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Bagus Hargo Utomo
Indonesian Community for Schizophrenia Care

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Caught in Between: Family Caregivers and the Ethics of Severe Mental Illness Care Aan Kurniawan; Irwan Martua Hidayana; Bagus Hargo Utomo
Humaniora Vol 38, No 1 (2026)
Publisher : Faculty of Cultural Sciences, Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jh.115227

Abstract

Family caregiving for individuals with severe mental illness (SMI) is frequently regarded as a central element of community-based mental health systems, especially in settings where services are limited or fragmented. This study investigates the practice and negotiation of caregiving in everyday life in Jakarta, Indonesia, utilising an ethnographic case study approach. In-depth interviews were conducted with family caregivers recruited through a peer-support network. Five cases are presented to examine how caregivers make decisions over time in response to crisis, relapses, treatment, household demands, and evolving relationships. Drawing on care ethics, particularly Joan Tronto's framework, the analysis demonstrates that caregiving is not a static role or a fixed set of tasks. Rather, it is a context-dependent practice that requires ongoing judgment, with caregivers continuously adjusting their actions amid risk, ambiguity, and constraint. Across cases, care takes multiple forms, including direct daily tasks, monitoring and guidance, household adaptation, and delegation to paid helpers. The findings indicate that care evolves over time through turning points, periods of stability, and episodes of disruption. This article contends that “good care” cannot be defined solely by symptom control or clinical improvement. In the cases examined, care also encompasses maintaining social relationships, preserving household stability, managing uncertainty, and sustaining the caregiver’s capacity to continue providing care. By tracing these everyday negotiations, the study contributes to care ethics and mental health research by illustrating how family caregiving is enacted, contested, and sustained within unequal social and institutional contexts.