Mental disorders are common health conditions and are associated with severe disability, cost and mortality. The burden of mental disorders in low income countries is compounded by the huge treatment gap, where in some countries, the lifetime treatment gap reaches 90% [1]. In these low income settings, 60%-80% of the population rely on traditional form of health care [2, 3]. A one year prevalence of use of traditional healers services was found to be 61% among South Africans [4]. In Ghana, 71% had consulted traditional healers in the previous one year while only 53% consulted modern care system [5]. There is a similarly high use of traditional services in Ethiopia [6].

Among the reasons that attract people to traditional care are cultural acceptability, relatively lower cost, accessibility [6, 7] availability, shared social norms, and beliefs about the meaning, cause and treatment of illness people share with Faith and Traditional Healers (FTHs) [7–9]. Additional factors considered relevant for choosing FTHs are simplicity and convenience [10], inclusiveness [11] and positive personal or family experience [12].

People become aware of FTH services and seek help from them by word of mouth, advice from friend and families, referral from fellow traditional healers as well as modern health care providers [13]. People are either self-referred or referred by someone else, including cross-referral between traditional healers [12]. People use traditional healing practices for all kinds of health problems including mental disorders, either exclusively or along with modern care concurrently or sequentially [13]. Peoples’ belief systems and culturally specific explanations of illness influence their acceptance of the care and support being provided [14]. People tend to attribute mental illness to supernatural phenomenon, and FTHs are viewed as having the expertise to address the illness than biomedical practitioner [15, 16].

Based on their primary practice FTHs can be divided in to four types: Faith healers (practicing prayer, recitation or sprinkling of holy water in churches, holy water places and mosques) use the power of God to heal sickness [17]; Divine healers (Ritualist or spiritualists, kalechas, and Tenquay/wizard in the case of Ethiopia, who practice astrology, read zodiac sign, etc) [18]; Herbalists (called secular healers and treat patients using herbs, plant remedies or even extracts of animal origin) [19]; and Mixed (Herbalist-Ritualist i.e. healers who use both rituals and herbal medicine). Faith healers and diviners are also called spiritual healers. In the Ethiopian context, secular healers are those involved in manipulation of body using a variety of techniques such as bone-setting by the wegesha (a physiotherapist/orthopedic surgeon) or assisting births by the Yelimd awalaj (traditional mid-wife), dressing wounds or excising affected body parts, draining abscesses, pulling out ‘bad’ teeth (tooth extractors), or cutting out the uvula or tonsils, inoculation, and provision of remedies such as herbs, minerals, animal products and thermal waters by the medhanit awuqi (herbalist) [20, 21]. Spiritual healers are the ones who claim that they have certain magical power, usually governed by either bad spirit to make a person ill or good spirit to protect form developing a psychotic illness, and included in this group are at’maqi (baptizer-exorcist), Debtera (cleric-diviner-healer) [20] ’Tenquay’ (witch doctors), ’Bale-Weqaby’ and ’Kalicha’ [22, 23]They exorcise malign spirits such as buda (evil eye) and ganen (devil) [20]by use of incantation, sorcery, enchantment and certain rituals [24]. Exorcism is a procedure that involves conducting special ceremonies, burning incense, praying, using holy water, and advise to put amulets containing a written script [16]

Almost all traditional practices are private practices and are entirely financed by patients or caregivers. Fees vary greatly and usually affordable by majority of the people, and can be made either monetarily or in kind. Traditional healers are an integral part of the society and the people, and are believed to share similar beliefs and attitude towards all life events (health and ill-health) as well as expectations with the people they are living [25].

In general, the number of traditional healers outweigh that of medical practitioners [2, 3, 10, 17, 26, 27], however, it is usually difficult to exactly know their number and type of their practice [28].

The agenda of establishing collaboration between the traditional and modern health services has long been advocated by the World Health Organization (WHO) to improve access to mental health care [29, 30]. Understanding FTHs in terms of basic socioeconomic and demographic characteristics, modalities of healing practices (what and how they are practicing), users’ physiognomies and healers explanatory models of mental illness as well as their attitude towards bio-medical service and intention to collaborate helps the development of evidence informed strategies to improve access to timely bio-medical care for Seever Mental Disorders (SMDs). Although traditional healers are an important part of Ethiopia societies, information about the extent and characteristic of healing and the people involved in the practice is limited [30]. This knowledge is important first step to introduce interventions as well as scale up of mental healthcare.

The main purpose of this study was to describe the profile of FTHs in a rural district in Ethiopia and their experience in managing mental illnesses. The study is part of the Programme for Improving Mental health care (PRIME), a study which works in this rural district to develop evidence on the best approaches of integrating mental health care [31, 32].