Over one million Indonesian’s suffer from a severe mental disorder, according to Dr Diah Utami, the director of mental health at the University of Indonesia. Yet nearly 90% of people in Indonesia who want to access mental health services are unable to.
A recent Human Rights Watch (HRW) report found that across Indonesia there is a widespread belief that mental health conditions are the result of possession by evil spirits, having sinned, displayed immoral behaviour, or lacking faith.
People reported to HRW that they are more likely to go to traditional healers for mental illness, then to a doctor. Reported treatments from traditional healers include moonlight baths, painful massages with stones, herbal concoctions, among other treatments.
A shortage of psychiatrists also acts as a barrier to those wanting access to mental health services. The World Health Organisation (WHO) found that there are 725 psychiatrists in Indonesia, which means that there are three psychiatrists for every one million people.
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Many people who are mentally ill experience pasung in Indonesia, which HRW stated as a common practice in their report ‘Living in Hell’. Pasung is when someone is held in restraints such as chains, stocks, rope, cages, and kept in a confined space. There are currently 18,800 Indonesian’s who are in pasung for mental health conditions, according to government data.
HRW director of disability rights, Shantha Rau Barriga, said that HRW interviewed a woman who had been kept in pasung for 15 years.
‘She stayed there for 15 years without any kind of access to medical treatment, very limited access to food, she never had a bath in the 15 years that she stayed in this room.
‘This is the type of experiences that people are having, some thousands and thousands of people with mental health conditions are experiencing this across Indonesia.’
The Indonesian government banned pasung in 1977, but it is still widely used. Indonesia started a program called ‘Indonesia Free from Pasung 2014’ with the aim of ending pasung by the end of 2014, but that target has been extended to 2020.
Many people use pasung because they don’t know or understand how to treat them. Another barrier is being able to afford proper treatment for them, according to HRW.
People who are placed in mental institutions can also face similar abuses to those who are treated at home. Barriga said HRW ‘documented violence against people with mental health conditions in mental health facilities in Indonesia, they were beaten by staff, they were put in seclusion rooms, they were locked up in chains or ropes. In many cases as a form of punishment or control.’
There are 48 mental health hospitals in Indonesia, the majority located on Java. There are 7,700 beds in mental hospitals, which averages to 3 beds per every 100,000 person living in Indonesia. But this has led to over crowding in many mental hospitals.
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HRW visited Panti Laras, a social care institution outside of Jakarta. They found 90 women in a room, that could only accommodate 30. There was no space to walk or stand.
The main recommendation HRW made in their report was for the government to amend the 2014 Mental Health Act, so that admission and treatments to mental health services is voluntary.
If you or anyone else you know needs help:
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Lifeline on 13 11 14
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Kids Helpline on 1800 551 800
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Suicide Call Back Service on 1300 659 467
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Beyond Blue on 1300 22 46 36
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Headspace on 1800 650 890
