Vivianne Kovess-Masfety1, Sara Evans-Lacko2, David Williams3, Laura Helena Andrade4, Corina Benjet5, Margreet Ten Have6, Klaas Wardenaar7, Elie G Karam8, Ronny Bruffaerts9, Jibril Abdumalik10, Josep Maria Haro Abad11, Silvia Florescu12, Benjamin Wu13, Peter De Jonge14, Yasmina Altwaijri15, Hristo Hinkov16, Norito Kawakami17, Jose Miguel Caldas-de-Almeida18, Evelyn Bromet19, Giovanni de Girolamo20, José Posada-Villa21, Ali Al-Hamzawi22, Yueqin Huang23, Chiyi Hu24, Maria Carmen Viana25, John Fayyad26, Maria Elena Medina-Mora27, Koen Demyttenaere28, Jean-Pierre Lepine29, Samuel Murphy30, Miguel Xavier31, Tadashi Takeshima32, Oye Gureje10. 1. EA 4057 Paris Descartes University Paris, UFR Institut de Psychologie, 71, avenue Edouard Vaillant, 92774, Boulogne-Billancourt, France. vkovess@gmail.com. 2. Kings College London, Institute of Psychiatry, Psychology and Neuroscience Health Service and Population Research, London, UK. 3. Department of Society, Human Development and Health, Harvard School of Public Health, Boston, USA. 4. Institute of Psychiatry, University of Sao Paulo Medical School, Sao Paulo, Brazil. 5. Department of Epidemiologic and Psychosocial Research, National Institute of Psychiatry Ramón de la Fuente, Mexico, Mexico. 6. Netherlands Institute of Mental Health and Addiction, Epidemiology, Utrecht, Netherlands. 7. Department of Psychiatry, University of Groningen, University Medical Center Groningen (UMCG), Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), Groningen, The Netherlands. 8. IDRAAC, Psychiatry and Clinical Psychology, Ashrafieh, Beirut, Lebanon. 9. Katholieke Universiteit Leuven (UPC-KUL), Universitair Psychiatrisch Centrum Leuven, Kortenberg, Belgium. 10. Department of Psychiatry, University of Ibadan, Ibadan, Nigeria. 11. Departament de Recerca Sant Boi de Llobregat, Parc Sanitari Sant Joan de Déu-CIBERSAM, Barcelona, Spain. 12. National School of Public Health and Professional Development, Research and Evaluation, Bucharest, Romania. 13. Department of Health Care Policy, Harvard Medical School, Boston, USA. 14. Department of Developmental Psychology, Faculty of Social and Behavioural Sciences, University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion Regulation, Groningen, The Netherlands. 15. King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia. 16. Department of Global Mental Health, National Center for Public Health Protection, Sofia, Bulgaria. 17. Department of Mental Health, School of Public Health, The University of Tokyo, Tokyo, Japan. 18. Chronic Diseases Research Center (CEDOC) and Department of Mental Health, Faculdade de Ciencias Medicas Lisbon, Universidade Nova de Lisboa, Lisbon, Portugal. 19. Department of Psychiatry, Stony Brook University, Stony Brook, NY, USA. 20. IRCCS St. John of God Clinical Research Centre, Brescia, Italy. 21. Saldarriaga Concha Foundation, Development Rehabilitation System FSC Bogotá, Bogota, Colombia. 22. College of Medicine Diwania Governate, Al-Qadisiyah University, Diwania, Iraq. 23. Institute of Mental Health, Peking University, Beijing, China. 24. Shenzhen Institute of Mental Health and Shenzhen Kangning Hospital, Shenzhen, Guangdong, China. 25. Department of Social Medicine, Federal University of Espírito Santo (UFES), Vitoria, Brazil. 26. Institute for Development, Research, Advocacy, and Applied Care (IDRAAC), Beyrut, Lebanon. 27. Instituto Nacional de Psiquiatria, Epidemiology and Psychosocial Research, Mexico, Mexico. 28. Department of Psychiatry Leuven, University Hospital Gasthuisberg, Louvain, Belgium. 29. Department of Psychiatry, Fernand Widal Hospital, Paris, France. 30. Psychology Research Institute Londonderry, University of Ulster, Coleraine, UK. 31. Medical Sciences Lisboa, University Nova of Lisboa, Lisbon, Portugal. 32. Japan National Institute of Neurology and Psychiatry, Epidemiology, Tokyo, Japan.
Abstract
OBJECTIVES: To examine the role of religious advisors in mental health care (MHC) according to disorder severity, socio-demographics, religious involvement and country income groups. METHODS: Face to face household surveys in ten high income (HI), six upper-middle income (UMI) and five low/lower-middle (LLMI) income countries totalling 101,258 adults interviewed with the WMH CIDI plus questions on use of care for mental health problems and religiosity. RESULTS: 1.1% of participants turned to religious providers for MHC in the past year. Among those using services, 12.3% used religious services; as much as 30% in some LLMI countries, around 20% in some UMI; in the HI income countries USA, Germany, Italy and Japan are between 15 and 10% whenever the remaining countries are much lower. In LLMI 20.9% used religious advisors for the most severe mental disorders compared to 12.3 in UMI and 9.5% in HI. For severe cases most of religious providers use occurred together with formal care except in Nigeria, Iraq and Ukraine where, respectively, 41.6, 25.7 and 17.7% of such services are outside any formal care. Frequency of attendance at religious services was a strong predictor of religious provider usage OR 6.5 for those who attended over once a week (p < 0.0001); as seeking comfort "often" through religion in case of difficulties OR was 3.6 (p = 0.004) while gender and individual income did not predict use of religious advisors nor did the type of religious affiliation; in contrast young people use them more as well as divorced and widowed OR 1.4 (p = 0.02). Some country differences persisted after controlling for all these factors. CONCLUSIONS: Religious advisors play an important role in mental health care and require appropriate training and collaboration with formal mental healthcare systems. Religious attitudes are strong predictors of religious advisors usage.
OBJECTIVES: To examine the role of religious advisors in mental health care (MHC) according to disorder severity, socio-demographics, religious involvement and country income groups. METHODS: Face to face household surveys in ten high income (HI), six upper-middle income (UMI) and five low/lower-middle (LLMI) income countries totalling 101,258 adults interviewed with the WMH CIDI plus questions on use of care for mental health problems and religiosity. RESULTS: 1.1% of participants turned to religious providers for MHC in the past year. Among those using services, 12.3% used religious services; as much as 30% in some LLMI countries, around 20% in some UMI; in the HI income countries USA, Germany, Italy and Japan are between 15 and 10% whenever the remaining countries are much lower. In LLMI 20.9% used religious advisors for the most severe mental disorders compared to 12.3 in UMI and 9.5% in HI. For severe cases most of religious providers use occurred together with formal care except in Nigeria, Iraq and Ukraine where, respectively, 41.6, 25.7 and 17.7% of such services are outside any formal care. Frequency of attendance at religious services was a strong predictor of religious provider usage OR 6.5 for those who attended over once a week (p < 0.0001); as seeking comfort "often" through religion in case of difficulties OR was 3.6 (p = 0.004) while gender and individual income did not predict use of religious advisors nor did the type of religious affiliation; in contrast young people use them more as well as divorced and widowed OR 1.4 (p = 0.02). Some country differences persisted after controlling for all these factors. CONCLUSIONS: Religious advisors play an important role in mental health care and require appropriate training and collaboration with formal mental healthcare systems. Religious attitudes are strong predictors of religious advisors usage.
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