Hostname: page-component-77c89778f8-5wvtr Total loading time: 0 Render date: 2024-07-21T16:53:31.202Z Has data issue: false hasContentIssue false

Health worker confidence in diagnosing and treating mental health problems in Papua New Guinea

Published online by Cambridge University Press:  05 May 2015

Betty E. Koka*
Affiliation:
Illawarra Institute for Mental Health, University of Wollongong
Frank P. Deane
Affiliation:
Illawarra Institute for Mental Health, University of Wollongong
Gordon Lambert
Affiliation:
Illawarra Institute for Mental Health, University of Wollongong
*
Illawara Institute for Mental Health, University of Wollongong. E-mail: [email protected]; or, alternatively, [email protected]

Abstract

Confidence in identifying different diagnostic categories of mental disorders by general health workers who provide the bulk of Papua New Guinea's (PNG) mental health care is vital for the country's provision of mental health care. Making a psychiatric diagnosis is complicated by PNG's diverse culture and estimated 800 distinct languages. These cultural-linguistic factors influence help-seeking behaviour and continued use of traditional treatment despite the introduction of western approaches to mental health care. The aim of this study was to determine the confidence of health workers in identifying and diagnosing different categories of mental health problems in this complex environment. A sample of 209 Papua New Guinea health workers from four geographic regions completed a questionnaire that assessed background levels of training and confidence in diagnosing a range of modern and culture specific diagnoses. Overall, respondents reported relatively little prior mental health training. Consistent with this were the relatively low levels of confidence for culture specific diagnoses (e.g. sorcery), but significantly higher levels of confidence with modern diagnoses (e.g. depression). The implications of the findings for training and provision of mental health care are discussed.

Type
Articles
Copyright
Copyright © University of Papua New Guinea and Massey University, New Zealand/Aotearoa 2004

