Confinement of People with Mental Disorders from the Perspective of Spiritual Leaders of Banggai Culture, Indonesia: An Ethnosemantic Approach

Abstract

The practice of confinement of people with mental disorders not only infringes upon individuals’ fundamental rights but also contravenes established health legislation, including in Indonesia, the setting for this study. In this country, confinement may be practiced by isolation or seclusion in a room or a small hut built in the family’s garden or rice field, some ten-minute walk from the house to the hut. Leg restraints or shackles may also be used. This study delved into the significance of confining individuals with mental disorders by analyzing the linguistic expressions of spiritual leaders from the Banggai culture in Central Sulawesi, Indonesia. Engaging with cultural and spiritual leaders within a community is imperative to gain insights into the underlying perspectives that influence family decisionmaking processes. This exploration involved a detailed examination of the linguistic expressions these leaders conducted within the cultural context of the Banggai community from March to June 2023. This study employed an ethnosemantic approach and in-depth interviews according to the framework outlined in Spradley’s Developmental Research Sequence model. The participants were 13 cultural and spiritual leaders in the Banggai region, commonly referred to as Talapu. They were chosen using snowball sampling techniques.The data-gathering process was facilitated through in-depth interviews structured to incorporate descriptive queries, structured inquiries, and contrasting questions. The data processing involved the analysis of interview transcripts utilizing domain analysis, taxonomic analysis, and component analysis techniques. This analytical approach yielded 11 domains, six taxonomies, and six paradigms, contributing to identifying three distinct cultural themes. These themes were utilizing spiritual rituals as an intervention for the treatment of individuals with mental disorders, the multifaceted roles played by Talapu in managing individuals with mental disorders, and the association between Talapu and the practice of confining individuals with mental disorders. The use of physical restraint and confinement by the Talapu in treating individuals with mental disorders raises ethical concerns, particularly regarding autonomy, non-maleficence, and adherence to international human rights standards in contemporary nursing practice. Nurses in Indonesia should engage in collaborative education with the Talapu, emphasizing the careful and strategic implementation of Indonesia’s health legislation to prohibit human rights infringements, ensuring effective treatment and psychosocial support for individuals with mental disorders, and promoting their seamless integration into family and society.