The Clergy As Gatekeepers of Mental Health in Ghanaian Communities

Abstract

Background and Purpose: While there are multiple studies on the clergy in Ghana which found that clergy and congregants believe in the spiritual causation and treatment for mental illness, and people seek treatment for mental illness from the clergy instead of mental health professionals, there is very limited research on Ghanaian American clergy’s beliefs and treatment practices for mental illness. This paper adds towards filling this gap by examining the held beliefs of Ghanaian American clergy about the causes of mental illness and treatment for mental illness. In the study, participants reflected on their experiences with the health system in the United States and how it contributed to their changing views about mental illness and its treatment.

Methods: The study employed a qualitative approach and conducted 10 semi-structured interviews with Ghanaian American pastors in New York City. The sample was made up of 7 males (70%) and 3 females (30%). Participants were recruited via letters distributed through the Ghanaian Pastors’ Association in New York City. The interviews were conducted in-person and elicited participants’ beliefs and treatment practices concerning mental illness. The information was recorded and transcribed verbatim. The data was analyzed using NVivo to develop codes and themes.

Findings: Analysis of the data showed participants’ evolving views about the causes and effective treatment approaches for mental illness. The findings indicated that prior to their arrival in the United States, participants attributed spiritual causes and prescribed spiritual treatment, for mental illness. However, their experiences with the health system in the United States led to their evolving views from the spiritual model to the medical/psychological model for mental illness.

An overwhelming majority of the participants indicated that, while in Ghana, they lacked education about mental illness and, therefore, attributed mental illness to spiritual causes, and prescribed spiritual treatment through fasting and prayer. Participants stated that the availability of treatment resources including medication and psychotherapy in the United States contributed to their improved knowledge about mental illness and changed their views about the condition and its treatment. Additionally, the findings show participants’ shift from prayer as the sole form of treatment to referring patients to hospitals and therapists for treatment, while they still pray for them. The findings thus emphasize the Ghanaian American clergy’s shift from the complete reliance on spiritual models to the adoption of the hybrid model of spiritual and the medical models in their approach to mental health.

Conclusion and Implication: The findings of the study suggest that when people lack mental health literacy and evidence-based treatment resources, they tend to resort to and rely heavily on spiritual interpretation for illnesses including mental illness. The findings highlight the cruciality of the provision of mental health literacy and evidence-based treatment resources such as psychiatric hospitals, medication, and psychotherapy, to change wrongly held beliefs about mental illness by the clergy, who are key players in mental health in Ghana, and improve mental health in communities in Ghana.