Sakit Hati: A state of chronic mental distress related to resentment and anger amongst West Papuan refugees exposed to persecution.

There has been an increasing interest in the role of gross injustices in generating pathological states of anger. The goal of this study amongst 41 West Papuan refugees conducted in Australia between 2007 and 2010 was to explore the phenomenology of Sakit Hati, a condition in which there appeared to be a close link between human rights violations and anger. West Papuan refugee participants made repeated reference to the condition of Sakit Hati in the early phase of the study so that the remainder of the study focused specifically on this construct. The qualitative approach involved an iterative process including focus groups, in-depth interviews, and semi-structured confirmatory interviews. The research revealed that Sakit Hati included elements of chronic brooding, resentment and anger attributed to experiences of injustice, a state that created vulnerability to episodes of explosive rage and aggression in response to reminders of persecution. Sakit Hati was distinguished from a depression-loss constellation, Susah Hati, although the two reactions overlapped. Sakit Hati led to substantial personal suffering and interpersonal difficulties. The intractable political conditions in West Papua made it difficult to achieve a durable resolution for the condition. Sakit Hati provides a cross-cultural illustration of the nexus between injustice and chronic anger, demonstrating how this dynamic interaction can be perpetuated by ongoing social and political forces. Greater attention may be warranted by psychiatric classification systems to the recognition of anger as an affective state that may be provoked and maintained by experiences of injustice.