Abstract

Stigma is of central importance to people with mental illness and their families. It impacts how they experience their illness and access available health services. An important principle in mental healthcare is empowering patients to live independently and productively, which requires optimal caring from family members. Stigma can seriously hinder this principle. This qualitative study was based on Straussian grounded theory. Participants were 25 family members of people with mental illness. Data were collected through semi-structured interviews, field notes and memos, and managed using Paillé data analysis. We extracted four interrelated categories: pasung (confinement), demonic/devil possession, alternative treatments and social isolation. Because of misunderstandings about mental illness, participants turned to alternative treatments provided by shamans and religious leaders. Participants reported being expelled from or isolated by their community, suggesting stigma is a reality experienced by families of people with mental illness in Indonesia. Addressing family stigma is important to ensure on-going support for patients and families. It is also important to develop and evaluate anti-stigma interventions in the Indonesian context. The present findings are relevant for mental healthcare professionals, related practice areas where families may be exposed to stigmatization and for international audiences with similar cultural and religious contexts.

摘要

对于精神疾病患者及其家人来说，耻辱至关重要。它影响他们如何经历疾病和获得可用的医疗服务。精神保健的一个重要原则是使患者能够独立且富有成效地生活，这需要家庭成员的最佳护理。耻辱会严重阻碍这一原则。这项定性研究基于施特劳斯扎根理论。参与者是 25 名精神疾病患者的家庭成员。通过半结构化访谈、现场笔记和备忘录收集数据，并使用 Paillé 数据分析进行管理。我们提取了四个相互关联的类别：pasung（禁闭）、恶魔/魔鬼附体、替代疗法和社会隔离。由于对精神疾病的误解，参与者转向萨满和宗教领袖提供的替代疗法。参与者报告说，他们被社区驱逐或孤立，这表明印度尼西亚精神疾病患者的家人面临着耻辱。解决家庭耻辱对于确保为患者和家庭提供持续支持非常重要。在印度尼西亚背景下制定和评估反耻辱干预措施也很重要。目前的研究结果与精神保健专业人员、家庭可能遭受污名化的相关实践领域以及具有相似文化和宗教背景的国际受众相关。表明耻辱是印度尼西亚精神疾病患者家庭所经历的现实。解决家庭耻辱对于确保为患者和家庭提供持续支持非常重要。在印度尼西亚背景下制定和评估反耻辱干预措施也很重要。目前的研究结果与精神保健专业人员、家庭可能遭受污名化的相关实践领域以及具有相似文化和宗教背景的国际受众相关。表明耻辱是印度尼西亚精神疾病患者家庭所经历的现实。解决家庭耻辱对于确保为患者和家庭提供持续支持非常重要。在印度尼西亚背景下制定和评估反耻辱干预措施也很重要。目前的研究结果与精神保健专业人员、家庭可能遭受污名化的相关实践领域以及具有相似文化和宗教背景的国际受众相关。