Pathway to psychiatric care in Bali

Abstract

The aim of the present study was to trace the help-seeking pathway of mental patients and to elucidate the role of traditional healing in Bali. The source of care before attending Bangli Mental Hospital (Bali) of 54 consecutive patients with no prior psychiatric treatment was investigated. Subjects who had sought help from traditional healers were asked to evaluate treatment effect retrospectively according to a 5-point scale. The pathway to psychiatric care was dominated by traditional healers. Of the patients, 47 (87.0%) consulted a healer (mean number 2.9) before visiting the mental hospital. Consultation with the healers was associated with treatment delay. However, of the 137 traditional healers on the pathway, 11 (8.0%) recommended that the subjects to go to a mental hospital, and all 11 subjects immediately followed the advice. Of the 47 subjects, 14 (29.8%) evaluated the treatment effect as much improved by at least one traditional healer on the pathway, although they ultimately attended the mental hospital. Subjects without psychotic symptoms tended to evaluate the treatment effect as much improved more often than psychotic subjects. Traditional healers function not only as a barrier to reaching psychiatric care, but as either an effective provider of care or a decision-making support for seeking help from psychiatric care for some mental patients in Bali. The knowledge and recognition of psychological disorders by the traditional healers are crucial for early treatment intervention for psychiatric patients.

The role of global traditional and complementary systems of medicine in the treatment of mental health disorders

“…Practitioners of orthodox medicine will have to deal with the fundamental clash of ideologies between the Western view based in a materialistic empiricism, and the TH worldview based in magic, religion and sorcery 96,105 . Such practitioners may also be concerned about evidence suggesting that patients attending TH may be less likely to comply with biomedical treatment 96 , are more likely to have longer duration of untreated psychosis and about some of the potentially harmful practices employed by TH such as the use of toxic potions, physical beatings, inhumane restraints and longer duration of untreated psychosis 115,116,117 . On the other hand, given the important role of ritual and symbolism in traditional healing practice, TH may feel that their effectiveness is undermined by any collaborative arrangement that discourages the use of ritual and symbolism 118 .…”

Roles of Religious and Spiritual Advisors Among Adults in Singapore With Mental Illnesses

“…Religious beliefs may also affect medical decision making, generate beliefs that conflict with medical care, induce spiritual struggles that create stress and impair health outcomes, and interfere with disease detection and treatment compliance (8). Most of the studies conducted in Asia have focused on help-seeking behavior among people with mental health problems (16)(17)(18)(19) or the role of religion and spirituality in coping with mental health problems (20,21).…”

Implementing an innovative intervention to increase research capacity for enhancing early psychosis care in Indonesia

“…This leads to unscientific practices such as ritual healing and invoking black magic. Of the small amount of research conducted on this population, we know that routes of access to care are diverse and varied typically involving traditional healers, community leaders with much less involvement from organized care (Kurihara, Kato, Reverger, & Tirta, 2006b;Marthoenis, Aichberger, & Schouler-Ocak, 2016).…”