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.

The aim of this study was to assess the effectiveness of a spiritual-hypnosis assisted therapy (SHAT) for treatment of posttraumatic stress disorder (PTSD) in children. All children, age 6-12 years (N=226; 52.7% females), who experienced the terrorist bomb blasts in Bali in 2002, and subsequently were diagnosed with PTSD were studied, through a longitudinal, quasi-experimental (pre-post test), single-blind, randomized control design. Of them, 48 received group SHAT (treatment group), and 178 did not receive any therapy (control group). Statistically significant results showed that SHAT produced a 77.1% improvement rate, at a two-year follow up, compared to 24% in the control group, while at the same time, the mean PTSD symptom score differences were significantly lower in the former group. We conclude that the method of spiritual-hypnosis is highly effective, economic, and easily implemented, and has a potential for therapy of PTSD in other cultures or other catastrophic life-threatening events.

Balinese women face the dilemma of maintaining their vital role amid a rapidly changing society. In Bali, the primary female role is one of fostering balance and harmony within families. The Balinese people view women not from the vantage of career success but rather from the vantage of whether they can produce good quality children, and can work as part of a family team. Balinese men and women work together as partners. Indeed, men are not enemies; the genders help and need each other. Values underlying emancipation for women clash with traditional values, leading to frequent misunderstandings. Emancipation advocates neglect those elements necessary for complementing Balinese values. Applying educational and preventative methods, as well as therapeutic innovations to such problems, is helpful at all levels of society.

Patients with minor psychiatric disorders, including neuroses, situational adjustment reaction or acute emotional reaction, were investigated using symptom questionnaires at five research sites in Asia including: Chiang-Mai, Thailand; Bali, Indonesia; Kao-Hsiung, Taiwan, China; Shanghai, China; and Tokyo, Japan. The results revealed that the symptom profiles differ significantly among groups of different settings indicating that sociocultural background does contribute to the manifestation of neurotic symptomatology. It was also found that numerous and various subtypes of somatic scales were identified through factor analysis of symptoms for these Asian populations. It demonstrates that the spectrum of neurotic symptoms has a different focus for subjects in different sociocultural settings.

This paper considers the psychiatrist-traditional healer relationship in clinical management of mental disorders in Bali. It also concerns the role of sociocultural factors in the etiology and management of mental disorder. The basic concepts and therapeutic strategies of Western psychiatry co-exist with the beliefs and methods of traditional healers. Often psychiatrists and traditional healers are involved with the same patients. A clinical case study of an episode of mass dissociative disorder (trance state) in which psychiatrists acted as consultants illustrates the integration of concepts of Western psychiatry and Balinese culture in the diagnostic evaluation and therapeutic strategies.