenders of native faith healers in rural Pakistan

Background: Although native faith healers are found in all parts of Pakista n, where they practice in harmony with the cultural value system, their pra ctice is poorly understood. This study investigated the prevalence, classif ication and treatment of mental disorders among attenders at faith healers. Method: The work of faith healers with 139 attenders was observed and reco rded. The mental status of attenders was assessed using a two-stage design: screening using the General Health Questionnaire followed by diagnostic in terview using the Psychiatric Assessment Schedule. Results: The classificat ion used by faith healers is based on the mystic cause of disorders: saya ( 27%), jinn possession (16%) or churail (14%). Sixty-one percent of attender s were given a research diagnosis of mental disorder: major depressive epis ode (24%), generalized anxiety disorder (15%) or epilepsy (9%). There was l ittle agreement between the faith healers' classification and DSM-IIIR diag nosis. Faith healers use powerful techniques of suggestion and cultural psy chotherapeutic procedures. Conclusions: Faith healers are a major source of care for people with mental health problems in Pakistan, particularly for women and those with little education. Further research should assess metho ds of collaboration that will permit people with mental health problems to access effective and culturally appropriate treatment.