The use of pasung for people with mental illness: a systematic review and narrative synthesis
Abstract Background Pasung is the term used in Indonesia and a number of other countries for seclusion and restraint of people with mental illness in the community, usually at home by their family. While pasung has been banned because it is contrary to human rights, its practice continues to exist w...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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BMC
2020-12-01
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| Series: | International Journal of Mental Health Systems |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13033-020-00424-0 |
| _version_ | 1818599927901585408 |
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| author | Muhamad Taufik Hidayat Sharon Lawn Eimear Muir-Cochrane Candice Oster |
| author_facet | Muhamad Taufik Hidayat Sharon Lawn Eimear Muir-Cochrane Candice Oster |
| author_sort | Muhamad Taufik Hidayat |
| collection | DOAJ |
| description | Abstract Background Pasung is the term used in Indonesia and a number of other countries for seclusion and restraint of people with mental illness in the community, usually at home by their family. While pasung has been banned because it is contrary to human rights, its practice continues to exist within the community, particularly where community mental health services are limited, and in the absence of adequate social support, and pervasive negatives beliefs about mental illness. It is essential to understand the reasons for the ongoing use of pasung and to examine potential solutions. Methods A systematic review and narrative synthesis of peer-reviewed international literature was conducted to identify the socio-cultural contexts for pasung use, and interventions to address it. The analysis draws on the socio-ecological framework, which focused on relationships between the individual and their environment. Result Fifty published articles were included in the review; all studies were conducted in Asia and Africa, with 32 undertaken in Indonesia. Most studies were qualitative (n = 21). Others included one case–control study, one cross-sectional study, and seven surveys; only four studies examined the application of an intervention, and each used a pre and post methodology. Of these, two studies tested psychoeducational interventions which aimed to overcome family burden due to pasung, and each suggested a community mental health approach. The remaining two studies evaluated the intervention of ‘unlocking’; one study used a community-based culturally sensitive approach, and the other used a community-based rehabilitation program. Reasons for pasung given by family appear to be as a last resort and in the absence of other supports to help them care for the person with severe mental illness. Conclusion The findings highlight that a mixture of individual, interpersonal, community and policy interventions are needed to reduce the use of pasung. While consumer and carer involvement as part of a socio-ecological approach is understood to be effective in reducing pasung, an understanding of how to elaborate this in the management of pasung remains elusive. Review Registration CRD42020157543: CRD |
| first_indexed | 2024-12-16T12:27:23Z |
| format | Article |
| id | doaj.art-d9ff0fcfb2ac4417bff7e045f07db8d9 |
| institution | Directory Open Access Journal |
| issn | 1752-4458 |
| language | English |
| last_indexed | 2024-12-16T12:27:23Z |
| publishDate | 2020-12-01 |
| publisher | BMC |
| record_format | Article |
| series | International Journal of Mental Health Systems |
| spelling | doaj.art-d9ff0fcfb2ac4417bff7e045f07db8d92022-12-21T22:31:48ZengBMCInternational Journal of Mental Health Systems1752-44582020-12-0114112110.1186/s13033-020-00424-0The use of pasung for people with mental illness: a systematic review and narrative synthesisMuhamad Taufik Hidayat0Sharon Lawn1Eimear Muir-Cochrane2Candice Oster3College of Medicine and Public Health, Flinders UniversityCollege of Medicine and Public Health, Flinders UniversityCollege of Nursing and Health Sciences, Flinders UniversityCollege of Medicine and Public Health, Flinders UniversityAbstract Background Pasung is the term used in Indonesia and a number of other countries for seclusion and restraint of people with mental illness in the community, usually at home by their family. While pasung has been banned because it is contrary to human rights, its practice continues to exist within the community, particularly where community mental health services are limited, and in the absence of adequate social support, and pervasive negatives beliefs about mental illness. It is essential to understand the reasons for the ongoing use of pasung and to examine potential solutions. Methods A systematic review and narrative synthesis of peer-reviewed international literature was conducted to identify the socio-cultural contexts for pasung use, and interventions to address it. The analysis draws on the socio-ecological framework, which focused on relationships between the individual and their environment. Result Fifty published articles were included in the review; all studies were conducted in Asia and Africa, with 32 undertaken in Indonesia. Most studies were qualitative (n = 21). Others included one case–control study, one cross-sectional study, and seven surveys; only four studies examined the application of an intervention, and each used a pre and post methodology. Of these, two studies tested psychoeducational interventions which aimed to overcome family burden due to pasung, and each suggested a community mental health approach. The remaining two studies evaluated the intervention of ‘unlocking’; one study used a community-based culturally sensitive approach, and the other used a community-based rehabilitation program. Reasons for pasung given by family appear to be as a last resort and in the absence of other supports to help them care for the person with severe mental illness. Conclusion The findings highlight that a mixture of individual, interpersonal, community and policy interventions are needed to reduce the use of pasung. While consumer and carer involvement as part of a socio-ecological approach is understood to be effective in reducing pasung, an understanding of how to elaborate this in the management of pasung remains elusive. Review Registration CRD42020157543: CRDhttps://doi.org/10.1186/s13033-020-00424-0PasungLived experienceSystematic reviewNarrative synthesisCommunity mental healthRestraint |
| spellingShingle | Muhamad Taufik Hidayat Sharon Lawn Eimear Muir-Cochrane Candice Oster The use of pasung for people with mental illness: a systematic review and narrative synthesis International Journal of Mental Health Systems Pasung Lived experience Systematic review Narrative synthesis Community mental health Restraint |
| title | The use of pasung for people with mental illness: a systematic review and narrative synthesis |
| title_full | The use of pasung for people with mental illness: a systematic review and narrative synthesis |
| title_fullStr | The use of pasung for people with mental illness: a systematic review and narrative synthesis |
| title_full_unstemmed | The use of pasung for people with mental illness: a systematic review and narrative synthesis |
| title_short | The use of pasung for people with mental illness: a systematic review and narrative synthesis |
| title_sort | use of pasung for people with mental illness a systematic review and narrative synthesis |
| topic | Pasung Lived experience Systematic review Narrative synthesis Community mental health Restraint |
| url | https://doi.org/10.1186/s13033-020-00424-0 |
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