Submission ID 131530
| Issue/Objective | Indigenous communities continue to experience disproportionate mental health burdens, driven by structural inequities and compounded by the dominance of biomedical models. To strengthen community resilience, frameworks such as the WHO's Mental Health Gap Action Programme (mhGAP) have potential to improve access to care in low-resource settings. However, their effectiveness depends on meaningful adaptation to local knowledge systems and cultural formulations. Grounded in Ubuntu, African cosmology, and decoloniality frameworks, this study responds directly to that need by centering Indigenous epistemologies of distress, healing, and well-being within health systems design. The objectives are to: (1) explore Indigenous community perceptions and attitudes toward mental illness; (2) deepen understanding of Zulu epistemologies, language and idioms of distress; (3) and (4) develop a theoretical framework to inform culturally responsive programming. The study addresses health equity by centering marginalized voices to inform cultural adaptation and implementation of the mhGap. |
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| Methodology/Approach | Partnered with a local NGO and guided by a community advisory council, the study employed a community-based participatory research approach involving three adapted Forum Theatre (aFT) workshops and focus groups with women (n=16), men (n=16), and youth (n=16) in rural South African villages. Data sources included audio-recorded inner monologues and drama skits, FGD, and photographic documentation of final tableaux. All data were transcribed verbatim, translated into English, and supplemented by an additional community-wide forum to capture broader perspectives. Data were analyzed using NVivo-14 following Braun and Clarke's six-phase reflexive thematic analysis. Socio-demographic data were also collected to describe the sample. |
| Results | Findings revealed culturally specific terminology, explanatory models, and collective responses to mental distress, often grounded in spiritual and relational frameworks, including beliefs related to ancestors. Persistent stigma, knowledge gaps in early identification, and limited access to culturally appropriate services were also identified. Notably, emerging patterns suggest gendered and generational differences in understandings of mental distress/illness. |
| Discussion/Conclusion | These findings highlight the need for culturally grounded mental health approaches that centre Indigenous voices; and will inform the community-led cultural adaptation and implementation of the mhGAP that will also involve training local Community Health Workers, thus improving equitable access to holistic mental health services and supports for prevention, diagnosis, and treatment. |
| Presenters and Affiliations | Nomusa Mngoma Queen's University Amrita Roy Queen's University Sphesihle Radebe Woza Moya Oyedeji Ayonrinde Queen's University |
