MHM Magazine

Issue 61 | 2022 | MENTAL HEALTH MATTERS | 39 MHM In South Africa, western psychology is regarded as a preferred psychotherapeutic intervention in addressing mental health issues. This is despite the existence of approximately 200 000 traditional health practitioners offering emotional and psychological support to black people from rural and urban areas. Southern Africans live by traditional value and belief systems and do not only subscribe to western ideologies of wellness and (ill) health. Yet they are disadvantaged by the dichotomy of healing practices that exist in the modern world. The majority of South Africans are not able to attain a better quality of life due to ineffective health services and a health model that lacks support and funding for integrated indigenous healing practices that serve holistic healing of the mind, body and soul. Traditional and allopathic health services are perceived as separate entities. This results in additional costs for South Africans who subscribe to traditional beliefs in a Western world.   In terms of the Traditional Health Practitioners Act (Republic of South Africa [RSA], 2007), the recognition of healers under the state suggests collaboration and mutual acceptance between healers and biomedical practitioners. Healing practices among South Africans are widespread and diverse, and amagqirha (traditional healers) believe that there are specific illnesses that the biomedical practitioners cannot cure.  An overlap in presenting symptoms of mental ill health and the aetiology of disease may necessitate dual therapy to adequately and comprehensively tackle these. The importance of collective consciousness and a deeper understanding of the psychological value of traditional forms of healing that exist in Southern African cultures cannot be overemphasised. The quest to make meaning of everyday experiences requires a multi-faceted approach that integrates the plethora of cultural and cosmic contexts for health and mental health care delivery in Southern Africa. This requires intentional efforts to represent indigenous healing practices in professional training curricula. Holistic healing practices would allow for the development of positive resilience and trauma-informed interventions that serve to promote health and healing frommultidimensional perspectives.   Paradoxically, the emergence of the Covid-19 coronavirus at the start of 2020 has seen people across the world scramble to traditional home remedies in hopes to prevent and treat the spread of the virus in the absence of vaccines and treatments. This paper adds to the voices that call for the indigenisation of psychotherapy in Southern Africa. This is against the background that approaches to healing and health require holistic healing interventions that span the spectrum of illnesses, be it mental (mind), physiological (body) or spiritual (soul).  The use of traditional medicine in developing countries has been entrenched in cultural practices. The WHO estimated that 75% of South Africans rely on traditional medicine as the primary source of healthcare needs. The use of medicinal plants in South African traditional medicine can be traced back thousands of years from cave drawings. The harvesting of these plants has led to the establishment of stores and ultimately the growth of commercial trades, which include healing, therapeutic, and spiritual purposes, thereby boosting informal trade as the use of traditional medicines in the urban settings continues. Approximately 85, 0000 plant species are used globally, with the United States representing 35% of the market, followed closely by Europe with 33% which encompasses Germany, France, the UK, Italy and Scandinavia. Africa only contributes less than 1% to the market (USD 520 million).  South Africa also contributes towards this less than 1% market share from Africa, however, only a few plant species contribute to the herbal medicines that are used worldwide.   The use of medicinal plants is not only motivated by their affordability or availability but, most importantly, also by the remedial beliefs that certain communities have with regards to certain plant species. The spiritual meanings attached to use of unprocessed medicinal plants, such as the right time for harvesting, collection, and use, do not address critical concerns such as safety, efficacy and the mode of action, which are not thoroughly understood. Historically, plants have played a significant role in treating infectious diseases. Furthermore, the isolation of bioactive compounds does not only support claims of efficacy made by farmers, traditional healers and practitioners, but expands on the knowledge of safety and efficacy of medicinal plants. The integration of traditional and medical health practices that serve to heal holistically is possible. The role of the regulatory bodies such as the Health Professions Council of South Africa (HPCSA) is critical in the registration, capacity building and monitoring of any adverse implications associated with the practice. If the two models of health care were to be competently and comprehensively intergraded the community will be able to freely work with medical doctors without anxieties about how their African beliefs are received. TRANSFORM THE PROFESSIONAL TRAINING CURRICULA The psychological legacy of apartheid in South Africa remains one of collective trauma, as well as continuous struggle to develop interventions of collective healing which are relevant to all communities, in their diversity. Further exacerbating the efforts to heal as a nation are issues such as national, ethnic and individual identity crises and accessibility to health care provisions that bridge the gap between modern (Western) and traditional (African) practices. In the South African context, 16.5% of South Africans experience common mental health problems, and one in six have lived with anxiety, depression, or substance- use. A depressive disorder will be experienced by 20% of South Africans in their lifetime. The suppression of psychological tension leads to a continuous cycle of trauma that may be ineffectively addressed through conceptualisations of trauma and illness as an experience of individuation within collective cultures such as Southern African cultures. Thus, the collective trauma experienced by South Africans, post- apartheid, has entrapped vulnerable, currently disadvantaged communities in an intergenerational whirlwind of toxic behavioural patterns that affect their quality of life.