Common mental disorders among those attending primary health clinics and traditional healers in urban Tanzania

Background: Traditional healers provide a popular and accessible service across the African continent. Little is known of the characteristics or mental health status of those using these services. Aims: To determine and compare the prevalence of common mental disorder among, and the characteristics of, those attending primary health care clinics (PHCs) and traditional healer centres (THCs) in Dar-es-Salaam. Method: The Clinical Interview Schedule - Revised was used to determine the prevalence of mental disorders in 178 patients from PHCs and 176 fromTHCs, aged 16-65 years. Results: The prevalence of common mental disorders amongTHC patients (48%) was double that of PHC patients (24%). Being older, Christian, better educated, and divorced, separated or widowed were independently associated withTHC attendance. None of these factors explained the excess of mental disorder amongTHC attenders. Conclusions: The high prevalence of mental disorders among THC attenders may reflect the failure of primary health care services adequately to detect and treat these common and disabling disorders. Traditional healers should be involved in planning comprehensive mental health care.