A Qualitative Exploration of Stakeholder Perceptions of Schizophrenia

Abstract

Objective: Schizophrenia is a severe mental disorder associated with substantial social stigma that impedes patients' access to quality care and social support. In Indonesia, where cultural and religious beliefs strongly influence mental health perceptions, stakeholders’ attitudes critically shape responses to this condition. This study explored how various stakeholder groups perceive schizophrenia in Indonesia.

Method: A phenomenological qualitative design was employed with 29 participants (families, healthcare workers, and policymakers) selected through purposive sampling in Yogyakarta, Indonesia. Data were collected through face-to-face semi-structured in-depth interviews (60-90 minutes), audio-recorded and supplemented by direct observations. Interview transcripts were analyzed using thematic analysis with triangulation and member checking to ensure data validity.

Results: Five main themes emerged: (1) healthcare workers demonstrated clinical understanding, while families showed experiential knowledge; (2) stakeholders recognized multifactorial causation combining genetic and environmental factors; (3) realistic expectations focused on symptom management rather than cure; (4) persistent cultural stigma, rooted in supernatural beliefs, hindered help-seeking; (5) and collaborative family-healthcare worker partnerships were essential for patient stability.

Conclusion: This study provides novel insights into Indonesian stakeholders’ perspectives on schizophrenia, revealing culturally-specific stigma patterns rooted in supernatural beliefs—a factor understudied in Southeast Asian contexts. Findings inform development of targeted anti-stigma interventions and integrated care models that leverage family-healthcare worker collaboration to improve patient outcomes in Indonesia's mental health system.