West African Beliefs About Mental Illness

TOPIC. Traditional West African beliefs about the cause and treatment of mental illnesses PURPOSE. To demonstrate how learning about West Africa's cultural beliefs allowed the instructor to teach psychiatric nursing in a way that integrated, rather than dismantled, the students' cultural beliefs SOURCE. Content analysis of West African students' written assignments CONCLUSION. Psychiatric/mental health nurses must understand the client's culture in order to understand the client. Key words: Culture, elder, Liberia, throw a sign, West Africa, zoe Mental health/psychiatric nurses are becoming more sensitized to the need for incorporating cultural data in the assessment and care of their clients (Tripp-Reimer & Lively, 1993). Indeed, understanding a client's cultural beliefs is a core value central to health care, the nursing profession, and nursing education (Leininger, 1970, 1978, 1985, 1993; Murillo-Rohde, 1978; Spector, 1985). Moreover, ignoring a client's cultural beliefs can seriously compromise quality nursing care, thereby limiting the client's return to a state of health (Leininger, 1978). Ideally, nursing educators ensure inclusion of cultural content in the nursing curricula. Cultural issues became relevant to me when faced with the task of teaching psychiatric nursing to Liberian nursing students from a cultural perspective entirely different from my own. For two years, I lived in Liberia, West Africa, while serving as a Peace Corps volunteer. As a nurse-educator from a different culture than both the students and clients, I explored Liberian beliefs regarding the causes and treatment of mental illness. Ethnohistory Liberia is a republic on the west coast of Africa. Located on the North Atlantic Ocean between Cote d'Ivoire and Sierra Leone, and bound by Guinea to its north, it is slightly larger than Tennessee. Thirty ethnic groups with 30 different languages reside within this area. The republic of Liberia was established in 1822 by the National Colonization Society of America. This society was founded to repatriate American slaves to Africa. In 1848, Liberian Governor Joseph Jenkins Roberts proclaimed Liberia an independent republic. Liberia was recognized by the United States as such in 1862. The population of Liberia, estimated in 1993 to be 2.8 million is 95% indigenous and 5% descendants of repatriated U.S. slaves. Liberia's Western influences were brought by these black American settlers (repatriated slaves), rather than by white European colonists. Seventy percent of Liberians practice traditional religions; approximately 40% of the total population can read and write. The life expectancy of a Liberian male is 54.88 years, and 59.76 years for a female. The fertility rate per woman is 6.42 children, and the infant mortality rate is 115.9 deaths per 1,000 live births. Liberia is West Africa's largest tropical rain forest. Hot and humid, the annual mean temperature is about 82 degrees Fahrenheit. Annual rainfall varies from 70 inches to 200 inches, with the heaviest rainfall along the coast. The terrain is mostly flat to rolling coastal plains, with low mountains in the northeast. Since 1990, civil war has destroyed much of Liberia's economy, especially the infrastructure in and around the nation's capital, Monrovia. Approximately 750,000 Liberian refugees have fled to neighboring countries (Goldberg, 1995), while 150,000 have been killed. A United States Travel Advisory prohibits Americans from entering Liberia (GPO62-830cc: The Ongoing Civil War, 1992). Evacuation of remaining expatriots in Liberia began in April 1996 and is now considered to be a completed process. Cultural Assessment When Oyefeso (1994) surveyed 480 senior federal civil servants in Nigeria about their attitudes toward ex-mental clients, he found,pervasive negative attitudes. Wondering whether Liberian beliefs would be similar, I assigned the Liberian psychiatric nursing students two projects: a) to write a short paper about their experience with someone they believed to be mentally ill; and b) to interview a grandparent, older relative, or village elder about their beliefs about mental illness. …