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Stigma is of central importance to people with mental illness and their families. It impacts how they experience their illness and access available health services. An important principle in mental healthcare is empowering patients to live independently and productively, which requires optimal caring from family members. Stigma can seriously hinder this principle. This qualitative study was based on Straussian grounded theory. Participants were 25 family members of people with mental illness. Data were collected through semi-structured interviews, field notes and memos, and managed using Paillé data analysis. We extracted four interrelated categories: pasung (confinement), demonic/devil possession, alternative treatments and social isolation. Because of misunderstandings about mental illness, participants turned to alternative treatments provided by shamans and religious leaders. Participants reported being expelled from or isolated by their community, suggesting stigma is a reality experienced by families of people with mental illness in Indonesia. Addressing family stigma is important to ensure on-going support for patients and families. It is also important to develop and evaluate anti-stigma interventions in the Indonesian context. The present findings are relevant for mental healthcare professionals, related practice areas where families may be exposed to stigmatization and for international audiences with similar cultural and religious contexts. [ABSTRACT FROM AUTHOR]

Background: Stigma refers to the discrediting, devaluing, and shaming of a person because of characteristics or attributes that they possess. Generally, stigma leads to negative social experiences such as isolation, rejection, marginalization, and discrimination. If related to a health condition such as mental illness, stigma may affect a person's illness and treatment course, including access to appropriate and professional medical treatment. Stigma has also been reported to affect patients' families or relatives, along with professionals who work in mental healthcare settings. Stigma is strongly influenced by cultural and contextual value systems that differ over time and across contexts. However, limited information is available on how types of stigma are experienced by patients with mental illness and mental health nurses in Indonesia. Method: We explored the stigma-related experiences of 15 nurses and 15 patients in Indonesia. The study design and analysis of interview data were guided by deductive (directed) content analysis. Results: Five themes emerged. Four themes were patient-related: personal/patients' stigma, public/social stigma, family stigma, and employment stigma. The fifth theme related to stigma toward healthcare professionals working with patients with mental illnesses, which we categorized as professional stigma. Conclusions: This study has achieved a deep understanding of the concept of stigma in the Indonesian context. This understanding is a prerequisite for developing appropriate interventions that address this phenomenon and thereby for the development of mental health services in Indonesia. This study may also be transferable to other countries that share similar cultural backgrounds and adhere to traditional and religious value systems. [ABSTRACT FROM AUTHOR]