Cultural Construction of Mental Illness and Health Seeking Behaviour among Caregivers in Uasin Gishu County, Kenya

Negative beliefs and practices play a significant role in determining treatment for people with mental illness. Although there has been development in biomedical intervention to mental illness, culture’s role in mental illness construction and perception remains unexplored. This study sought to determine the influence of cultural construction of mental illness on the health-seeking behaviour of caregivers for people with mental illness in Uasin Gishu County moderated by contextual factors. Five objectives guided the study including: establishing the influence of stereotypes on health-seeking behaviour of caregivers for people with mental illness, determining the influence of prejudice on health-seeking behaviour of caregivers for people with mental illness, analyzing the influence of discrimination on health-seeking behaviour of caregivers for people with mental illness, exploring the influence of cultural adaptation intervention on health-seeking behaviour of caregivers for people with mental illness, and determining the moderation influence of contextual factors on the relationship between cultural construction of mental illness and health-seeking behaviour. The study adopted the concurrent mixed methods design that integrated both the qualitative and quantitative approaches. The study was based on pragmatism philosophy. The study was anchored on the constructivism theory and the health-seeking behaviour theory. The target population was caregivers of people with mental illness who were treated at MTRH which is located in Uasin Gishu County and healthcare service providers in the mental unit of the Moi Teaching and Referral Hospital (MTRH). A sample of 487 caregivers of people with mental illness was selected purposively, while a census was conducted to identify 18 health care providers. Structured questionnaires and focus group discussions were used to gather data from caregivers. Data from health-care providers were collected using interviews. Quantitative data were analyzed using descriptive and inferential statistics, while qualitative data were analyzed thematically and presented through direct quotation. The Hayes’ Macro PROCESS model 1 was used to determine the direct and moderating effects. The study revealed that at the 5% significance level, stereotypes against people with mental illness had a negative and significant effect on health-seeking behaviour (b=-0.367, þ<0.05). Similarly, prejudice against people with mental illness had a negative and significant effect on health-seeking behaviour (b=-0.332, þ<0.05). Likewise, discrimination against mental illness negatively affected health-seeking behaviour (b=-0.630, þ<0.05). However, cultural adaptation intervention positively and significantly affected health-seeking behaviour (b=0.452, þ<0.05). This also revealed that contextual factors were significant moderators of the relationship between the cultural construction of mental illness and health-seeking behaviour. The study concluded that stereotypes, prejudice, and discrimination were elements of the cultural construction of mental illness. The study recommends that caregivers of people with mental illness seek to exploit factors in the context to moderate the relationships involving mental illness. Future studies should consider widening the geographical scope to include caregivers of people with mental illness drawn from mental units in the other counties.