Mental Health, Religion & Culture

Vol. 11, No. 7, November 2008, 729740

Resort to faith-healing practices in the pathway to care for

mental illness: a study on psychiatric inpatients in Orissa
Nilamadhab Kar*
Wolverhampton City Primary Care Trust, Corner House Resource Centre,
Wolverhampton, UK
(Received 9 February 2008; final version received 28 February 2008)
Belief in supernatural causation of mental illnesses and resort to faith healing as
the method of intervention continue in many parts of the world. This study
intended to find out the belief and utilisation of faith-healing, its implications,
and associated socio-cultural factors in a sample of psychiatric inpatients in
Orissa, an eastern state of India. It was found that the majority (85.5%) of the
patients believed in supernatural causation, 75% attended faith healing
before seeking medical help, and a considerable proportion had related
psychopathology and continued to believe in the therapeutic efficacy of the
faith healing, even while continuing medicinal treatment. Resort to faith-healing
effectively delayed medical intervention to an extent in many patients and some of
the faith-healing methods were traumatising. These observations raised concern.
A considerable proportion of patients and families found faith healing
supportive, reassuring, and more acceptable in the community. Sensitivity
to these belief systems and faith healing practices is important for practising
mental-health professionals.
Keywords: faith healing; psychiatric inpatients; psychopathology; implications

Introduction
Traditional healing has always been a component of health care (Puckree, Mkhize,
Mgobhozi, & Lin, 2002). Faith healing, a form of traditional healing, is reported to be
practised as an alternative medicine in almost all parts of the world (Chadda, Agarwal,
Singh, & Raheja, 2001; Puckree et al., 2002; Thacore & Gupta, 1978; Wardwell, 1994).
This continues as people will always be keen to try anything from biomedicine to culturally
sanctioned traditional therapies that helps them (Bhui & Bhugra, 2003). While faith-based
healing is sought for all forms of illnesses, it is probably more common for psychiatric
illnesses where perceptions regarding uncertainties in causation, progression, and recovery
are high.

*Email: nmadhab@yahoo.com
ISSN 13674676 print/ISSN 14699737 online
2008 Taylor & Francis
DOI: 10.1080/13674670802018950
http://www.informaworld.com

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N. Kar

Causal connection
In many parts of the Third World, explanations of mental illness take into account wider
social and religious factors. These include spirit possession, witchcraft, breaking of
religious taboos, divine retribution, and the capture of the soul by a spirit (Dein, 1997).
Angered ancestral souls, evil spirits, supernatural agents, and witchcraft (Patel, Musara,
Butau, Maramba, & Fuyane, 1995; Patel et al., 1997; Razali, Khan, & Hasanah, 1996) are
seen as potent causes of mental illness. Sudden death of infants and children is explained as
resulting from the attack of blood-sucking witches (Fabrega & Nutini, 1993); death from
malaria is interpreted as witchcraft, and other deaths are attributed to the agency of ghosts
(Sharp, 1982). Zezuru adults and children take into account concepts of evil in directing
their lives, especially in managing incidents of trauma and sickness, misfortune, and death
(Reynolds, 1990).
Non-medical explanatory models for mental illness are more commonly seen in
developing countries compared to Western countries (McCabe & Priebe, 2004). In a
comparative study, it has been found that even well-educated Sri Lankans favour
superstitious, family, and sociological causes to explain the development of schizophrenia,
while the British favoured more biological explanations (Furnham & Pereira, 2008).

Seeking help from faith healing

Resort to faith healing becomes more common in mental illness as supernatural
explanations are more frequently offered for it as one of the causes. The belief systems
take the people to faith healers, anti-witches, witch doctors, shamanas, saints, traditional
medical practitioners and religious priests (Patel et al., 1997). Faith-based treatments are
common in Asian countries (Halliburton, 2003; Shankar, Saravanan, & Jacob, 2006).
A significant proportion of the patients consult faith healers as a first choice in different
cultures (Chadda et al., 2001; Puckree et al., 2002; Razali et al., 1996). Belief and
adherence to such practices, however, vary in different cultures (Callan, Wilks,
& Forsyth, 1983).
Faith healers treat almost all types of illnesses, though there are reports that some
focus on a particular type of problem and even refer some for medical treatment
(Campion & Bhugra, 1998). It has been reported that faith-based interventions in South
India take a pluralistic holistic approach, and individual healers have several models of
mental illness in their repertoire. The shrines are virtually specific in dealing with specific
psychiatric problems. Some healers, reportedly, can identify serious mental illness and are
able to refer these individuals to psychiatrists, whereas many others feel that they are able
to deal with these themselves (Campion & Bhugra, 1998).

