Those are not the same things and again you are pathologizing a belief system you see to be inferior to your own views.

The majority of people who live within animist cultures that have shamans are polyphasic meaning that they embrace the multiple types of consciousness and Patients as well as shamans interact with the spirit world often. Regardless if one hears a voice that does not mean that they are mentally ill. I and many other people I know hear voices and have experiences just like the ones described by avatar and do not suffer from a mental illness.