Psychology in sub-Saharan Africa: Challenges, prospects and promises

The cultural sensitivity continuum of mental health interventions in Sub-Saharan Africa: A systematic review

Although there is a small but growing literature examining mental health interventions in Sub-Saharan Africa (SSA), there are very few systematic reviews of mental health interventions in the region. Those that exist primarily examine interventions for specific ailments (e.g., substance use, trauma) or specific modes of treatment (e.g., traditional healers, interpersonal psychotherapy). No systematic review has sought to assess the extent to which interventions used in SSA reflect local cultural context. The current systematic review is unique in that it aims to: quantify the number of published studies examining distinct mental health interventions in SSA that reflect local culture; identify and characterize mental health interventions that can be considered indigenous; identify Western mental health interventions in SSA that have undergone cultural adaptation and characterize the nature and extent of those adaptations; and provide recommendations for researchers and practitioners seeking to develop mental health interventions for African populations. A total of 980 articles were identified across five databases from January 31st to February 1st, 2021, and 29 were included in the study. The Ecological Validity Model (EVM) was used to assess degree of cultural sensitivity of non-indigenous interventions within eight cultural dimensions. Findings indicate that few studies examine mental health interventions in SSA and much of this research is authored by Western rather than local researchers. The most common intervention approaches were cognitive-behavioral therapy and problem-solving therapy. Assessment with the EVM framework demonstrated that concepts and goals of treatment were the cultural dimensions that were most likely to lack culturally sensitive elements. Recommendations are provided regarding achieving cultural sensitivity and collaborations between indigenous practitioners and contemporary healthcare systems. This review is an important step in evaluating progress towards achieving global equity in access to suitable mental health care.

"How Can We Help You": Mental Health Practitioners' Experiences of Service Provision in Northern Namibia

Although 12-13% of Namibians are reported to struggle with psychological distress, very few practitioners are available to provide mental health services in Namibia. Those practitioners who are available are often trained from Western counseling and psychiatric perspectives that may not readily align to beliefs about illness held constructed in Namibian cultures. Institutional effort is invested in the education and use of mental health practitioners, including counselors, social workers, nurses, psychologists, and psychiatrists. However, little is known about the experiences of these providers. Therefore, this study, a grounded theory ethnography, was undertaken as part of broader ethnographic work to understand how mental health practitioners (N = 7) in Northern Namibia view their work with Aawambo Namibians given that Namibian mental health practitioners are few but embedded in the country's health care system. Four categories were identified in analyses: Provision of Mental Health Services in the North, Practitioners' Conceptualizations of Psychological Distress: Western and Aawambo Influences, Beliefs about Mental Health Services in the North, and Integration of Traditional Treatment and Counseling. Results are discussed with respect to cultural competence in Namibian mental health practice and potential for integrating traditional practices and mental health services.

African psychology and the emergence of the Madiban tradition

The recent welcome inclusion of the study of African psychology within the psychology degree curriculum of some forward-thinking African universities has been lauded as a great positive drive in the right direction. In the past, the practices that prevailed were those of mainstream Western psychology imported to Africa. This awkward situation originated during the period of colonialism and the emergence of missionary Christianity in Africa. This article proposes that if the current positive attitude toward African psychology is to last and bear fruit, there is a need to formally inaugurate a new order or tradition (referred to in this paper as the Madiban tradition) that would anchor and open up the study of psychology in African universities towards a new future: a future in which the progressive arm of both Western and African approaches to psychology would coexist and enjoy enduring mutual respect and equitable participatory presence in these programmes. This paper highlights the theoretical framework undergirding this vision and the challenges to be faced and new shifts to be made in implementing such a vision.

From Handmaidens to POSH Humanitarians: The Case for Making Human Capabilities the Business of I-O Psychology

Industrial-organizational (I-O) psychology has begun to shed its reputation as a handmaiden to corporate and managerial interests, in part, through its engagement with humanitarian concerns. However, as highlighted by recent commentary, I-O psychology still has a decidedly POSH perspective on the world; that is, it has focused on Professionals who hold Official jobs in a formal economy and who enjoy relative Safety from discrimination while also living in High-income countries. This POSH perspective reflects an underlying bias away from people living in multidimensional poverty. We empirically illustrate some of the connections between a POSH perspective and poverty by reviewing 100 years of research in I-O psychology, and then we make a case for why a neglect of people living in poverty undermines the discipline's science, its practice, and its humanist charge. As moral justification for greater engagement with humanitarian concerns and as a guide to navigate the difficult ethical quandaries involved in doing so, we suggest that I-O psychologists should consider the capability approach. We discuss the concept of human capabilities, relate it to I-O psychology, and demonstrate its utility in the form of three hypothetical scenarios. Perhaps our most controversial claim is that there is a moral imperative for I-O psychology to overrepresent people living in the deepest forms of poverty in both its science and practice.