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Al-Krenawi, A., Graham, J.R., Ophir, M., & Kandah, J. (2001). Ethnic and gender differences in mental health utilization: The care of Muslim Jordanians and Morocco Jewish Israeli out-patient psychiatric patients. International Journal of Social Psychiatry, 47, 4254.CrossRefGoogle ScholarPubMed
American Psychiatric Association, (1994). Diagnostic and statistical manual of mental disorders, Fourth Edition. Washington, DC. Author.Google Scholar
Barnejee, G., & Roy, S. (1998). Determinants of help seeking behaviour of families of schizophrenia patients attending two teaching hospitals in India: An indigenous explanatory model. International Journal of Social Psychiatry, 44, 199214.Google Scholar
Burton-Bradley, B.G. (1965). Cross cultural psychiatry. Australasian Bulletin, 6, 1218.Google Scholar
Burton-Bradley, B.G. (1973). Longlong! Transcultural psychiatry in Papua New Guinea. Port Moresby: PNG Department of Health.Google Scholar
Burton-Bradley, B.G. (1990). History of medicine in Papua New Guinea: Vignettes of an earlier period., Kingsgrove, NSW, Australia. Australasian Medical Publishing Co. Google Scholar
Burton-Bradley, B.G., & Julius, C. (1965). Folk psychiatry of certain villages in the central district of Papua. Technical paper N0.146, Noumea, South Pacific Commission.Google Scholar
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, 7178.CrossRefGoogle Scholar
Chakraborty, A. (1991). Culture, colonialism and psychiatry. The Lancet, 337, 12041209.CrossRefGoogle ScholarPubMed
Decock, A., Hiawalyer, G., & Katz, C. (1997). Talking health: The wisdom of the village. Port Moresby: Health Promotion and Education Unit, Population and Family Planning project, PNG Department of Health.Google Scholar
Flaskerud, J.H. (1986). The effects of cultural compatible intervention on utilization of mental health services by minority clients. Community Mental Health Journal, 22, 127141.CrossRefGoogle ScholarPubMed
Frankel, S. (1986). The Huli response to illness. Cambridge, UK. Cambridge University Press.CrossRefGoogle Scholar
Hamnett, P., & Connell, J. (1981). Diagnosis and cure: The resort to traditional and modern medical practitioners in the North Solomons, Papua New Guinea. Social Science and Medicine, 15, 489498.Google ScholarPubMed
Hoskins, J.O., Cuthbertson, G., & Cawte, J.E. (1969). Community psychiatry in the Islands Region of New Guinea: I. Epidemiology. Australian and New Zealand Journal of Psychiatry, 3, 376382.CrossRefGoogle Scholar
Hoskins, J.O. (1969). Community psychiatry in the Islands Region of New Guinea: II. A Design. Australian and New Zealand Journal of Psychiatry, 3, 383389.CrossRefGoogle Scholar
Jeiyeoba, A.D. (1988). Notes on the utilisation of traditional and modern/western mental health practices among the Yoruba, Nigeria. International Journal of Nursing Studies, 25, 179184.CrossRefGoogle Scholar
Kim, M., Han, H., Kim, B.K., & Duong, D.N. (2002). The use of traditional and western medicine among Korean American elderly. Journal of Community Health, 27, 100120.CrossRefGoogle ScholarPubMed
Langness, L.L. (1965). Hysterical psychosis in the New Guinea highlands: A Bena Bena example. Psychiatry, 28, 258277.CrossRefGoogle ScholarPubMed
Lepowsky, M. (1990). Sorcery and penicillin: Treating illness on a Papua New Guinea Island. Journal of Social Science and Medicine, 30, 10491063.CrossRefGoogle ScholarPubMed
Lewis, G. (1975). Knowledge of illness in a Sepik society. A study of the Gnau, New Guinea. University of London: The Athlone Press.Google Scholar
Meggitt, M.J. (1965). The lineage system of the Mae-Enga of New Guinea. London: Oliver and Boy.Google Scholar
Mai, M. (1997). The practice of forensic psychiatry in Papua New Guinea: A Review. Unpublished thesis submission. University of Papua New Guinea.Google Scholar
Moi, W. (1976). Growing up in Ambasi. Papua New Guinea Medical Journal, 19, 1418 Google Scholar
Newman, P. (1964). Wild man behaviour in a New Guinea highlands community. American Anthropologist, 66, 119.CrossRefGoogle Scholar
Ng, C.H. (1997). The stigma of mental illness in Asian cultures. Australian and New Zealand Journal of Psychiatry, 31, 382389.CrossRefGoogle ScholarPubMed
Noble, F.S. (1997). Long-term psychiatric care in Papua New Guinea. Psychiatric Bulletin, 21, 113116.CrossRefGoogle Scholar
Papua New Guinea National Department of Health. (1998). National inventory of health facilities 1998. Port Moresby, Author.Google Scholar
Papua New Guinea National Department of Health. (2000). National health plan 2001-2010. Health vision 2010: Program policies and strategies, Volume II. Port Moresby, Author.Google Scholar
Pusford, R.L., & Cawte, J. (1972). Health in a developing country: Principles of medical anthropology in Melanesia. Melbourne, Jacaranda Press.Google Scholar
Razali, S.M., & Najib, M.A. (2000). Help-seeking pathways among Malay psychiatric patients. The International Journal of Social Psychiatric Services, 46, 281289.CrossRefGoogle ScholarPubMed
Reay, M. (1960). Mushroom madness in the New Guinea highlands. Oceania, 31, 137139.CrossRefGoogle Scholar
Reay, M. (1965). Mushrooms and collective hysteria. Australian Territories, 5, 1828.Google Scholar
Roberts, H. (2001). A way forward for mental health care in Ghana? The Lancet, 357, 1859.CrossRefGoogle ScholarPubMed
Robin, R. (1979). Psychopathology in Papua New Guinea: A collection of four papers. University of Papua New Guinea Printery.Google Scholar
Rodrigue, R. (1963). A report on a widespread psychological disorder called Lulu seen among the Huli linguistic group in Papua. Oceania, 33, 274279.CrossRefGoogle Scholar
Salisbury, R. (1966). Possession on the New Guinea Highlands: Review of literature. Transcultural Psychiatric Research Review, III: 103108.Google Scholar
Sinclair, A.J.M. (1957). Field and clinical survey report of the mental health of the indigenes of the Territory of Papua New Guinea. Port Moresby: Government Printer.Google Scholar
Stavovy, T. (1996). Idioms of psychosis in Papua New Guinea: Thesis submitted for Masters degree of Psychological Medicine, Monash University. Carlton, Victoria.Google Scholar
Stephan, M. (1987). Sorcerer and witch in Melanesia. Melbourne University Press.Google Scholar
World Health Organisation. (1982). Primary health care training manual for developing countries. Manilla, Unpublished Paper.Google Scholar
Author World Health Organisation. (1993). The ICD-10 classification of mental and behavioural disorders. Diagnostic criteria for research. Switzerland.Google Scholar
Author Zhang Feng, (2001, 02 21). China Daily, China daily staff; New York, pp. 23.Google Scholar