Religion and Spirituality in Psychiatry

Teaching Religious and Spiritual Issues 341is available about whether trainees are educatedabout religion-spirituality. However, the existenceof the Institute of Traditional Medicineindicates Tanzanian academic medicine is likelyaware of traditional healing practices that maybe linked to spiritual beliefs. This author was notable to find information about psychology trainingin Tanzania.3.2.9. African Psychiatry and PsychologyTraining: KenyaThe medical director of Mathari Hospital inNairobi, Dr. Frank Njenga, reported in 2002 (53)that all psychiatrists in Kenya were Europeansat the time of the country’s independence in the1960s. In 1971, the Department of Psychiatryof Nairobi University School of Medicine(NUSOM) was founded in Nairobi. (56) In 1982,this department began to train adult and childpsychiatrists at Kenyatta and Mathari NationalHospitals for certification in the United Kingdomand established a three-year master of medicinein psychiatry degree. At Mathari Hospital, mostof the patients are Christian; treatment is Westernand biological.( 53 , 57 , 58 )The first indigenous Kenyan qualified in psychiatryin 1970 from the United Kingdom. In1975, NUSOM arranged with the University ofLondon to place four Kenyans each year for psychiatricstudies in the United Kingdom, trainingunder U.K. psychiatry standards. (53) In 2008,the NUSOM Department of Psychiatry was alsotraining medical students and nursing studentsand was offering degrees in other mental healthspecialties, including a master of science in clinicalpsychology, a master of medicine in psychiatry(psychiatry residency), and postgraduatediplomas in psychiatry, substance abuse, andsocial work. This author was not able to findinformation on whether religion-spirituality areaddressed in these degree programs, but found arequired course in social and transcultural psychiatryin the master of medicine in psychiatrycurriculum.Kenyan psychiatrists use Western approachesin large hospitals where the most severely illpatients are treated. However, in much of Kenya,traditional healers are used more than psychiatrists.In regional health centers across Kenya,psychiatrists work collaboratively rather thancompetitively with traditional healers such asherbalists and spiritualists, and even offer themtraining. (58) Publications by Kenyan psychiatristsoften refer to indigenous beliefs and practicesthat are effective in treating many mentalillnesses. It is unknown if Kenyan psychiatryresidents are taught about religion-spiritualityissues, but their faculty appear well aware ofthese issues. A second Kenyan medical school,Moi University, established in 1990 does not offerpsychiatric training. (59)3.2.10. Psychiatry Training: South AfricaEmsley (60) reports “qualification for registrationas a psychiatrist” [in South Africa] canbe accomplished either by completing a university-basedmaster’s degree in psychiatry –MMed(Psych), or completing the fellowship ofthe College of Psychiatrists of the Colleges ofMedicine of South Africa– FCPsych. Both theMmed(Psych) and FCPsych degrees require a4-year full-time training period in an approvedregistrar post. Admission requirements includean MBChB degree, a year of internship, andan additional year as a medical practitioner.Psychiatry is a popular specialty among SouthAfrican physicians. (60) Training programshave waiting lists. Psychiatric treatment takesa biological approach, but South Africa alsohas a Jungian Psychoanalytic Institute.In 2001, South Africa had eight medicalschools, with approximately 130 registrar(resident) posts. Since the national regulatorybody, the Health Professions Council ofSouth Africa, recognized psychiatry as thefifth major clinical specialty, a clinical rotationin psychiatry is required in the sixth yearof MBChB training. Most medical schools, inspite of staff shortages, provide undergraduateteaching courses in psychiatry. South Africanacademic psychiatrists spend an average of 7.5hours weekly teaching while managing largeclinical loads. (61)