Presentation Information
[O-4-04]Cultural Explanatory Models of Mental Illness in Southeast Asia and Their Impact on Help Seeking and Clinical Practice: A Systematic Review
*Charlotte Alyssia Jonatan1, Claudya Hadilianti1, Darien Alfa Cipta1,2 (1.Department of Medicine, Universitas Pelita Harapan, Tangerang(Indonesia), 2.Department of Psychiatry, Siloam Hospitals Lippo Village, Tangerang(Indonesia))
Keywords:
Cultural Explanatory Models,Help-Seeking Behavior,Mental Health in South-East Asia
Background:
Cultural explanatory models rooted in spiritual, supernatural, and psychosocial worldviews remain highly influential in Southeast Asia. These models shape how individuals interpret mental health symptoms, often guiding help-seeking behavior and impacting stigma, diagnosis, and service engagement. As a result, they contribute to treatment delays, misdiagnosis, and underutilization of psychiatric care.
Objective:
This review aimed to systematically examine the dominant cultural explanatory models of mental illness across Southeast Asia and assess their influence on help-seeking behavior, stigma, and clinical practice outcomes.
Methods:
This review analyzed 16 peer-reviewed studies using qualitative, cross-sectional, and mixed-method designs across Southeast Asia. Studied populations included ethnic minorities, religious leaders, healthcare providers, and community members. The review examined dominant explanatory models, help-seeking pathways, and clinical implications in conditions such as depression, schizophrenia, anxiety, and perinatal disorders.
Results:
Supernatural and spiritual explanations were predominant. In Malaysia, mental illness was attributed to witchcraft, black magic, spirit possession, and loss of “semangat”. Indonesian beliefs centered on jinn, curses, and energy imbalance. Vietnamese and Cambodian views emphasized karma, ghost-related causes, and spiritual loss, while Thai models integrated Buddhist ideas of merit and karmic debt. Help-seeking followed a pluralistic, staged process beginning with family, traditional, or religious healers, and later biomedical services leading to delays, misdiagnosis, and reduced treatment adherence. Rural communities exhibited stronger reliance on traditional models and faced greater access barriers.
Discussion:
Cultural models significantly influence mental illness recognition, stigma, and clinical engagement in Southeast Asia. Individuals often prioritize traditional and spiritual care before accessing psychiatric services. These findings underscore the need for culturally adapted diagnostic practices, community-informed psychoeducation, and clinician training in culturally responsive care. Aligning psychiatric services with local belief systems through policy initiatives and cross-sector collaboration, including with traditional and religious healers could improve help-seeking, diagnostic accuracy, and long-term mental health outcomes.
Cultural explanatory models rooted in spiritual, supernatural, and psychosocial worldviews remain highly influential in Southeast Asia. These models shape how individuals interpret mental health symptoms, often guiding help-seeking behavior and impacting stigma, diagnosis, and service engagement. As a result, they contribute to treatment delays, misdiagnosis, and underutilization of psychiatric care.
Objective:
This review aimed to systematically examine the dominant cultural explanatory models of mental illness across Southeast Asia and assess their influence on help-seeking behavior, stigma, and clinical practice outcomes.
Methods:
This review analyzed 16 peer-reviewed studies using qualitative, cross-sectional, and mixed-method designs across Southeast Asia. Studied populations included ethnic minorities, religious leaders, healthcare providers, and community members. The review examined dominant explanatory models, help-seeking pathways, and clinical implications in conditions such as depression, schizophrenia, anxiety, and perinatal disorders.
Results:
Supernatural and spiritual explanations were predominant. In Malaysia, mental illness was attributed to witchcraft, black magic, spirit possession, and loss of “semangat”. Indonesian beliefs centered on jinn, curses, and energy imbalance. Vietnamese and Cambodian views emphasized karma, ghost-related causes, and spiritual loss, while Thai models integrated Buddhist ideas of merit and karmic debt. Help-seeking followed a pluralistic, staged process beginning with family, traditional, or religious healers, and later biomedical services leading to delays, misdiagnosis, and reduced treatment adherence. Rural communities exhibited stronger reliance on traditional models and faced greater access barriers.
Discussion:
Cultural models significantly influence mental illness recognition, stigma, and clinical engagement in Southeast Asia. Individuals often prioritize traditional and spiritual care before accessing psychiatric services. These findings underscore the need for culturally adapted diagnostic practices, community-informed psychoeducation, and clinician training in culturally responsive care. Aligning psychiatric services with local belief systems through policy initiatives and cross-sector collaboration, including with traditional and religious healers could improve help-seeking, diagnostic accuracy, and long-term mental health outcomes.