Effects of attending faith healing

The methods of faith healing may range from prayer for the patient to extreme forms of
psychological and physical interventions. Besides reassurances of faith, patients are often
exposed to herbs, chemicals, physical traumas, and other various often harmful treatments
leading to physical problems (Coakley & McKenna, 1986; Otieno, McLigeyo, & Luta,
1991). In addition, there are reports where families also get ostracized and isolated
(Patel et al., 1995).
It has been found that patients who believe in supernatural causes of mental illness are
reported to show poor drug compliance, with significantly lower follow-up rates than

Mental Health, Religion & Culture

731

the corresponding figure for those who do not believe in supernatural causes
(Razali et al., 1996).
Concerns have been raised regarding the individuals who practice faith-healing; a study
reported that some witch doctors themselves may have psychiatric problems or were found
to be antisocial (McDonald, 1998). These factors, though not generalisable to all faith
healers, definitely bring forth the risk towards vulnerable psychiatric patients.
It is suggested that cultural explanatory models may need to be considered if treatment
is to be accepted. For example, taking tablets may not make sense to a patient who
perceives their problems as lying in some religious misdemeanour (Dein, 1997). However,
views regarding the role and utilisation of faith healing methods alongside medical models
of understanding and treatment are far from any consensus. At one end, it has been
suggested that if exorcism is helpful for recovery from illness, rather than disease, it should
not be hindered (Bhui & Bhugra, 2003). On the other hand, if the cultural explanatory
model is accepted, should an exorcist be enlisted in a treatment model, withholding
pharmacological treatment (Dein, 2002) with proven efficacy? These debates suggest the
need for further studies of actual practices, the methods employed, and their implications.
As cultural beliefs and help-seeking from faith healing are still common and in all
probability are going to stay, an endeavour to study them can open up new understanding
and possibilities (Neki et al., 1986). There is a need for more studies to elicit explanatory
cultural models of psychiatric illnesses, to understand the methods of healing and their
effects, and to improve cultural competency of psychiatrists managing patients from
diverse cultural backgrounds. For the above reasons, a study was conducted to determine
the current status of help seeking from faith-healing by patients with severe mental illness
who are admitted to a psychiatric ward. We intended to explore the belief systems,
psychopathology and the socio-cultural factors associated with it, and the effect of faith
healing methods on the patients.

Method
The study was conducted in the Department of Psychiatry, Mental Health Institute,
Cuttack. This institute is the referral centre for the whole state of Orissa, situated in the
Eastern part of India. The study sample consisted of consecutive patients admitted to the
psychiatric ward during a period of 1 month.
For the purpose of this study, faith healing was defined as a specific observation, event
and involvement of a faith healer for the treatment of the person. Prayer was not included
unless it involved a specific ritualistic observation or activity for the patient. Treatments
from homeopathy, Ayurved, or Unani were not included as faith healing.
Information was collected through exploratory interview in the local language, Oriya,
by the author. A semi-structured questionnaire was developed in the local language to
collect specific information on the experiences of faith healing: reasons for seeking faith
healing, the methods of the faith healing employed, about the motivator or the key person
involved in arranging faith healing. It was piloted before being used in the study.
A verbatim account of the patients experiences of faith healing was noted. Clinical
information like psychopathology and diagnoses, and socio-demographic data were also
collected.
A global assessment of the attitudes towards faith healing practices was made,
considering its effectiveness. It was rated as positive, negative, or indeterminate.
The adversities, if any, faced in social, personal, and economic areas were ascertained.

732

N. Kar

The diagnoses were clinically arrived at, following an evaluation of the patient and
discussion in the treating team, which involved consultant psychiatrists. Criteria for
diagnoses were based on ICD 10 (World Health Organisation, 1992).
Information was collected in the psychiatric ward, from the patients and their key
relatives in multiple sessions. Interviews with the patients for the study were conducted
following stabilisation of acute symptoms when they were more comfortable for
discussion.
Written informed consent was obtained from the participants. The study protocol was
approved by the research ethics committee of Quality of Life Research and Development
Foundation and local institutional ethics committee in Mental Health Institute. The data
were analysed using appropriate statistical methods.

