Introduction

This chapter considers how the adoption of psychiatric values and practices imported from Europe in the nineteenth century has had an impact on local populations in the Malayan region, with a specific focus on Sarawak. In doing so, it draws upon two main areas of discussion. The first focuses on how psychiatry as a discipline has traditionally sought scientific and cultural hegemony in relation to existing and adapting healing methods that are indigenous to this region. Psychiatric service user views are used in conjunction with those of traditional healers to illustrate the issues that emerge from this background of competing and overlapping paradigms of healing. The second part considers two aspects of the process of socialization that women patients experience upon hospitalization in terms of gendered notions of appropriate care that is not always closely compatible with traditional and cultural norms.

This account is supported primarily by findings developed from a recently completed ethnographic study of mental health and women service users in Sarawak. The study sought to privilege the experiences of patients at a local psychiatric hospital and serves to balance more numerous, medically orientated studies focusing only on the pathology of psychiatric service users (Arif and Maniam 1995; Osman and Ainsah 1994; Ramli 1989; Varma and Sharma 1995). Narratives from both female and male patients were originally solicited in relation to personal experiences of contemporary psychiatric institutional care and personal meanings attached to these accounts. These were balanced by views from staff and other caregivers and these served to contextualize polarized ideologies of care. Finally, these accounts are set against the historical backdrop of psychiatric care in Borneo and Malaya that has been informed and shaped by medical practices that can be traced back to prevalent practices and attitudes imported during the colonial period.

Sarawak Women in Psychiatric Care: Research Narratives

Although many of the experiences of patients were equally shared by both men and women, especially with regard to medical treatment, in other areas findings indicated sharply defined gender differentials. Here the condition of women patients as understood and described by themselves, was both illuminating and powerful in the implied or overt critique of social norms and social forces, where the resulting pressures of society bear down oppressively on women who cannot or are unable to conform to convention.