Paper in European Archives of Psychiatry & Clinical Neuroscience
  • Suryani, L.K., Lesmana, C.B.J. and Tiliopoulos, N. (2011). Treating the untreated: Applying a community-based, culturally sensitive psychiatric intervention to confined and physically restrained mentally ill individuals in Bali, Indonesia. European Archives of Psychiatry & Clinical Neuroscience, 261, 140-144.

    This study identified, mapped and treated the clinical features of  mentally ill people, who had been isolated and restrained by family  and community members as a result of a functional failure of the  traditional medical, hospital-based mental health model currently  practiced in Indonesia. A 10-month epidemiological population survey  was carried out in Karangasem regency of Bali, Indonesia. A total of  404,591 individuals were clinically interviewed, of which 895  individuals with mental health problems were identified, with 23  satisfying criteria of physical restraint and confinement. Of the  latter, twenty were males; age range was 19 - 69 years, all diagnosed by  the researchers with schizophrenia-spectrum disorder (ICD-10  diagnostic criteria). Duration of restraint ranged from 3 months to 30  years (mean = 8.1 years, SD = 8.3 years). Through the application of a  holistic intervention model, all patients exhibited a remarkable  recovery within 19 months of treatment. We conclude that the  development of a community-based, culturally sensitive and respectful  mental health model can serve as an optimum promoter of positive  mental health outcomes.