Background: It has been recognized that explanatory models (EMs) of mental distress play an important role in how people perceive causes of mental illness, how these illnesses are presented and where treatment is sought. The main objective of this study was to explore EMs within a non-clinical sample in a low-income and multicultural setting and to identify the most common category of EMs. The secondary objectives were to assess the influence of demographic factors, perceived accessibility of health services, and choice of health service for mental distress across the EM categories.
Methods: Cross-sectional data were collected using the Mental Distress Explanatory Model Questionnaire (MDEMQ) from 399 participants resident in Mayo, Khartoum. The frequency distribution across different EMs was assessed to reveal the most common EMs and category of EMs. Frequencies of perceived accessibility were conducted to identify the preferred health service. Predictive Analytic SoftWare Statistics (PASW) Version 18 was used for all analysis.
Results: The most prevalent EMs of mental distress were found to be in the category of stress, but supernatural/magical EMs were also prevalent in the sample. Factors significantly associated with the EM categories stress and supernatural were found to be area of origin and years since migration from the area of origin. Choice of health service was not found to be significantly associated with EMs, with 84 % of the sample choosing hospital as their first choice for mental illness.
Conclusion: Cultural beliefs of mental distress are important to recognize to facilitate positive interactions between health workers and the patient. Findings from this study indicates that both western and non-western EMs are prevalent in Mayo, which suggests a heterogeneous approach to EMs of mental distress, and that beliefs in one EM category not automatically excludes other categories of EMs.