More than 57,000 people in Indonesia with mental health conditions have been subject to pasung. Pasung is the practice of being shackled or locked up in a confined space for an extended period of time as form of “treatment.” Currently, there are an estimated 18,000 people in Indonesia who are victims to pasung, and nearly 57,000 people have experienced it in their lifetime.
According to Human Rights Watch’s 74-page report, “Living in Hell: Abuses Against People With Psychological Disabilities in Indonesia,” people with mental health conditions often end up chained or locked up in overcrowded and unsanitary institutions, without their consent, due to stigma, and the absence of adequate community-based support services or mental health care. In institutions, they face physical and sexual violence, involuntary treatment including electroshock therapy, seclusion, restraint, and forced contraception. When in pasung, people are forced to eat, drink, sleep, and defecate, all in the same spot. Often times these victims are left in the same spot for years at a time without ability to move or even shower. Many victims experience muscle atrophy due to this long-term abuse.
While the government in Indonesia has outlawed this brutal practice, pasung still remains widespread throughout the country. A new mental health law requires integrating mental health care with primary health care. Teams of government officials, medical personnel, and staff in government institutions are tasked with freeing people from shackling. However, partly because Indonesia’s government is so decentralized, implementation at the local level has been very slow.
Indonesia, like the United States, also has a shortage of mental health professionals. It is estimated that in Indonesia, there is only one psychiatrist to every 300,000 to 400,000 people. According to Psychiatric Times, the US has roughly 10 per 100,000 people. While we have significantly more professional, we still feel the strain. Funding is also a major problem. According to government data, only 1.5% of Indonesia’s budget goes towards mental health services. Government funding and reimbursement rates have been an ongoing challenge in the States as well.
The mistreatment of people with mental illness is a global problem. Whether it is intentional or unintentional, humanity must do everything we can to protect the most vulnerable members of society, including those with mental health disorders.
Jill Hamilton, Project Coordinator, The Kim Foundation
Jill Hamilton has been the Project Coordinator at The Kim Foundation since 2014. She graduated with a bachelor’s degree in journalism and public relations from The University of Nebraska at Omaha in 2009. Since working at the foundation, she has become an active member of the Nebraska State Suicide Prevention Coalition, Nebraska LOSS Advisory Committee, The Omaha Metro Hoarding Taskforce, The Early Childhood Mental Health Coalition, Nebraska State Conference Planning Committee; she is a volunteer mentor with Y.E.S., and serves as the Outreach Coordinator for the Metro Area LOSS Team.