Confinement of People with Mental Disorders from the Perspective of Spiritual Leaders of Banggai Culture, Indonesia: An Ethnosemantic Approach

Authors

DOI:

https://doi.org/10.60099/prijnr.2024.266871

Keywords:

Confinement, Culture, Ethnosemantics, Indonesia, Mental Disorders, Traditional Healers, Seclusion, Spiritual Leaders, Transcultural Nursing

Abstract

The practice of confinement of people with mental disorders not only infringes upon individuals’ fundamental rights but also contravenes established health legislation, including in Indonesia, the setting for this study. In this country, confinement may be practiced by isolation or seclusion in a room or a small hut built in the family’s garden or rice field, some ten-minute walk from the house to the hut. Leg restraints or shackles may also be used. This study delved into the significance of confining individuals with mental disorders by analyzing the linguistic expressions of spiritual leaders from the Banggai culture in Central Sulawesi, Indonesia. Engaging with cultural and spiritual leaders within a community is imperative to gain insights into the underlying perspectives that influence family decisionmaking processes. This exploration involved a detailed examination of the linguistic expressions these leaders conducted within the cultural context of the Banggai community from March to June 2023. This study employed an ethnosemantic approach and in-depth interviews according to the framework outlined in Spradley’s Developmental Research Sequence model. The participants were 13 cultural and spiritual leaders in the Banggai region, commonly referred to as Talapu. They were chosen using snowball sampling techniques.
The data-gathering process was facilitated through in-depth interviews structured to incorporate descriptive queries, structured inquiries, and contrasting questions. The data processing involved the analysis of interview transcripts utilizing domain analysis, taxonomic analysis, and component analysis techniques. This analytical approach yielded 11 domains, six taxonomies, and six paradigms, contributing to identifying three distinct cultural themes. These themes were utilizing spiritual rituals as an intervention for the treatment of individuals with mental disorders, the multifaceted roles played by Talapu in managing individuals with mental disorders, and the association between Talapu and the practice of confining individuals with mental disorders. The use of physical restraint and confinement by the Talapu in treating individuals with mental disorders raises ethical concerns, particularly regarding autonomy, non-maleficence, and adherence to international human rights standards in contemporary nursing practice. Nurses in Indonesia should engage in collaborative education with the Talapu, emphasizing the careful and strategic implementation of Indonesia’s health legislation to prohibit human rights infringements, ensuring effective treatment and psychosocial support for individuals with mental disorders, and promoting their seamless integration into family and society.

References

Ulya Z. Coercion (pasung) and people with a mental disorder in Indonesia: bioethics and health law. Int J Law Psychiatry. 2019;66:101477. doi: 10.1016/j.ijlp.2019.101477. DOI: https://doi.org/10.1016/j.ijlp.2019.101477

Minas H, Diatri H. Pasung: physical restraint and confinement of the mentally ill in the community. Int J Ment Health Syst. 2008;2(1):8. doi: 10.1186/1752-4458-2-8. DOI: https://doi.org/10.1186/1752-4458-2-8

Eka AR, Daulima NHC, Susanti H. The role of informal leaders in restraint and confining people with mental health issues in Manggarai, Indonesia. Eur J Ment Health. 2022; 17(1):25–36. DOI: https://doi.org/10.5708/EJMH/17.2022.1.3

Daulima NHC. The decision-making process of family-initiated restraint for clients with mental disorders [Dissertation]. [Depok]: Universitas Indonesia; 2014 (in Indonesian).

Daulima NHC. Preventing Pasung by mentally ill patients’ families. Enferm Clin. 2018;28:256–9. doi: 10.1016/S1130-8621(18)30079-2. DOI: https://doi.org/10.1016/S1130-8621(18)30079-2

Dormeier J. Banggai customary law. Martinus Nijhoff. 1947 (in Dutch). Available from: https://lobo.apps01.yorku.ca/wp-content/uploads/2021/08/Dormeier-1947.pdf

Laila NH, Mahkota R, Shivalli S, Bantas K, Krianto T. Factors associated with pasung (physical restraint and confinement) of schizophrenia patients in Bogor regency, West Java Province, Indonesia 2017. BMC Psychiatry. 2019;19(1):162. doi: 10.1186/s12888-019-2138-z. DOI: https://doi.org/10.1186/s12888-019-2138-z

Perry BL. The labeling paradox: stigma, the sick role, and social networks in mental illness. J Health Soc Behav. 2011;52(4):460–77. doi: 10.1177/0022146511408913. DOI: https://doi.org/10.1177/0022146511408913

Link BG, Phelan JC. Labeling and stigma. In: Aneshensel CS, Phelan JC, Bierman A, editors. Handbook of the sociology of mental health. Springer; 2013. pp. 525–41. DOI: https://doi.org/10.1007/978-94-007-4276-5_25

