Bridging the Gap: An Intervention Study on Traditional Healers as Mental Health Gatekeepers in KwaZulu-Natal

**Background:** In KwaZulu-Natal, South Africa, a substantial treatment gap exists for common mental disorders. Traditional healers are frequently the initial point of contact, yet their potential as gatekeepers to formal mental health services is not systematically leveraged.

**Purpose and objectives:** This study aimed to design, implement, and evaluate a training intervention to enhance traditional healers’ capacity to identify, support, and refer individuals with common mental disorders to primary healthcare clinics.

**Methodology:** A quasi-experimental design was employed from 2023 to 2024. A cohort of 147 registered traditional healers from three districts received a culturally adapted, five-day training programme on mental health literacy and referral pathways. Pre- and post-intervention assessments measured changes in knowledge, attitudes, and self-reported referral practices, compared with a control group of 140 healers.

**Findings/Key insights:** Post-intervention, trained healers demonstrated a 42% increase in accurate identification of depression symptoms against baseline. Qualitative data indicated a key theme of improved collaboration with clinic staff. Systemic barriers, such as a lack of feedback on referrals, persisted. The control group showed no significant change.

**Conclusion:** A structured training programme can effectively improve traditional healers’ mental health gatekeeping competencies and foster collaboration between informal and formal healthcare sectors.

**Recommendations:** Integrate this training model into provincial health partnership strategies for 2025–2026. Establish a standardised, bidirectional referral system with formal feedback mechanisms to sustain engagement and improve continuity of care.

**Key words:** traditional healers, mental health, gatekeeper training, referral pathways, task-sharing, South Africa, KwaZulu-Natal

**Contribution statement:** This study provides a replicable framework for leveraging traditional healing systems to improve early detection and access to mental health services in low-resource, high-need settings.