There is a misconception that a religious person is unlikely to have mental health problems such as depression, anxiety, sleep disorder, or panic attack.
That if a believer who has a mental illness seeks help from a clergy or an Imam, who are usually their first point of contact, the obvious course of action would be spiritual healing through exorcism, which is the expulsion of a supposed evil spirit through prayers and chanting.
Many people combine Christianity with African cultures and believe that mental illnesses are caused by malicious or ancestral spirit possession or curses by enemies.
Amisa Rashid Kiligah, a counselling psychologist who works with low-income communities in Kenya, says many patients and their families turn to religious leaders and traditional healers for help than to psychiatry experts.
They believe that a depressed person or someone with schizophrenia is demon-possessed and requires spiritual healing.
“You’ll still find families taking their loved ones to religious leaders for exorcism sessions, or if Muslim, to be recited for the Quran. And because these mental health disorders are diseases just like malaria, the patients get worse,” she says.
Ms Amisa remembers a young woman suffering from a panic attack and anxiety disorder who went through several sessions of exorcism and prayers.
Because prayers rarely heal these patients, they are accused of having weak faith or a convenient explanation offered that God is testing their perseverance.
“By the time she came to me, her condition was so bad. She had been married off, and had children but was suffering. Now I’m helping her cope,” she says.
Part of the reason why myths and misconceptions are rife is because in Africa, mental health is less prioritised.
Also, the practice of counselling is seen as foreign. There is stigma attached to counselling for fear of sharing family secrets or a patient embarrassing the family by seeking psychiatric care.
“Counselling isn’t an African thing. Most people would ask me, ‘If therapy is just about talking, then why can’t I or our loved one talk to friends or family members? However, some of these people have been abused by family members. You, for instance, find a girl who was raped by her father, she gets pregnant and develops post-traumatic stress disorder. She cannot talk to anyone because she has to protect the family’s reputation. Some African practices encourage intergenerational trauma, isolate victims so that they cannot speak out and get help,” Ms Amisa says.
Lack of access to specialists
Another challenge is the lack of access to mental health specialists and hospitals in Kenya, meaning that there is low awareness about these disorders and what causes them.
This has forced many to turn to spiritual healers. In most cases, even spiritual healers do not know the causes of mental health.
In a study published in the African Journal of Psychiatry, 15 spiritual healers from different churches were asked about their knowledge of mental illness.
“They attributed the causes of mental illness to preternatural causes such as witchcraft (93.3 percent), cannabis (86.7 percent), punishment for sins (73.3 percent), supernatural causes such as curses and punishment from gods and ancestors (66.7 percent), genetic causes (63.3 percent) , and as a complication of physical illness (56.7 percent),” the study reported.
The healers said they diagnose mental illnesses through prayer, dreams, trance, or prophecy. For treatment, they usually recommend fasting, drinking holy water, praying, beating, bathing, and sacrificing.
“The use of water (to bath or drink) was the commonest mode of treatment for mental illness, it was always used in combination with other materials such as candle sacrifice,” the study noted.
Some critics argue that the focus on the prosperity gospel and emphasis on health and wealth in most African churches is to blame.
The preaching that “health and wealth” are the automatic divine right of all Bible-believing Christians, makes people believe that if they become sick, it is a punishment from God or a curse of their family.
“I have seen some families turn to traditional healers. They believe that a family member with mental illness has been bewitched or received money from satan. So they perform certain rituals like sacrificing a lamb to try and cleanse them,” says Ms Amisa.
Rose Moseti, a psychologist who is studying for a Master’s degree in suicidal psychology to help address the growing number of suicides, says the Covid-19 pandemic necessitated a serious conversation about mental health.
Of concern is having a candid discussion on how Africans’ upbringing and teachings in some churches are acting as drivers of suicide.
“Men who have lost their jobs and relationships commit suicide because they feel that society will judge them for the inability to provide and have control. African men have been raised to be providers and to be in control. A man died by suicide recently because he couldn’t pay his daughter’s hospital bill,” she says.
For religious people, the church gives them a sense of purpose and belonging, she says.
Whole and holy perception
“There is a perception that a church-goer must be whole and holy. That his family ought to be okay, marriage intact until death does you part. So when things are not working in a marriage, a religious person will be asked ‘have you been praying? What sin have you committed? Have you been submitting to your husband? God hates divorce,” she says, adding that those in failing relationships are then forced to stay on despite the pain, leading to mental problems.
There is so much churches are failing to do, Ms Moseti says, including teaching that submission in marriage does not necessarily mean slavery and that sinners should not be side-lined or excommunicated because they end up feeling that no one cares about them and the emptiness can trigger suicidal thoughts.
“How many churches have you seen shun members who are seeking divorces or are alcoholics, yet that’s when they need acceptance most?” She says.
Ms Moseti adds that for the longest time, deliverance has been an important part of worship and healing in churches.
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And because mental health is now becoming everyone’s business globally, especially after the pandemic, some religious leaders fear that deliverance will have no place.
“They’re wondering, ‘How are we going to treat deliverance and exorcism now that most of these people are not demonic, they are just mentally ill?,” says Ms Moseti who is also training the clergy on mental health.
The churches in Kenya, she says, still constitute an important place of healing therefore they must be one of the pathways to spreading the word about mental illness.
“We must start conversations on what we can do to empower the clergy on signs, symptoms and causes of mental illnesses, including highlighting that some pastors transfer their trauma to congregants. We must educate them that if someone has anxiety, prayers aren’t the solution. That if a person is hearing voices and wishes to end her life, those are not demons speaking but hallucinations caused by a chemical imbalance in the brain,” says Ms Moseti who works at the Centre for Suicide Research and Intervention, an organisation looking for ways to prevent suicides.
But as the professionals seek to integrate religious leaders into mental health awareness, the question of competition arises.
One group sees this as a disease that needs daily medicines and counselling sessions, treatments that would help a patient to experience God with more clarity.
The other group sees this as a prophecy that requires overnight prayer, three candles lit inside the church and placed around the altar, and three around the client wearing a white garment.
Such spiritual healers do not see the value of psychiatrists, psychologists, or counsellors in helping patients cope with mental illnesses.
“Churches need to understand that mental health experts are not in competition with them. God created medicine. The question is when should we stop praying and start acting,” Ms Moseti says.