Hinshaw SP, Cicchetti D. Stigma and mental disorder: conceptions of illness, public attitudes, personal disclosure, and social policy. Dev Psychopathol. 2000;12(4):555–98. doi: 10.1017/S0954579400004028. DOI: https://doi.org/10.1017/S0954579400004028

Koelkebeck K, Uwatoko T, Tanaka J, Kret ME. How culture shapes social cognition deficits in mental disorders: a review. Soc Neurosci. 2017;12(2):102–12. doi: 10.1080/17470919.2016.1155482. DOI: https://doi.org/10.1080/17470919.2016.1155482

Miklowitz DJ. The role of family systems in severe and recurrent psychiatric disorders: a developmental psychopathology view. Dev Psychopathol. 2004;16(3):667-88. doi: 10.1017/S0954579404004729. DOI: https://doi.org/10.1017/S0954579404004729

Kpobi L, Swartz L. ‘That is how the real mad people behave’: beliefs about and treatment of mental disorders by traditional medicine-men in Accra, Ghana. Int J Soc Psychiatry. 2018; 64(4):309–16. doi: 10.1177/0020764018763705. DOI: https://doi.org/10.1177/0020764018763705

Kpobi LNA, Swartz L, Omenyo CN. Traditional herbalists’ methods of treating mental disorders in Ghana. Transcult Psychiatry. 2019;56(1):250–66. doi: 10.1177/1363461518802981. DOI: https://doi.org/10.1177/1363461518802981

Kajawu L, Chingarande SD, Jack H, Ward C, Taylor T. What do African traditional medical practitioners do in the treatment of mental disorders in Zimbabwe? Int J Cult Ment Health. 2016;9(1):44–55. doi: 10.1080/17542863.2015.1106568. DOI: https://doi.org/10.1080/17542863.2015.1106568

Wardani Y. The competencies, roles and scope of practice of advanced psychiatric nursing in Indonesia. Nurse Media J Nurs. 2013;3(2):631–48. doi: 10.14710/nmjnv3i2.6004. DOI: https://doi.org/10.14710/nmjn.v3i2.6004

Moczygemba LR, Osborn RD, Lapane KL. Utilization of behavioral health outpatient therapy and psychiatry services among homeless people recently hospitalized for a psychiatric condition. J Ambul Care Manag. 2014;37(4): 303–13. doi: 10.1097/JAC.0000000000000020. DOI: https://doi.org/10.1097/JAC.0000000000000020

Jordow RL. Patient-centered medical homes: presenting a role for the advanced practice mental health nurse. J Psychosoc Nurs Ment Health Serv. 2014;52(3):26–32. doi: 10.3928/02793695-20131029-03. DOI: https://doi.org/10.3928/02793695-20131029-03

Marriner-Tomey A, Alligood MR. Nursing theorists and their work. Mosby Elsevier; 2006.

Leininger MM, McFarland MR. Transcultural nursing: concepts, theories, research, and practice. 3rd ed. New York: McGraw-Hill, Medical Pub. Division; 2002.

Kurniawati ED. The relationship between transcultural nursing knowledge and self-efficacy in conducting culturally sensitive nursing care among professional nursing students [undergraduate thesis]. [Depok]: Universitas Indonesia; 2016 (in Indonesian).

Butar PO. Self-efficacy in transcultural nursing among nurses in hospitals [undergraduate thesis]. [Depok]: Universitas Indonesia; 2018 (in Indonesian).

Safitri A. Implementation of individual and group psychiatric nursing therapy for anxiety in hypertensive clients using a transcultural nursing approach in Bogor City [undergraduate thesis]. [Depok]: Universitas Indonesia; 2015 (in Indonesian).

Parfitt B. Using Spradley: an ethnosemantic approach to research. J Adv Nurs. 1996;24(2):341–9. doi: 10.1046/j.1365-2648.1996.18616.x. DOI: https://doi.org/10.1046/j.1365-2648.1996.18616.x

Spradley JP. The ethnographic interview. Illinois: Waveland Press; 2017.

Sikolia D, Biros D, Mason M, Weiser M. Trustworthiness of grounded theory methodology research in information systems. MWAIS 2013 Proceedings. 2013;16. Available from: https://aisel.aisnet.org/mwais2013/16

Whittemore R, Chase SK, Mandle CL. Validity in qualitative research. Qual Health Res. 2001;11(4):522–37. doi: 10.1177/104973201129119299. DOI: https://doi.org/10.1177/104973201129119299

Sangasubana N. How to conduct ethnographic research. Qual Rep. 2014;16(2):567–73. doi: 10.46743/2160- 3715/2011.1071.

