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International Journal of Mental Health Systems
Published in: International Journal of Mental Health Systems 1/2018

Open Access 01-12-2018 | Research

Perceptions about pasung (physical restraint and confinement) of schizophrenia patients: a qualitative study among family members and other key stakeholders in Bogor Regency, West Java Province, Indonesia 2017

Authors: Nenden Hikmah Laila, Renti Mahkota, Tri Krianto, Siddharudha Shivalli

Published in: International Journal of Mental Health Systems | Issue 1/2018

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Abstract

Background

The UN resolution recommends treating all mentally ill patients with humanity and respect. However, social stigma continues to prevail for patients with schizophrenia. Physical restraint and confinement of the mentally ill is a well-known phenomenon in Indonesia and is termed as pasung.

Objective

To explore the perceptions of family members of patients of schizophrenia and other key stakeholders concerning pasung in Bogor Regency, West Java Province 2017.

Methods

This qualitative exploratory study was conducted in Bogor Regency, West Java Province from May to June 2017. This study involved 12 key stakeholders including family members, neighbors, community leaders, and mental health officers. In-depth interviews were conducted with family members (n = 3) who practiced pasung for patients with schizophrenia and key informant interviews of neighbors, community leaders (two household heads and one from a health cadre) (n = 3) and mental health officers of puskesmas (three midwives). Data triangulation was performed by interviewing residents and mental health workers. Content analysis was conducted and themes were identified based on valid inference and interpretation.

Results

Family members and society in general perceived that pasung is necessary for security reasons due to the patient’s aggressive behavior such as physical violence to neighbors, stealing food etc. According to community leaders, families often do not respond to patient’s request to be released from pasung. Family members had financial constraints to seek mental healthcare and were also dissatisfied with available services. Healthcare providers highlighted the poor knowledge and prevailing misconceptions about schizophrenia in the community.

