Erimias Biniam FirrChiang Mai University, , Thailand
Title: The Social Aspects of Mental Illness Among Orthodox Christians of the Tigrinya Ethnic Group in Eritrea
This study is situated within the religio-cultural milieu of Coptic Orthodox Christians of the Tigrinya ethnic group in Eritrea. With this ethnic group being conservative and religio-culturally bound, extended family structures dissected along various clans and expansive community networks are the distinguishing mark of its members. Notably, Coptic Orthodox of the Tigrinya ethnic group constitutes the largest percentage of all Christian denominations in the country. As religio-cultural beliefs, rituals and teachings permeate in all aspects of social life, a distinct worldview and traditionally bound health and illness conceptualization impacts across the social aspects of mental illness. As such, this study argues that religio-culturally bound illness ideologies immensely determine the perception, help seeking behavior relating to mental illness of Coptic Tigrinya of Eritrea. Given that this study is ethno-linguistically [within the Tigrinya ethnic group], spatially [central region of Eritrea] and religiously [Coptic Christianity] specific, it bears significance and bridges an important knowledge gap. The conceptual framework that guided this research is centered on the social determinants of mental health, exploring through the lens of critical theory how existing systems generate social vulnerability and structural inequality, providing a platform to reveal how the psychosocial model has the capacity to emancipate and empower those with mental health disorders to live productive and meaningful lives. A case study approach was employed to explore the interrelationship between religio-cultural beliefs and practices and perception, healing preferences and help seeking behaviors towards common mental disorders of depression, bipolar affective, schizophrenia and anxiety, and the impact of these perceptions and help seeking behaviors on people with those mental health disorders. Purposive sampling was used to recruit 41 participants representing seven diverse cohorts; people with common mental disorders, family caregivers, general community members, ex-fighters, priests, hospital staff at St. Mary’s Hospital and clinic staff at Biet-Mekae Community Health Center; resulting in rich data for thematic analysis. Findings highlighted current religio-cultural perceptions, causes and treatment of mental disorders among Coptic Tigrinya result in widespread labeling, stigma and discrimination of those with mental health disorders and their family caregivers. As such, reliance on maladaptive management strategies of mental health disorders and devaluation of the worth and efficacy of the government provided mental health service was found to be alarming and pervading. Traditional healing sources are almost exclusively tried, sometimes for many years, before families and sufferers seek medical assessment and treatment, resulting difficult to treat illness chronicity. Service gaps in the formal medical system and the current mental health care of the country result in the inability to meet the principles enshrined in the WHO Comprehensive Mental Health Action Plan 2013-2020 to which the Eritrean Government is a signatory. However, the study found that across all participant cohorts, there was a desire for a culture of change within the current mental health sector of the country. Therefore, this study recommends for the adoption of a collaborative approach and the establishment of a multi-sectorial taskforce dedicated to creating a suitable environment whereby those with mental disorders will have restored hope, connectedness, healing, self-determination and productive lives.
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