Results
The sample consisted of 76 patients (age range 1460 years), which included 52 (68.4%)
males and 24 (31.6%) females. Their characteristics are presented in Table 1. Amongst
them, 39.5% had school education, 28.9% college, and 17.1% university education.
The majority (75.0%) had attended faith healing; their mean age was 33.9
11.9 years,
which was not significantly different from those who did not (32.3
13.1 years) attend
faith healing. Most of the participants (75%) had psychotic illness; others had mood
disorder (severe mania and depression) as the primary diagnoses.

Reasons for seeking faith-healing

A considerable proportion (66.7%) of patients sought help from faith healers, as they
believed black magic and sorcery as the cause of illness, and 29.8% of them believed in a
planetary influence. About one in five (21.1%) consulted for special prayer or offering.
Turning to or remembering God for help was a common experience and was seen in any
one or more care-giving family members of all patients. Lack of awareness that their
problems can be helped medically was found in 5.3% of patients. Most people believed
that the person having an abnormal mental state was a victim of external factors, without
any problem in body or mind; and considering the nature of this causative factor, faith
healing would help rather than medicines.
Faith healing was available easily and locally, in contrast to psychiatric treatment for
which most patients and families had to travel a considerable distance. There was always a
cost involved for the psychiatric treatment. The cost of faith healing ranged from almost
nothing to a considerable amount of money arranging the offerings.
Families reported that abnormal behaviour of the patient was felt as secondary to
black magic or other external supernatural causes by the people around; it was easily
accepted and aroused supportive responses. This included suggestions to take the patient
to faith healers. In contrast, perception of abnormal behaviour as a manifestation of
mental illness was associated with a degree of discomfort, and it was believed to have
long-term negative repercussions.
In the majority of instances (71.9%) a first-degree relative had suggested faith healing.
Educational background of the persons who suggested faith healing revealed that 42% of
them did not have a formal education; 28.1% had school education, 24.6% had college
education, and 5.3% had university education. In contrast, 42% of families who did not
attend faith healing had members with a university education.

733

Mental Health, Religion & Culture

Table 1. Sample characteristics.

N
Variables
Gender
Male
Female
Marital status
Married
Unmarried
Highest level of education in family (in years)
19
1013
1416
Religion
Hindu
Others
Habitat
Rural
Urban
Economic status
Low
Middle
Diagnoses
Organic psychosis
Schizophrenia
Delusional disorder
Acute and transient psychotic disorder
Schizoaffective
Psychosis unspecified
Mania
Depression

Attended faith
healing (n 57)

Did not attend faith

healing (n 19)

76

52
24

37
20

71.1
83.3

15
4

28.9
16.7

52
24

40
17

76.9
70.8

12
7

63.2
15.7

19
33
24

14
27
16

73.7
81.8
66.7

5
6
8

26.3
31.6
42.1

62
14

49
10

79.0
71.4

13
4

21.0
28.6

57
19

48
9

84.2
47.4

9
10

15.8
52.6

14
62

10
47

71.4
75.8

4
15

28.6
24.2

2
34
3
11
2
5
10
9

2
26
3
9
1
3
5
8

100.0
76.5
100.0
81.8
50.0
60.0
50.0
88.9

0
8
0
2
1
2
5
1

00.0
23.5
00.0
18.2
50.0
40.0
50.0
11.1

Relation to psychopathology
In the sample, 19 (25.0%) patients had psychopathology related to witchcraft ideation.
Persecution through black magic, possession, and being controlled by a black magician
were the predominant contents. All these patients had attended faith healing. These people
believed in the causative role of black magic bringing mental problems.

Mode of faith healing

Most of the patients (84.2%) received a talisman to wear or were asked to recite a mantra
as a form of faith healing. Three-quarters of the patients received chemical compounds of
unknown composition in the form of powder, handmade tablets, and plant derivatives in
the process of faith healing. Physical treatments like beating, slapping, tying in ropes and
chains, scalding, and even blistering by a red hot iron in one form or other were received
by 14% of patients. These interventions in some persons led to injuries. Various other

734

N. Kar

Table 2. Duration of illness and pattern of help seeking of psychiatric inpatients who attended
faith healing.
Sought faith healing
Duration of illness
1 week
1 week to 1 month
1 month to 6 months
More than 6 months

n (%)
21
17
13
6

(36.8)
(29.8)
(22.8)
(10.5)

