Explanatory models of depression among traditional leaders: implications for community mental health care

Abstract Explanatory models are culturally shaped beliefs about health and illness that play a critical role in how individuals interpret their illness experiences, attach meaning to them, and decide on treatment options. This qualitative study explored how traditional leaders in Mokhotlong District, Lesotho, conceptualise depression, focusing on how they label it and its perceived causes. It also examined the influence of socio-demographic factors such as gender, age, and educational background on participants’ explanations to highlight commonalities and differences across groups. By offering culturally grounded perspectives, explanatory models provide contextually relevant explanations for understanding depression in Lesotho. Fourteen traditional leaders (11 men and three women) were recruited using purposive sampling. The findings indicate that shared cultural understandings shape traditional leaders’ conceptualisations of depression more strongly than demographic characteristics. Strengthening recognition of the biological dimensions of depression through culturally appropriate mental health literacy initiatives may foster a more comprehensive biopsychosocial understanding of depression.