A scoping review of mental health counseling practices, challenges, and prospects in Ethiopia.

backgroundWhile Ethiopia has a long history of relying on traditional and spiritual practices to support persons with mental health needs, modern mental health counseling is a relatively new field in the country. This scoping review aimed to map the current state of counseling services in Ethiopia and to identify existing practices, service delivery settings, key challenges, and opportunities for growth.

methodA scoping review of literature was made by retrieving 49 published articles from PubMed, Google Scholar and Google. The review included peer-reviewed research articles, conceptual papers, fact sheets and policy reports published in English or Amharic between 1983 and May 9, 2025. A content analysis approach was used to extract and synthesize key themes related to counseling practices, service delivery contexts, challenges, and future prospects.

findingsMental health counseling in Ethiopia is delivered in schools, hospitals, private clinics, and online platforms. Despite the expansion of services, they remain largely inaccessible to the majority of the population, especially in rural areas. Service delivery has been concentrated in urban centers due to increasing demand, globalization, urbanization, and the expansion of counseling education. The future of counseling services in Ethiopia faces several challenges (limited public awareness, stigma, shortage of trained professionals, and poor accessibility); of which the use of Western counseling frameworks without sufficient cultural adaptation was the major one. IMPLICATION: There is an urgent need to develop an Ethiopia-centered counseling approach that integrates cultural relevance with professional practices to better meet the needs of the population.