Thousands of Mentally Ill Indonesians Remain Shackled or Locked Up: HRW


OCTOBER 04, 2018

Jakarta. Human Rights Watch says thousands of people with mental illness remain either shackled or locked up in confined spaces in various institutions across Indonesia, and called on the government to ramp up efforts to end these abusive practices.

There were about 12,800 people with psychosocial disabilities who shackled or locked up as of July this year, compared with about 18,800 two years ago, HRW said in a report released in Jakarta on Tuesday (02/10).

It says the lower number was partly due to community outreach programs initiated by the Ministry of Health. The program already reached 16.2 million households by September.

"Over the past two-and-a-half years, the Indonesian government has undertaken serious efforts to tackle shackling and lack of community-based [mental health] services," HRW researcher Andreas Harsono said during the release of the report.

"But with little oversight, thousands of people with disabilities remain in chains or locked up in institutions across Indonesia," he added.

In faith-based healing centers, the organization found people are abused and receiving alternative treatments, such as being forced to listen to Koranic recitations. In private institutions, people with psychosocial disabilities often face sexual violence, restraints and solitary confinement.

Jeffrey, a University of Indonesia law graduate who was involuntarily confined to a social care institution for two years, said he witnessed patients spending years without receiving proper care, and that some even died while living in dire conditions.

In 2009, after complaining about hearing voices, Jeffrey was taken to a social care institution where he was chained and kept in solitary confinement.

"This is real, I experienced it myself – my freedom was taken from me … I felt like I was taken there not for the sake of healing, but to be discarded," he said.

Jeffrey's experience illustrates a bigger problem in Indonesian society when it comes to mental health, which should push the government to increase its efforts to create greater awareness.

Indonesia banned shackling in 1977, and the government has ratified the Convention on the Rights of People with Disabilities. But current regulations in Indonesia, according to HRW, still make it relatively easy to confine people with psychosocial disabilities to institutions against their will.

"... The government must educate the public about mental health and provide people who have psychosocial disabilities with services that extend beyond medication, including access to education, housing and employment," said Kriti Sharma, senior disability rights researcher at HRW.

The Ministry of Social Affairs must adopt a deinstitutionalization policy that moves away from putting people in institutions and instead support them to live independently in the community, she said.

Yeni Rosa Damayanti, co-founder of the Indonesian Mental Health Association, said the lack of legal capacity for patients to discharge themselves from these institutions, along with cases where they do not have anywhere to go, are problems the government must consider.

"It's the state's responsibility to provide housing that is not a prison – and [these] institutions are essentially prisons. [It is] a practice that must be stopped," Yeni said.

She suggested that these institutions be transformed into open-door facilities where patients can admit or discharge themselves. She said the government should also consider developing a public housing scheme to ensure people with mental health disorders have a place to live.

The Social Affairs Ministry seeks to completely eradicate shackling in the country by 2018, while the Health Ministry aims to do it by 2019.