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Global Mental Health - Indonesia and the Practice of 'Pasung'

3/21/2016

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PicturePhoto by: Andrea Star Reese
Today, the Human Rights Watch released a shocking and disturbing report regarding the treatment of thousands of individuals living in Indonesia with ‪mental illness‬ and related disabilities. The report, aptly titled "Living In Hell", discusses how over 18,000-19,000 Indonesians live in "pasung", a practice that involves individuals being shackled and confined and forced to eat, sleep, defecate and urine in their small cell or room. While the Human Rights Watch report that these facilities put individuals at risk of physical ailments as well as physical and sexual abuse, they also report that treatments ranging from traditional herbal concoctions and rituals to ECT without anesthesia are forced onto those who live there.

Though the Indonesian government considered "pasung" inhumane and subsequently banned the use of the practice back in 1977, it continues to be utilized today. The report points to both the culturally held beliefs about mental illness, as well as an extreme lack of psychiatrists and mental healthcare facilities/services across the country as major barriers to more appropriate and humane mental health care.

"Across Indonesia, there is a widespread belief that mental health conditions are the result of possession by evil spirits or the devil, having sinned, displayed immoral behavior, or lacking faith. As a result, families typically first consult faith or traditional healers and often only seek medical advice as a last resort.

Even if they do look for access to medication, however, people may find it impossible to access it. Ministry of Health data shows that nearly 90 percent of those who may want to access mental health services cannot. The country of 250 million people has only 48 mental hospitals, more than half of them located in just four provinces of Indonesia’s 34 provinces. Eight provinces have no such hospitals, and three have no psychiatrists. In all of Indonesia there are just 600 to 800 psychiatrists—or one trained psychiatrist per 300,000 to 400,000 people. The few facilities and services that exist often do not respect the basic rights of people with psychosocial disabilities and contribute to the abuses against them."

You can read more about the report via the video below and the following articles and photo documentation:
https://www.hrw.org/node/287537
http://time.com/4265623/indonesia-mental-illness-chains-pasung-hrw/

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