Prevalence, associated factors and perceived causes of mental distress among visitors to holy water in Mekelle City, Tigray, North Ethiopia

Kenfe Tesfay Berhe^1,2*Tilahun Belete Mossie^3,4Desalegn Massa Teklemichael⁵

• ¹College of Health Sciences, Mekelle University, Mekelle, Tigray, Ethiopia
• ²Research Centre for Public Health, Equity and Human Flourishing, Torrens University Australia, Australia, Adelaide, Australia
• ³Bahir Dar University, Bahir Dar, Amhara Region, Ethiopia
• ⁴Department of Psychiatry, School of Medicine, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Amhara Region, Ethiopia
• ⁵Department of Epidemiology, College of Health Sciences, Mekelle University, Mekell, Tigray, Ethiopia

Background: In low-income countries, mental disorders contribute to 12% of the Global Burden of Disease, compared to 8.1% in the developed world. Seeking help from religious institutions, which offer prayer and treatment with holy water, were strategies reported by several studies, particularly in the developing world. Despite the presence of many holy waters in the study setting, the problem is not well studied. Therefore, the aim of this study was to assess perceived causes, associated factors, and the prevalence of mental distress among visitors to holy water in Mekelle town, North Ethiopia. Methods: A cross-sectional study design was employed on a total of 380 subjects for the quantitative study and 9 subjects for the qualitative study, who were selected from three holy water places in Mekelle town, Ethiopia. Mental distress was measured by a Self-Reported Questionnaire (SRQ-20). Data were analyzed using the Statistical Package for Social Sciences (SPSS) software, version 20, for Windows, and logistic regression analysis was used to determine the degree of association at a P-value <0.05. Results: Among the 380 holy water visitors investigated, 147 (38.7%) had mental distress. Headache was identified as the most common symptom of mental distress among the holy water visitors, followed by feelings of being easily tired and nervousness. Factors independently associated with mental distress were female sex (AOR = 1.68 (95% CI; 1.04, 2.72)), illiteracy (AOR = 3.2 (95% CI; 1.28, 6.91)), recent serious conflict within family members (AOR = 3.82 (95% CI; 1.89, 7.68)), and belief in a lack of faith as a cause of mental illness (AOR = 2.33 (95% CI; 1.43, 3.79)). Conclusion: The magnitude of mental distress is high among holy water visitors when compared to prior studies, highlighting the importance of working with religious leaders and community members on how to implement both religious and modern mental health care together.