(Courtesy Andrea Star Reese)

While sitting in a Parisian café where nearby cars are honking loudly because of a demonstration blocking the main junction, Andrea Star Reese explains how she grew to love and respect the mentally sick people she visited in various regions of Indonesia.

The photographer had just returned from the 25th anniversary of Visa Pour l'€™Image festival for photojournalists in Perpignan, South of France where her work in Indonesia was presented by Jean-Francois Leroy.

Reese is currently a member of staff at the International Center of Photography and she was a 2010 fellow in Photography from the New York Foundation for the Arts and a reGeneration2 photographer.

Blue-eyed Reese who is based in New York believes in understanding her subjects with the help of Indonesian friends translating like producer Iin Purwanti Cox. She took almost two years to complete her sensitively portrayed Indonesian project that she named Disorders, or Pasung (Indonesian term for restraints or shackles).

'€œFrom January 2011 through the end of 2012, I spent time photographing people in Indonesia being held in homes, shelters, schools and hospitals. Many had not been seen by a psychiatrist or diagnosed with mental illness, stress or physical conditions that might explain symptoms or behaviors they exhibited.'€

Reese had taken part in the Angkor Wat Photo Festival and traveled to Yogyakarta just after Mount Merapi had erupted. Here she encountered a homeless Javanese man after witnessing a ceremony to bless the volcano. Curiosity led her to visit a nearby pesantren (Islamic boarding school) where many patients are left by their families to be cared for. In fact the social cohesion and mutual help that many Indonesians offer each other made a great impression on her.

Reese'€™s journey took her to more pesantrens in Java, such as the government licensed Galuh shelter in Bekasi, where students learn martial arts, as well as shelters, schools, hospitals and many homes in Bali and Kalimantan where she discovered people chained to posts, barely fed by their families.

The photographer was always careful to observe the photojournalist code of ethics and usually showed the images to the people she had photographed. One extremely touching image was an image of a girl named Ana in the experimental shelter at Tasikmalaya, West Java, where she sits with great dignity despite obvious resignation to her fate.

A great contrast to the contemporary dance performances Reese used to film. She converted to still photography using a Canon Digital Five D Mark 3 camera after hurting her shoulder filming a documentary about the first democratic election in Indonesia after the Soeharto era. Before that she witnessed the horrors of 9/11 in New York and filmed the skyscrapers close to where she lived as they were disintegrating.

The mentally disturbed are simply not aware that they are ill meaning they are oblivious to the stigma experienced by their families. They do not realize that they can be spiritually healed, or even receive appropriate medication from the few psychiatrists practicing in Indonesia '€” only 600 to 800 for the entire country. These health practitioners who are paid less than other qualified doctors tend to work in the big cities with the majority based in the capital.

Some visionaries like Dr. Pandu Setiawan are trying to install special training programs for personnel at Puskesmas (community medical centers), besides advocating for heightened awareness of the problem for the general public. Reese explained how moving it was to observe over-worked personnel in a center attempting to help mentally ill patients with great patience and understanding of their suffering.

There is also a government program called Pasungfree 2014 that aims to ban the practice of shackling entirely. However, as Balinese Dr Luh Suryani'€™s heart-wrenching film portrays, many are forgotten behind main family houses, or even spend years living in a box.

People resort to pasung when they cannot afford care, are skeptical about medication, want to avoid the stigma or feel it is necessary to protect the family, community and the disturbed individuals. Now even the meager support Suryani received for her work has been stopped.

However Reese is fully aware that the problem is not restricted to Indonesia but a universal one, she worked with the urban displaced in New York City for three years on a long-term project she named Urban Cave.

Effective regional programs continue to be rare and underfunded according to observations made by Reese. The common obstacles include access to care, cost of treatment and the lack of wide-spread dissemination of basic information.

Shamans and traditional healers continue to be the main source of help in regards to mental health care throughout the country as it is better and cheaper to attribute confusing or abnormal behavior to spiritual weakness, spells or possession. There is no stigma attached to being under a spell or possessed.

To further complicate efforts for reform, the Department of Health is responsible for overseeing mental hospitals while shelters for the mentally ill are the responsibility of a separate department. Mental illness is a condition that can be treated successfully maintains Reese.

'€œAs my project demonstrates, inadequate access to medication and treatment that are commonly available throughout much of the world has devastating consequences. The largest may be that many people don'€™t even know that they can get better.'€™'€™ She added.   

Reese also reminds us that World Mental Health Day is on Oct. 10 each year.

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