The African Indigenous Lens of Understanding Spirituality: Reflection on Key Emerging Concepts from a Reviewed Literature.

In this paper, we will present a reflection on reviewed literature on African indigenous understanding of spirituality, highlighting the influence of this concept on notions of the self, motivation and well-being. The indigenous understanding of spirituality is central to the understanding of the self as distinct, but positioned within the relational-collective self. This African indigenous perception of the self is grounded within the autonomous experience of the tenets of spirituality, which is explored in this paper through the lens of self-determination theory. The experience of autonomy, which is represented in this paper as choice and consent, competence and relatedness within spirituality, is considered as an intrinsic motivation factor for African indigenous communities to achieve well-being. Hence, we argue for the relevance of identifying and exploring ways that an understanding of the African indigenous spiritual belief systems, and the various ways that this understanding impacts on well-being for African indigenous communities, can be unearthed and scrutinized.

Understanding the local context for the application of global mental health: a rural South African experience.

BACKGROUND: The global mental health movement has supplied ample evidence of treatment gaps for mental health care in low and middle-income countries. It is also clear that substantial progress has been made in developing an evidence base for innovative treatments which have been shown to work. It is only through rich and detailed understandings of local contexts and individual experiences that the challenges global mental health faces can be fully appreciated. METHODS: In this article, we use a single, qualitative case study from one context and of one family affected by mental disorder. This is to elucidate core issues which we regard as key to further developments in the global mental health agenda. RESULTS: Core issues are poor mental health literacy, transport and lack of outreach, limitations of formal health care, challenges at the interface with indigenous health care and lack of follow-up and rehabilitation. CONCLUSION: We propose shifting the focus of mental health care from cure to promotion and prevention, using an interdisciplinary team of lay and trained health workers from the professional, folk and popular sectors. The challenges are complex, as this small study shows, but it is only by looking closely at local conditions that it is possible to develop interventions which are contextually appropriate and make optimal use of local resources.