Channeling the right path-to-care: Improving religious leaders’ knowledge and beliefs about suicide prevention in south west Nigeria

Background In African societies, the path-to-care that the ill and their relatives seek via consultation of traditional and religious healers is related to the concept of the causation, nature and origin of mental illness. There is a shortage of mental health personnel and facilities in Nigeria; hence, alternative healthcare providers such as Religious Leaders are often sought first. This intervention research was conducted with the aim of improving knowledge, beliefs and practices of Religious Leaders in relation to depression and suicide and their understanding of their role in suicide prevention. Methods This comparative cross sectional study with 102 Religious Leaders was conducted in two states in South West Nigeria. Religious Leaders were invited for a day medico-religious training on depression and suicide prevention among their congregation. Measures for inclusion comprised of correctly filled and completed semi-structured questionnaires pre and post training. Results Out of 102 Religious Leaders, 58.8% were 50 years and above, 76.5% were males. The average years of clerical experience as Religious Leaders was 15.9 years. Most of them (82.4%) had no previous training in suicide prevention and the average congregation size of Religious Leaders in Lagos was larger than Ile-Ife (256 vs 113). Only a few Religious Leaders (21.6%) counseled at least an individual with suicidal thoughts, 3 months preceding the training, while most (57.8%) of them noted that there are penalties for members of their congregation who attempted or died by suicide. The average knowledge score at pretest and post-test were 3.37 and 5.98 respectively out of a total score of 8. Percentage difference in knowledge scores from pretest to post-test showed a drop in low and fair scores by 19.6% and 54.9% respectively and an increase in good and very good scores by 46.1% and 28.4% respectively. Conclusion The outcome of this intervention in improving Religious Leaders’ knowledge about depression being a medical condition and major contributor to suicide has far-reaching implications on suicide prevention. In particular, through their involvement in this medico-religious collaboration, Religious Leaders have the right information required to preach and counsel towards encouraging their congregation to seek appropriate mental health care.