Examining help-seeking patterns within modern and traditional resources for support in Afghanistan
Qais Alemi1, Susanne Montgomery2, Valerie Smith3, Carl Stempel4, Patrick Marius Koga5, Brianna Taylor6, Catherine Fisher7
1 PhD, MPH, MBA, Department of Social Work & Social Ecology, Loma Linda University, Loma Linda, California, USA
2 PhD, MPH, MS, School of Behavioral Health, Loma Linda University, Loma Linda, California, USA
3 PhD, MPH, Department of Health Sciences, California State University, East Bay, Hayward, California, USA
4 PhD, Department of Sociology and Social Services, California State University, East Bay, Hayward, California, USA
5 MD MPH, Refugee Health Research, Department of Public Health Sciences, UCD School of Medicine, University of California, Davis, California, USA
6 MPH, Department of Epidemiology, School of Public Health, Loma Linda University, Loma Linda, California, USA
7 MSW, Graduate Student; Department of Social Work & Social Ecology, School of Behavioral Health, Loma Linda University, Loma Linda, California, USA
Assistant Professor, Department of Social Work & Social Ecology, School of Behavioral Health, Loma Linda University, 1898 Business Center Drive, San Bernardino, CA 92408
Source of Support: None, Conflict of Interest: None
Little is known about who and what Afghans turn to cope with mental distress precipitated by ongoing socio-political and economic problems. In a cross-sectional survey, the authors examined help-seeking behaviour for mental distress in 306 Afghans residing in Kabul, Afghanistan, and how their choice of what to access for help is influenced by various social and mental health-related factors. Factors predicting the use of six distinct resources for support were examined, including biomedical and behavioural health and community-based resources. Results indicated that Afghans mostly draw on their faith, followed by social support, to cope with mental distress. Higher distress symptoms had a moderate, but statistically significant influence, on seeking help across all resources, whereas demographic factors only predicted encounters with primary care physicians. Female gender predicted social support seeking, and income increased the likelihood of encounters with herbalists. Meeting the psychosocial needs of Afghans through promoting a more integrated mental healthcare system is discussed.
Key implications for practice
- Help-seeking for mental distress among Afghans in Kabul is highly pluralistic
- Although religious activities were the most widely used coping resource, those seeking care outside, from biomedical practitioners and traditional healers were, on average, more distressed.
- An integrated mental health system that embraces both modern and traditional healing practices may be more efficacious than medicalised mental health systems in meeting the unmet psychosocial needs of Afghans.