Predicting referral practices of traditional healers of their patients with a mental illness: an application of the Theory of Planned Behaviour

Objective: Although many studies indicate that traditional healers are willing to collaborate with Western practitioners in South Africa, none focus specifically on mental health care, and none use a theory of health behaviour to explain their findings. The present study applies the Theory of Planned Behaviour (TPB) to predict traditional healer referral practices of patients with a mental illness. Method: One hundred traditional healers were first interviewed to assess the TPB variables and were contacted again 5 months later to measure self-reported behaviour. Results: Herbalists were less likely than other types of healers to refer patients with a mental illness to Western health professionals. From the TPB application, the following cognitive variables were found to predict intentions: attitudes (beta = 0.612, p<0.01); perceived behavioural control (beta = 0.355, p<0.01); and past behaviour (beta = 0.704, p<0.01). Subjective norms and knowledge of mental illness did not predict intentions. Finally, past behaviour (beta = 0.297, p = 0.040) and intentions to refer patients (beta = 0.758, p<0.01) predicted greater self-reported behaviour. Conclusion: The TPB may be a useful theoretical model for predicting the referral practices of traditional healers. The empirical data here may be useful for future work designing interventions to provide traditional healers with the information and skills they require to appropriately refer patients with mental illness.