Sought medical help

Cumulative %

n (%)

Cumulative %

36.8
66.7
89.5
100.0

1 (1.8)
14 (24.6)
9 (15.8)
33 (57.9)

1.8
26.3
42.1
100.0

forms of interventions such as using fumes, oil baths, getting buried up to the neck, etc.
were noted in 12.1% of patients.
Methods also included ritualistic performances with recitation of religious scriptures.
Most of these methods were ceremonial; some were performed at odd hours and places.
The methods differed with different settings and faith healers. Many methods were aimed
at driving out the evil from the body or mind.
In the initial period following onset of mental symptoms, more people attended faith
healing than medicinal treatment. This trend continued for almost six months. The pattern
of help seeking of the patients who went for faith healing as a factor of time is presented
in Table 2.

Attitude towards faith healing

The majority of patients and their families (n 65; 85.5%) believed that there could
be supernatural cause for mental illness. They did not differ on factors like habitat
and highest level of education in family compared to those who did not believe so.
A great majority of those who believed in supernatural causation (87.7%; 57/65) went for
faith healing. A considerable proportion of families (68.4%) and patients (57.9%)
felt positive about the therapeutic effectiveness of faith healing; a smaller proportion
(22.4% and 32.9% respectively) felt faith healing was not effective, and harboured
a negative attitude towards it; and 9.2% of families and patients reported that they were
not sure.

Effects of faith healing

About 5.3% (3/57) felt that they have recovered by faith healing, even if they
were continuing medicinal treatment. All of them believed witchcraft as the cause
of their abnormal behaviour. Though 75% of patients attended faith healing at some
point along with seeking medical treatment, only 22.4% of families and 32.9% of
patients felt faith healing had no role. Many patients (57.9%) continued using or
following the directions of the faith healers, even while receiving psychiatric
treatment from the hospital. However, a great majority (94.7%; 54/57) felt that they
should have opted for medical treatment earlier for faster improvement, or at least
would have continued both faith healing and medicinal treatment. Adversities in any
one or more of social, personal, and economic areas were reported by all patients and
their families.

Mental Health, Religion & Culture

735

Discussion
Resort to faith healing by the patients with severe mental illness who were admitted to a
psychiatric ward in the Eastern Indian state of Orissa was evaluated in this study. The
belief systems, relation to psychopathology and the socio-psychological factors associated
with it were also explored.
It is already known that for almost all types of psychological and behavioural
anomalies the remedies through faith healing are sought; and that most common
diagnoses at the clinics of faith healers in a study from South India have been mixed
anxiety depression (Shankar et al., 2006). This study in Orissa intended to focus on the
patients with higher psychiatric morbidity. Most of the patients in this study had psychotic
disorders, and all others had severe mania or depression.

Faith healing in the pathway to psychiatric intervention

It was observed that most of the patients suffering from major psychiatric disorders
sought help from faith healing before seeking medical treatment. This supports findings
from other studies from the region (Chadda et al., 2001). Medical help seeking of
patients who attended faith healing suggested a patterned relationship with the duration
of illness. It was noted that a considerable number of patients attended faith healers
initially, and even within six months after onset half of the patients had not sought
medical help. It was evident that as the time passed, more and more people who had
gone initially for faith healing turned to medical intervention. However, there remained a
great degree of overlap, as many patients continued to seek remedies from both forms of
treatment.

Socio-demographic factors
Considering socio-demographic variables, more females (83.3%) than males (71.2%)
had been taken for faith healing. Education, habitat, and marital status of the patients
did not relate significantly to seeking treatment from faith healing. The rural population
was represented more in the sample, but this was not statistically significant.
A considerable proportion of the patients who went for faith healing had family
members with college and university level of education. It has been reported that
belief in supernatural causes of mental illness is not significantly associated with age,
gender, level of education, or occupation of the patients (Razali et al., 1996). These facts
highlight the fact that belief in faith healing is deeply ingrained in the socio-cultural
system.

Methods of faith healing

The most common faith healing method noticed was ritualistic prayer and the use of a
talisman. Some methods of faith healing like taking unknown chemical substances or
herbs, beating, slapping, tying in ropes and chains, scalding, and blistering by a red hot
iron were physically traumatizing. Similar treatment methods like piercing, scarification,
enema, and induced vomiting have been reported elsewhere (Shai-Mahoko, 1996). In a
similar vein, medical therapies have also been perceived negatively; in a study from south
India on healing processes, patients disliked adverse reactions, the effects of ECT and
injection of medications and moved away from medical therapies (Halliburton, 2003).

