M. A. Subandi1, Carla Marchira1, Mary-Jo DelVecchio Good2, Byron J Good2; 1Gadjah Mada University, 2Harvard Medical School
The cultural understanding of illness among caregivers of first episode psychotic persons is a crucial issue. Not only does it influences caregivers’ care-seeking behavior and length of time until receiving medical treatment (known as DUP, the Duration of Untreated Psychosis), but also in turn predicts outcome of illness. Purpose: This paper aims to explore cultural understanding and care-seeking behavior among caregivers of psychotic patients in Java Indonesia. Methods: Data for this paper were taken from several studies conducted by our research group in Yogyakarta, Indonesia. Methods of data collection include an epidemiological survey, ethnographic fieldwork, in depth interviews, and an intervention program. Findings: Results of analyses within and across studies indicate that caregivers employed diverse cultural explanatory model in understanding psychotic illness. Local cultural understandings, including possession and forms of black magic, were among the most common initial concepts used by family members in relation to psychosis. This echoes broader cultural beliefs in Java. However, it was not uncommon that caregivers also understood illness in psychological terms (frustration, dissapointment, and stress) and using medical explanations. Caregivers’ understanding of illness also changed over time, following the changing course of illness. Both models of illness and rapidity of care-seeking is also related to acuteness of onset. Conclusion: It is important for mental health providers, as well as those designing systems of care, to understand the diversity and changing nature of caregivers cultural understandings of psychotic illness.
