This thesis argues that knowledge about mental health and illness developed in the Global North is exported to Indonesia, and appropriated and navigated in ways contingent on local political contexts, cultural norms, and values. I support this argument based on epistemological tools developed during the COVID-19 pandemic and 15 months of ethnographic research in Indonesia, in a series of four articles. The first article, developed in the context of the COVID-19 pandemic, shows how global knowledge flows associated with international health structures can obscure what matters most for people during a health crisis. The findings of this article (drawn on data collected from Nigeria, Guinea, Singapore, and Germany) suggest that when people are confronted with complex threats to their health and well-being, their primary concern is not about biomedical information. Non-biomedical knowledge might be just as important – if not more important – than biomedical knowledge in shaping health-seeking behaviors. In the second article, the aim was to systematically engage with knowledge emerging from Indonesia around severe mental illnesses (SMI). The review of over 100 articles suggests that research questions and topics that dominate SMI research in Indonesia are very well aligned with research agendas established in the Global North, and hence with particular notions of the mind and its ailments. Noteworthy is that this consistency with entrenched understandings of health and illness emerges despite (hyper)diverse Indonesian cultural environments. The third article illustrates how this complex web of knowledge, corresponding to biomedical notions of mental health and illness, established within international health structures, is disseminated into local communities. And how these knowledge-flows play out and influence the experiences of patients and their immediate environments. The main argument of this article is that adopting psychiatric notions of mental health decreased uncertainty and created common ground and a sense of shared experience, leading to grassroots movements for the empowerment of the mentally ill, self-help groups, and other support structures. At the same time, these processes led to an increase in uncertainty and generated a culture of blame that, at its worst, pushed patients into a world of silence. The final article turns to mental pain amid this complex knowledge landscape. This article first outlines the salient attributes of mental pain as they emerged during conversations with patients and observations of their everyday lives. These attributes partly explained the uncertainties individuals faced as part of their experiences with severe psychiatric disorders. The main argument of this article is that the interplay between mental pain and uncertainties informed certain illness behaviors, particularly tendencies toward self-isolation.