Anney VN. Ensuring the quality of the findings of qualitative research: looking at trustworthiness criteria. JETERAPS. 2014;5:272–81.

Curtin M, Fossey E. Appraising the trustworthiness of qualitative studies: guidelines for occupational therapists. Aust Occup Ther J. 2007;54(2):88–94. doi: 10.1111/j.1440-630.2007.00661.x. DOI: https://doi.org/10.1111/j.1440-1630.2007.00661.x

Carcary M. The research audit trial—enhancing trustworthiness in qualitative inquiry. Electron J Bus Res Methods. 2009; 7(1):11–24.

Wijaya H. Qualitative data analysis using Spradley’s model (ethnography). Sekolah Tinggi Theologia Jaffray. 2018 (in Indonesian).

Morgan DL, Ataie J, Carder P, Hoffman K. Introducing dyadic interviews as a method for collecting qualitative data. Qual Health Res. 2013;23(9):1276–84. doi: 10.1177/1049732313501889. DOI: https://doi.org/10.1177/1049732313501889

Subu MA, Wati DF, Al-Yateem N, Netrida N, Priscilla V, Dias JM, et al. ‘Family stigma’ among family members of people with mental illness in Indonesia: a grounded theory approach. Int J Ment Health. 2021;52(2):102-23. doi: 10.1080/00207411.2021.1891363. DOI: https://doi.org/10.1080/00207411.2021.1891363

Anjara SG, Brayne C, Van Bortel T. Perceived causes of mental illness and views on appropriate care pathways among Indonesians. Int J Ment Health Syst. 2021;15(1):74. doi: 10.1186/s13033-021-00497-5. DOI: https://doi.org/10.1186/s13033-021-00497-5

Green B, Colucci E. Traditional healers’ and biomedical practitioners’ perceptions of collaborative mental healthcare in low- and middle-income countries: a systematic review. Transcult Psychiatry. 2020;57(1):94–107. doi: 10.1177/1363461519894396. DOI: https://doi.org/10.1177/1363461519894396

Ofori-Atta A, Attafuah J, Jack H, Baning F, Rosenheck R. Joining psychiatric care and faith healing in a prayer camp in Ghana: randomised trial. Br J Psychiatry. 2018; 212(1):34–41. doi: 10.1192/bjp.2017.12. DOI: https://doi.org/10.1192/bjp.2017.12

Kaselionyte J, Gumley A. Psychosis or spiritual emergency? A Foucauldian discourse analysis of case reports of extreme mental states in the context of meditation. Transcult Psychiatry. 2019;56(5):1094–115. doi: 10.1177/1363461519861842. DOI: https://doi.org/10.1177/1363461519861842

Ayinde OO, Fadahunsi O, Kola L, Malla LO, Nyame S, Okoth RA, et al. Explanatory models, illness, and treatment experiences of patients with psychosis using the services of traditional and faith healers in three African countries: similarities and discontinuities. Transcult Psychiatry. 2023;60(3):521-36. doi: 10.1177/13634615211064370. DOI: https://doi.org/10.1177/13634615211064370

Podolsky-Krupper C, Goldner L. “God is a painter”: How Jewish Ultra-Orthodox art therapists and clients perceive mental health treatment. Transcult Psychiatry. 2021;58(6): 731–44. doi: 10.1177/1363461520944742. DOI: https://doi.org/10.1177/1363461520944742

Baheretibeb Y, Soklaridis S, Wondimagegn D, Martimianakis MAT, Law S. Transformative learning in the setting of religious healers: a case study of consultative mental health workshops with religious healers, Ethiopia. Front Psychiatry. 2022;13:897833. doi: 10.3389/fpsyt.2022.897833. DOI: https://doi.org/10.3389/fpsyt.2022.897833

Bekele YY, Flisher AJ, Alem A, Baheretebeb Y. Pathways to psychiatric care in Ethiopia. Psychol Med. 2009;39(3): 475–83. doi: 10.1017/S0033291708003929. DOI: https://doi.org/10.1017/S0033291708003929

Luna MJ, Ameli R, Sinaii N, Cheringal J, Panahi S, Berger A. Gender differences in psycho-social-spiritual healing. J Womens Health (Larchmt). 2019;28(11):1513–21. doi: 10.1089/jwh.2019.7837. DOI: https://doi.org/10.1089/jwh.2019.7837

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Published

2024-03-21

How to Cite

1.
Yoduke F, Daulima NHC, Mustikasari M. Confinement of People with Mental Disorders from the Perspective of Spiritual Leaders of Banggai Culture, Indonesia: An Ethnosemantic Approach. PRIJNR [Internet]. 2024 Mar. 21 [cited 2024 Nov. 13];28(2):333-55. Available from: https://he02.tci-thaijo.org/index.php/PRIJNR/article/view/266871