736

N. Kar

However, it is also noted that even if doctors and patients believed in different
explanatory models, the patients followed and were satisfied with psychiatric interventions
(Callan & Littlewood, 1998). While more work is obviously needed regarding education on
medical interventions, concern regarding the effect of the injurious faith healing methods
cannot be ignored.

Reasons behind seeking help from faith healing

In the index study, the majority of the patients believed in the supernatural causation,
though not all of them went for faith healing. A quarter of all patients studied had
psychopathologies related to this belief in supernatural causation. It is commonly believed
in Asia that it is possible to influence the health or well-being of another person by action
at a distance. Culturally sanctioned ways of dealing with this often involve resorting to
traditional healers or the use of counter-magic (Dein, 1997).
It appears that supernatural causation is a pervasive background belief, which emerges
as an explanation for the mental problems, especially when there is no clarity in
understanding of the aetiologies in general public, and also gets reflected in the presenting
symptomatologies.
The majority of patients and families in this study continued to believe in
supernatural causation in spite of and while taking medicinal treatment. In fact, some
of them followed faith healing suggestions and treatments while in hospital and
remained positive about the therapeutic benefit of faith healing. It has been observed
that the majority of patients with multiple, divergent, and even contradictory
explanatory models may still be resorting to a medical model of intervention (Callan
& Littlewood, 1998; Saravanan et al., 2008). Both biomedical and indigenous beliefs
have been observed to be simultaneously held by a significant number of people who
often seek help from both modern and traditional health systems at the same time (Dein,
2001; Saravanan et al., 2008). It was evident that belief in a particular explanatory model
of illness and resort to different models of treatment may co-exist without major
dissonance.
Additionally, factors that led to seeking help from faith healing were trust, easy
availability and accessibility, and recommendations by the significant others besides the
belief in supernatural causation of illness, as has also been reported elsewhere in India
(Chadda et al., 2001).
It is also worth looking at the role of stigma against mental illness in society that might
have played a role in peoples hesitance in seeking medical help in the first instance. It has
been observed in Indian studies that people in the community were more likely to express
negative views about mental illness (Saravanan et al., 2008). In the index study, families
reported greater acceptance and supportive responses from the people around when the
manifestations were believed to be supernatural in causation, in contrast to these being
secondary to mental illness.

Implications of the belief system

In clinical psychiatric practice, as observed in the index study, it was common not to
interfere with any faith healing being followed by patients. However, the physically
traumatizing methods of faith healing raised clinical concern specifically. It has been
suggested that when a mental disorder is recognized, and treated in a medical model, it is

Mental Health, Religion & Culture

737

still important to elicit the patients own explanatory model of the illness. This will
enhance the patients trust in the doctor and improve compliance (Dein, 1997).
In addition, an understanding of local patient perspectives of common mental disorders
is expected to allow modern medicine to provide culturally sensitive and locally acceptable
health care (Shankar et al., 2006). However, there is a need to be aware of the harmful
effects of some of the faith healing methods, and there is probably a need for further
research into the impact of such practices.
Another concern was the delay in seeking medical treatment for the severe mental
illnesses. There is an association between longer duration of untreated psychosis and worse
outcome at six months in terms of total symptoms, overall functioning, positive symptoms,
and quality of life; and in these circumstances, it is significantly less likely to achieve
remission (Marshall et al., 2005).

