The legacy of colonial psychiatry on service provision in the post-colonial context of Malaysia
Sara Ashencaen Crabtree
Paper short abstract:
Ethnographic findings of Malaysian psychiatric inpatients and staff indicates that modernisation of services draws on international models but fits uneasily with a colonial ‘asylum’ approach set in the context of socio-political ethnic tension. This carries resonance for post-colonial societies.
Paper long abstract:
This paper draws on extensive ethnographic data of the experiences and perceptions of psychiatric in-patients and staff in institutional psychiatric settings in East Malaysia. Mental health provision in Malaysia offers interesting paradoxes with a slow progress towards revising anachronistic mental health legislation. The country has attempted to modernise its services by drawing on international models. However, the political and ideological value bases of Westernised models do not fit Malaysian values and norms. This is significant owing to Malaysia's colonial history where asylum services were developed to care for the colonial mad and migrant workforces from China and the Indian subcontinent following in its wake. The close association between anthropology, medicine and Imperialism also generated a fascination with the indigenous ethnic groups in the region. Today the reminders of Victorian psychiatric care are recognisable in Malaysian psychiatric daily practices, carrying resonance for other post-colonial societies. This socio-cultural-historical thread forms a narrative by which to trace other anomalies and contradictions played out in the system. Malaysian doctors have historically been trained overseas, unlike psychiatric medical assistants/nurses. Thus a disjuncture is found between the 'new' approaches introduced and customary practices. The highly religious context of Malaysia and rich traditional healing practices form another disjuncture in terms of secular, biomedical approaches that hold few cultural reference points for many of the ethnically diverse patients and staff. Additionally, diagnosed psychiatric morbidity and prevalence carry implications for ethnic groups, particularly in a modern Malaysia witnessing a growing Islamic resurgence and escalating ethnic tensions.
Ethnographic perspectives on 'global mental health'