Cultural perspectives and experiences of mental healthcare in Kwa-Zulu Natal, South Africa

Abstract

Background: Healthcare systems reflect worldviews, specifically in mental health, where norms dictate what is normal and abnormal. The era of coloniality promoted Western dogma over collectivist cultures, which were marginalised. This study explored the perspectives and experiences of Black, isiZulu-speaking, South Africans who utilised multidisciplinary services, based on a Western-based therapy model at a private psychiatric facility in KwaZulu Natal.

Methods: A qualitative descriptive design was utilised. Purposive sampling was utilised to recruit 10 participants. Data was collected through semi-structured interviews. Braun and Clarke’s six phases of thematic analysis were used to guide the data analysis.

Findings: Three themes with sub-themes emerged from the data: personal perceptions, which explored how isiZulu-speaking people made sense of mental health and mental illnesses. Cultural perceptions were the collectivist method of problem-solving, which stressed the importance of spiritual beliefs. Health-seeking behaviour considered the experience of the isiZulu-speaking mental health care user. Cognitive dissonance prevailed due to the difference between westernised mental health treatment and traditional healing systems.

Conclusion: The family and community are intertwined in participation, reputation, and healing. There is an emphasis on enduring hardship and following traditions, which are preserved by valued elders. Disregarding these norms can outcast the Zulu individual who strives toward inclusion within the community.

Implications for practice:

• Intervention cannot only be at individual level but also community level.
• Including the family in psychoeducation and therapeutic goal settingwould be beneficial to the Zulu MHCU.
• Group programmes should address gender-specific issues.
• Occupational therapists must recognise the importance of participating in spirituality for the healing of the Zulu MHCU and appropriately include it in intervention.
• Mental health resources and awareness programmes need to be disseminated atcommunity level.
• Competency in the isiZulu language is recommended.
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