Interface of faith and medical interventions

Though most patients and families felt that faith healing was beneficial, and readjustment
and acceptability in the society was better if one attended faith healing, understandably it
would be remission that would hold the key for ultimate opinion. In the major psychiatric
disorders, though medical treatment would have definite benefit, the helpful and
reassuring effect of faith healing seemed still a force worth considering in patients who
believed in it.
It has been suggested (Berg, 1980) that faith healing supports the concept of healing of
the whole person and challenges the medical scientist and practitioner to develop a greater
awareness of the unknown factors working in recoveries of patients beyond normal
medical expectation. Witchcraft beliefs take on a dynamic of their own, and they must be
resolved in terms of the patients culture as well as the clinicians treatment plan
(Weimer & Mintz, 1976). However, it is felt that modern medicine has no satisfactory
approach for dealing with some culture-bound phenomena (Sharp, 1982). It is opined that
both biomedical and traditional healers could help mentally ill persons by resolving
different issues relating to the same illness episode (Patel et al., 1995).
But the idea of referring such patients to faith healers would seem morally unjustifiable
and repugnant to many doctors, and that is for valid reasons. In fact, historians of
psychiatry have propagated the view that the witch hunts of the sixteenth and seventeenth
century were primarily a persecution of the mentally ill and that demonological
concepts of possession and witchcraft impeded psychiatric progress for centuries
(Schoeneman, 1977).
It was observed that belief in supernatural causation and faith healing served a variety
of social functions and personal defences, for individuals from a culture that held such
beliefs. People felt relieved to learn that the abnormal behaviour was due to external
factors, in which they did not have control, and that there was nothing wrong in their own
selves and that they could be saved from the external influence by the faith healer. Besides,
in an atmosphere of stigma against mental illness, being considered as a victim of
witchcraft was more acceptable in society. The families reported that readjustment and
reintegration into society after faith healing were better than that after treatment from a
psychiatric hospital. This was more so when the family and near and dear ones had a
positive attitude towards faith healing.
In dealing with supernatural causation, it appears that understanding should be based
as much on cultural as on personal empathy. It is better to avoid confrontation with it.

738

N. Kar

It may not be acceptable to mental-health professionals, but they must neither decry it nor
try prematurely to educate the patient out of it. This can be frustrating because belief in
supernatural causation and faith healing is deeply and firmly rooted in the patients entire
cultural environment. Any attempt to dislodge it straight away, stressing a medical model,
may leave the patient confused, helpless, and more anxious. At the same time, it is
important to explore the genesis and elaboration of a patients witchcraft ideation and if
possible to disentangle it from underlying psychopathology, and keep them away
specifically from the deleterious effects of faith healing measures.

Limitations
The findings of the index study cannot be generalised to persons who are not psychiatric
inpatients. It is possible that the attitude and utilisation of faith healing in communities
and places of faith healing can be very different. Besides, as the evaluations were done, and
information was collected by doctors while the patients were admitted in psychiatric ward,
the responses might have been influenced to a degree towards the medical interventions.
Factors like mode of onset and severity of illness, which can influence help-seeking,
behaviour were not studied.

Conclusions
The majority of mentally ill persons and their families in this study believed in
supernatural causation and resorted to faith healing before taking medicinal treatment.
A considerable proportion of patients had related psychopathologies. Some of the faith
healing methods were physically traumatic. Resorting to faith healing effectively
delayed medical intervention to an extent in many patients. A considerable proportion
of patients and families reported faith healing to be supportive, reassuring, and more
acceptable in the community. Awareness of, and sensitivity to, these belief systems
and faith healing practices in different cultures are important for practising mental
health professionals.

Acknowledgements
The study was conducted by the support of Mental Health Institute, Cuttack, India, and Quality
of Life Research and Development Foundation.

References
Berg, E.P. (1980). Faith healing. Australian Family Physician, 9(5), 3037.
Bhui, K., & Bhugra, D. (2003). Explanatory models in psychiatry. British Journal of Psychiatry, 183,
170.
Callan, A., & Littlewood, R. (1998). Patient satisfaction: Ethnic origin or explanatory model?
International Journal of Social Psychiatry, 44, 111.
Callan, V.J., Wilks, J., & Forsyth, S. (1983). Cultural perceptions of the mentally ill: Australian and
Papua New Guinean high school youth. Australian and New Zealand Journal of Psychiatry,
17(3), 280285.
Campion, J., & Bhugra, D. (1998). Religious and indigenous treatment of mental illness in South
India A descriptive study. Mental Health, Religion and Culture, 1, 2129.

