“他们认为我们是在努力整合知识,而我们是在努力协调它们”:对促进印度尼西亚精神卫生工作者和治疗师之间成功合作的因素的视觉探索。

IF 2.7 3区 医学 Q1 ANTHROPOLOGY
Transcultural Psychiatry Pub Date : 2025-10-01 Epub Date: 2025-07-22 DOI:10.1177/13634615251338906
Diana Setiyawati, Wulan Nur Jatmika, Ursula M Read, Erminia Colucci
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引用次数: 0

摘要

在印度尼西亚,社区精神卫生的实施是有限的,而且资源不足。Pasung(身体约束和禁闭)仍然普遍使用,许多人没有得到正式的精神保健。虽然传统和信仰治疗和精神科服务的多元使用是常见的,但这两个系统之间的关系是模糊的,在精神卫生政策中被忽视。与此同时,在包括印度尼西亚在内的各种环境中,都有卫生专业人员与传统和基于信仰的治疗师(TFHs)在精神卫生方面进行合作的例子。然而,对参与这种伙伴关系的人(包括精神卫生工作者、治疗师和家庭)的生活经历和日常实践以及他们成功的原因的研究有限。本文介绍了“共同促进精神健康”视觉研究项目的结果,以说明印度尼西亚背景下多元合作的促进因素和障碍。我们的重点是已经建立的伙伴关系,而不是作为研究项目或干预措施的一部分实施的伙伴关系。利用视觉人种学,我们观察了8个案例研究,这些研究地点代表了该国的三种主要宗教:爪哇(主要是穆斯林)、巴厘岛(印度教)和弗洛雷斯(罗马天主教)。我们对20名精神卫生专业人员、12名TFHs、28名精神卫生患者和16名护理人员进行了协作实践的民族学观察和深度访谈。该研究发现,印度尼西亚精神卫生保健多元化合作实践中的促进因素和障碍等主题趋于一致。促进因素包括行动者的角色认知和动机、合作的开放性和关怀的协商。障碍包括消极的角色认知、基础设施不足和不利的社会环境。调查结果表明,利用现有良好做法的经验教训,TFHs与正规精神卫生从业人员之间存在成功合作的潜力。为支持今后精神卫生保健方面的多元化合作,需要将这些经验教训纳入专业教育和政策,并加强精神卫生保健治理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
"They think we are trying to combine knowledges, whereas we are trying to harmonize them": A visual exploration of what promotes successful collaboration between mental health workers and healers in Indonesia.

Implementation of community mental health in Indonesia has been limited and under-resourced. Pasung (physical restraint and confinement) is still commonly used and many people do not receive formal mental health care. While pluralistic use of traditional and faith healing and psychiatric services is common, the relationship between the two systems is ambiguous and overlooked in mental health policy. Meanwhile, examples of collaboration between health professionals and traditional and faith-based healers (TFHs) for mental health exist in various settings, including Indonesia. However, there is limited research on the lived experiences and everyday practices of those engaged in such partnerships, including mental health workers, healers, and families, and what makes them successful. This paper presents findings from the visual research project 'Together for Mental Health' to illustrate the facilitators and barriers to pluralistic collaborations in the Indonesian context. Our focus was on partnerships that were already established, rather than those implemented as part of research projects or interventions. Using visual ethnography, we observed eight case studies in locations representative of the three main religions in the country: Java (predominantly Muslim), Bali (Hindu), and Flores (Roman Catholic). We conducted filmed ethnographic observations of collaborative practices and in-depth interviews with 20 mental health professionals, 12 TFHs, 28 people living with mental health conditions, and 16 caregivers. The study found converging themes related to facilitating factors and barriers in practices of pluralistic collaboration for mental health care in Indonesia. Facilitating factors included actors' role perception and motive, openness to collaboration, and negotiations of care. Barriers included negative role perceptions, inadequate infrastructure, and unfavourable social environments. Findings suggest potential for successful collaboration between TFHs and formal mental health practitioners, drawing on lessons from existing good practices. To support future pluralistic collaboration for mental health care, incorporating these lessons into professional education and policies and stronger mental health care governance are needed.

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来源期刊
CiteScore
5.10
自引率
12.00%
发文量
93
期刊介绍: Transcultural Psychiatry is a fully peer reviewed international journal that publishes original research and review articles on cultural psychiatry and mental health. Cultural psychiatry is concerned with the social and cultural determinants of psychopathology and psychosocial treatments of the range of mental and behavioural problems in individuals, families and human groups. In addition to the clinical research methods of psychiatry, it draws from the disciplines of psychiatric epidemiology, medical anthropology and cross-cultural psychology.
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