Conclusion

Concurrent efforts to strengthen basic mental health services and health education regarding schizophrenia, prevalent misconceptions, and importance of timely and appropriate treatment are needed, especially in rural settings.
Literature
1.
2.
3.
Daulima N. Proses pengambilan keputusan tindakan pasung oleh keluarga terhadap klien gangguan jiwa. Depok: Universitas Indonesia; 2014.
4.
5.
6.
Irmansyah I, Prasetyo YA, Minas H. Human rights of persons with mental illness in Indonesia: more than legislation is needed. Int J Ment Health Syst. 2009;3(1):14.CrossRefPubMedPubMedCentral
7.
Wirya A. Rezim Kebenaran Rasionalisme dalam Diskursus Kegilaan dan Tindakan Pendisiplinan Pasung sebagai Kejahatan. J Kriminol Indones. 2017;9(2):1–19.
8.
Firdaus F. Pemenuhan Hak Atas Kesehatan Bagi Penyandang Skizofrenia di Daerah Istimewa Yogyakarta (rights fulfillment on health of people with Schizophrenia In special region of Yogyakarta). J Ilm Kebijak Huk. 2007;10(1):87–103.
9.
Andreasen N, Black D. Introductory textbook of psychiatry. 4th ed. Washington, DC: American Psychiatric Publishing, Inc; 2006.
10.
Canada Ms. Schizophrenia: a hand book for family. Yogyakarta: Dozz; 2005.
11.
Balitbang Kemenkes R. Riset Kesehatan Dasar; RISKESDAS. Jakarta: Balitbang Kemenkes RI; 2013.
12.
P2P. Laporan Orang dengan Gangguan Jiwa. Kabupaten Bogor: Dinas Kesehatan; 2017.
13.
Sheth H. Human rights of mentally ill Clients. Int J Psychosoc Rehabil. 2016;20(2):25–33.
14.
Theodore D. Human rights in India; Mental health perspectives. 2009.
15.
Patel V. Universal health coverage for schizophrenia: a global mental health priority. Schizophr Bull. 2016;42(4):885–90.CrossRefPubMed
16.
17.
18.
Alem A. Human rights and psychiatric care in Africa with particular reference to the Ethiopian situation. Acta Psychiatr Scand Suppl. 2000;399:93–6.CrossRefPubMed
19.
Guan L, Liu J, Wu XM, Chen D, Wang X, Ma N, et al. Unlocking patients with mental disorders who were in restraints at home: a national follow-up study of China’s new public mental health initiatives. PLoS ONE. 2015;10(4):e0121425.CrossRefPubMedPubMedCentral
20.
Tyas T. Pasung: family experience of dealing with “the deviant” in Bireuen, Nanggroe Aceh Darussalam, Indonesia. University of Amsterdam: Faculty of Social and Behavioural Sciences; 2008.
21.
Asher L, Fekadu A, Teferra S, De Silva M, Pathare S, Hanlon C. “I cry every day and night, I have my son tied in chains”: physical restraint of people with schizophrenia in community settings in Ethiopia. Global Health. 2017;13(1):47.CrossRefPubMedPubMedCentral
22.
Read UM, Adiibokah E, Nyame S. Local suffering and the global discourse of mental health and human rights: an ethnographic study of responses to mental illness in rural Ghana. Global Health. 2009;5(1):13.CrossRefPubMedPubMedCentral
23.
“Like a death sentence”: abuses against persons with mental disabilities in Ghana. In Human rights watch; 2012.
24.
Marrow J, Luhrmann T. The zone of social abandonment in cultural geography: on the street in the United States, inside the family in India. Cult Med Psychiatry. 2012;36(3):493–513.CrossRefPubMed
25.
Ekawati FM, Claramita M, Hort K, Furler J, Licqurish S, Gunn J. Patients’ experience of using primary care services in the context of Indonesian universal health coverage reforms. Asia Pac Fam Med. 2017;16:4.CrossRefPubMedPubMedCentral
26.
Ramacciotti CE, Paoli RA, Catena M, Ciapparelli A, Dell’Osso L, Schulte F, et al. Schizophrenia and binge-eating disorders. J Clin Psychiatry. 2004;65(7):1016–7.CrossRefPubMed
27.
Lundgren JD, Allison KC, Crow S, O’Reardon JP, Berg KC, Galbraith J, et al. Prevalence of the night eating syndrome in a psychiatric population. Am J Psychiatry. 2006;163(1):156–8.CrossRefPubMed
28.
Lundgren JD, Rempfer MV, Brown CE, Goetz J, Hamera E. The prevalence of night eating syndrome and binge eating disorder among overweight and obese individuals with serious mental illness. Psychiatry Res. 2010;175(3):233–6.CrossRefPubMedPubMedCentral
29.
Palmese LB, DeGeorge PC, Ratliff JC, Srihari VH, Wexler BE, Krystal AD, et al. Insomnia is frequent in schizophrenia and associated with night eating and obesity. Schizophr Res. 2011;133(1–3):238–43.CrossRefPubMedPubMedCentral
30.
Palmese LB, Ratliff JC, Reutenauer EL, Tonizzo KM, Grilo CM, Tek C. Prevalence of night eating in obese individuals with schizophrenia and schizoaffective disorder. Compr Psychiatry. 2013;54(3):276–81.CrossRefPubMed
31.
Kouidrat Y, Amad A, Lalau J-D, Loas G. Eating Disorders in Schizophrenia: implications for research and management. Schizophr Res Treat. 2014;2014:1–7.CrossRef
32.
33.
Joint Commission on Accreditation of Health Care Organization: Restraint and Seclusion Standards. Comprehensive Accreditation Manual for Hospitals. Oakbrook Terrace, Illinois: JCAHO; 2001.
34.
Drew N, Funk M, Tang S, Lamichhane J, Chávez E, Katontoka S, et al. Human rights violations of people with mental and psychosocial disabilities: an unresolved global crisis. Lancet. 2011;378(9803):1664–75.CrossRefPubMed
35.
36.
Lancet Global Mental Health Group, Chisholm D, Flisher AJ, Lund C, Patel V, Saxena S, et al. Scale up services for mental disorders: a call for action. Lancet. 2007;370(9594):1241–52.CrossRef
37.
Wong FKD, Lam YKA, Poon A. Knowledge and preferences regarding schizophrenia among Chinese-speaking Australians in Melbourne, Australia. Soc Psychiatry Psychiatr Epidemiol. 2010;45(9):865–73.CrossRefPubMed
38.
Economou M, Richardson C, Gramandani C, Stalikas A, Stefanis C. Knowledge about schizophrenia and attitudes towards people with schizophrenia in Greece. Int J Soc Psychiatry. 2009;55(4):361–71.CrossRefPubMed
39.
Coton X, Poly S, Hoyois P, Sophal C, Dubois V. The healthcare-seeking behaviour of schizophrenic patients in Cambodia. Int J Soc Psychiatry. 2008;54(4):328–37.CrossRefPubMed
40.
Jacob K. Community care for people with mental disorders in developing countries: problems and possible solutions. Br J Psychiatry. 2001;178(04):296–8.CrossRefPubMed
41.
Girma E, Tesfaye M. Patterns of treatment seeking behavior for mental illnesses in Southwest Ethiopia: a hospital based study. BMC Psychiatry. 2011;11(1):138.CrossRefPubMedPubMedCentral
42.
Chong S, Mythily, Lum A, Chan Y, McGorry P. Determinants of duration of untreated psychosis and the pathway to care in Singapore. Int J Soc Psychiatry. 2005;51(1):55–62.CrossRefPubMed
43.
Jorm A. Mental health literacy: empowering the community to take action for better mental health. Am Psychol. 2012;67(3):231–43.CrossRefPubMed
44.
Marthoenis M, Aichberger M, Schouler-Ocak M. Patterns and determinants of treatment seeking among previously untreated psychotic patients in Aceh province, Indonesia: a qualitative study. Scientifica. 2016;2016:1–7.CrossRef
45.
Hass LJ. Handbook of primary care psychology. New York: Oxford University Press; 2004.
46.
Setiyawati D, Colucci E, Blashki G, Wraith R, Minas H. International experts’ perspectives on a curriculum for psychologists working in primary health care: implication for Indonesia. Health Psychol Behav Med. 2014;2(1):770–84.CrossRefPubMedPubMedCentral
47.
48.
Maharani D. Pemasungan, Cermin Buruknya Pelayanan Kesehatan Jiwa. 2014.
49.
Agung. Psikolog di Puskesmas, Solusi Kesehatan Jiwa di Indonesia. 2011.
50.
Crouch M, McKenzie H. The logic of small samples in interview-based qualitative research. Soc Sci Inf. 2006;45(4):483–99.CrossRef
51.
Guest G, Bunce A, Johnson L. How many interviews are enough? Field Methods. 2006;18(1):59–82.CrossRef
Metadata
Title
Perceptions about pasung (physical restraint and confinement) of schizophrenia patients: a qualitative study among family members and other key stakeholders in Bogor Regency, West Java Province, Indonesia 2017
Authors
Nenden Hikmah Laila
Renti Mahkota
Tri Krianto
Siddharudha Shivalli
Publication date
01-12-2018
Publisher
BioMed Central
Published in
International Journal of Mental Health Systems / Issue 1/2018
Electronic ISSN: 1752-4458
DOI
https://doi.org/10.1186/s13033-018-0216-0

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