Mental Health, Religion & Culture

739

Chadda, R.K., Agarwal, V., Singh, M.C., & Raheja, D. (2001). Help seeking behaviour of
psychiatric patients before seeking care at a mental hospital. International Journal of Social
Psychiatry, 47(4), 7178.
Coakley, D.V., & McKenna, G.W. (1986). Safety of faith healing. Lancet, 22, 327(8478), 444.
Dein, S. (1997). A.B.C of mental health: Mental health in a multiethnic society. British Medical
Journal, 315, 473476.
Dein, S. (2001). The use of traditional healing in South Asian psychiatric patients in the UK:
Interactions between professional and folk psychiatrists. Transcultural Psychiatry, 38,
245259.
Dein, S. (2002). Transcultural psychiatry. British Journal of Psychiatry, 181, 535536.
Fabrega, H., & Nutini, H. (1993). Witchcraft-explained childhood tragedies in Tlaxcala, and their
medical sequelae. Social Science and Medicine, 36(6), 793805.
Furnham, A., & Pereira, S. (2008). Beliefs about the cause, manifestation, and cure of schizophrenia:
A cross-cultural comparison. Mental Health, Religion and Culture, 11, 173191.
Halliburton, M. (2003). The importance of a pleasant process of treatment: Lessons on healing from
South India. Culture, Medicine and Psychiatry, 27(2), 16186.
Marshall, M., Lewis, S., Lockwood, A., Drake, R., Jones, P., & Croudace, T. (2005). Association
between duration of untreated psychosis and outcome in cohorts of first-episode patients:
A systematic review. Archives of General Psychiatry, 62(9), 97583.
McCabe, R., & Priebe, S. (2004). Explanatory models of illness in schizophrenia: Comparison of
four ethnic groups. British Journal of Psychiatry, 185, 2530.
McDonald, S.W. (1998). The witch doctors of Scotland. Scottish Medical Journal, 43(4),
11922.
Neki, J.S., Joinet, B., Ndosi, N., Kilonzo, G., Hauli, J.G., & Duvinage, G. (1986). Witchcraft and
psychotherapy. British Journal of Psychiatry, 149, 145155.
Otieno, L.S., McLigeyo, S.O., & Luta, M. (1991). Acute renal failure following the use of herbal
remedies. East African Medical Journal, 68(12), 993998.
Patel, V., Musara, T., Butau, T., Maramba, P., & Fuyane, S. (1995). Concepts of mental illness and
medical pluralism in Harare. Psychological Medicine, 25(3), 485493.
Patel, V., Todd, C., Winston, M., Gwanzura, F., Simunyu, E., Acuda, W., et al. (1997).
Common mental disorders in primary care in Harare, Zimbabwe: Associations and risk factors.
British Journal of Psychiatry, 171, 6064.
Puckree, T., Mkhize, M., Mgobhozi, Z., & Lin, J. (2002). African traditional healers:
What health care professionals need to know. International Journal of Rehabilitation
Research, 25(4), 247251.
Razali, S.M., Khan, U.A., & Hasanah, C.I. (1996). Belief in supernatural causes of mental
illness among Malay patients: Impact on treatment. Acta Psychiatrica Scandinavica, 94(4),
229233.
Reynolds, P. (1990). Zezuru turn of the screw. On childrens exposure to evil. Culture, Medicine and
Psychiatry, 14(3), 31337.
Saravanan, B., Jacob, K.S., Deepak, M.G., Prince, M., David, A.S., & Bhugra, D. (2008).
Perceptions about psychosis and psychiatric services: A qualitative study from Vellore, India.
Social Psychiatry and Psychiatric Epidemiology. 43, 231238.
Schoeneman, T.J. (1977). The role of mental illness in the European witch hunts of the sixteenth and
seventeenth centuries: An assessment. Journal of the History of the Behavioral Sciences, 13(4),
337351.
Shai-Mahoko, S.N. (1996). Indigenous healers in the North West Province: A survey of their clinical
activities in health care in the rural areas. Curationis, 19(4), 3134.
Shankar, B.R., Saravanan, B., & Jacob, K.S. (2006). Explanatory models of common mental
disorders among traditional healers and their patients in rural south India. International Journal
of Social Psychiatry, 52(3), 221233.
Sharp, P.T. (1982). Ghosts, witches, sickness and death: The traditional interpretation of injury and
disease in a rural area of Papua New Guinea. Papua and New Guinea Medical Journal, 25(2), 108115.

740

N. Kar

Thacore, V.R., & Gupta, S.C. (1978). Faith healing in a North Indian city. International Journal of
Social Psychiatry, 24(4), 235240.
Wardwell, W.I. (1994). Alternative medicine in the United States. Social Science and Medicine, 38(8),
10611068.
Weimer, S.R., & Mintz, N.L. (197677). Health practice at the technologic/folk interface: witchcraft
as a culture-specific diagnosis. International Journal of Psychiatry in Medicine, 7(4), 351362.
World Health Organisation. (1992). The, ICD 10 classification of mental and behavioural disorders:
clinical descriptions and diagnostic guidelines. Delhi: Oxford University Press.