Essence or experience? A new direction for African psychology

This article examines the attempts of psychologists in South Africa to “Africanize” the discipline. Beginning with a brief history of psychology on the continent, it contextualizes the call for an African psychology by outlining the state of the broader discipline in post-apartheid South Africa as well as the emergence of Afrocentric psychology in the United States. The article interrogates further the notion of an “African worldview” and suggests that Afrocentric psychologists remain beholden to Eurocentric audiences—the result of their continued marginalization by a Eurocentric discipline. Drawing on Fanon’s image of a Manichean psychology, the paper argues that African psychology—instead of organizing itself around cultural questions—must commit itself to a psychological analysis of the violence that exemplifies life in South Africa.

Madness (Eemwengu) and Its Sources

Integrating indigenous cultural knowledge into conceptualizing mental illness offers fruitful avenues to better contextualize mental health. What is abnormal and indicative of psychological distress varies in the meaning given to symptoms and the actual identification of disorders. This is no less true in Ovambo culture in Namibia, Southern Africa. The Namibian government, however, has noted that little is known about the mental health needs throughout the country. Although some researchers have identified symptoms of psychological distress in Namibian men and women, cultural tradition and belief systems are typically missing. The purpose of this study was to use ethnographic data to develop an understanding of what Ovambo men and women living in a rural area of Northern Namibia believe about mental illness. Informal discussions and formal interviews served as data. Participants ( N = 14) were all Ovambo men or women who were sampled after ongoing engagement in a rural community in northern Namibia. Data from field observations and interviews were analyzed using grounded theory open coding, resulting in two key categories: (a) Eemwengu (madness) and Omunanamwengu (the mad one) and (b) Where Madness Comes From: Explanations of Mental Illness. The first category offers insight into a culturally embedded way of identifying mental illness in Ovambo culture. The second category includes several subcategories oriented to the etiology of mental illness in Ovambo culture. Etiological beliefs about mental illness, eemwengu as a culturally embedded construct, and social control in the beliefs about psychological distress in Ovambo culture are discussed.

Health, Disease and Healthcare in Africa

This editorial introduction to `Health, disease and healthcare in Africa' addresses some of the key issues for health psychology in the continent. African populations face a health crisis driven by a double burden of disease, a nutrition transition, war and conflict, and poverty. Health systems are under-funded and underresourced. Research suggests that the most prevalent diseases in Africa are preventable and treatable, and that most deaths are avoidable. Health practices and systems that may aid equitable, cost-effective and sustainable healthcare exist but remain untapped. We advocate a reflective, action-oriented health psychology that challenges social injustice and racism, and develops strategies that promote more just and healthy societies.

Rural-to-urban migrations: acculturation experiences among university students in Botswana

Many students in Botswana migrate from small rural villages and towns to the larger urban centres to attend university, and are subsequently required to adapt or acculturate to their new environments. However, the existing literature and research on acculturation experiences of students who migrate from rural-to-urban centres in Botswana is almost non-existent. The current study was therefore a qualitative exploratory investigation of the experiences of the students who migrate from rural-to-urban centres. Purposive sampling was used to recruit participants who contributed to a Talking Circle focus group. Researchers transcribed the interviews and used content analysis to uncover response themes. Findings indicated that the majority of students experienced some culture shock and a number of environmental and specific systemic stressors in their first two years of university life. Theoretical implications for understanding rural-to-urban acculturation and practical implications for university counselling approaches are also discussed.

African indigenous knowledge and research

This paper seeks to heighten awareness about the need to include indigenous knowledge in the design and implementation of research, particularly disability research, in Africa. It affirms the suitability of the Afrocentric paradigm in African research and argues the necessity for an emancipatory and participatory type of research which values and includes indigenous knowledge and peoples. In the predominantly Western-oriented academic circles and investigations, the African voice is either sidelined or suppressed because indigenous knowledge and methods are often ignored or not taken seriously. This paper posits that to be meaningful and empowering, African-based research must, of necessity, include African thought and ideas from inception through completion to the implementation of policies arising from the research. In this way the work is both empowering and meaningful for context-specific lasting impact.