T

he World Federation for Mental Health picked an interesting topic, '€œLiving with Schizophrenia'€, to commemorate World Mental Health on Oct. 10. The word schizophrenia may sound unusual to us, but when we use a layman'€™s term, such as '€œthe mentally ill'€ or '€œcrazy patient'€, we know who they are instantly.

We all know about schizophrenic people: we notice them walking naked in the street, we hear jokes about them, we read about them in the paper and we have even seen them on television '€” both in the news and in movies. Our current perception of the schizophrenic gives rise to the question: '€œCan we really live with schizophrenia?'€

Although schizophrenia is a treatable disorder, more than half of people with the ailment don'€™t have access to adequate treatment. Most of the untreated or inadequately treated patients live in developing countries, including Indonesia. Where do those untreated patients reside? Some of them are abandoned on the street, some are still living at home without any treatment at all, while some others are shackled.

It'€™s ironic that Indonesia, a nation known for its strong sense of kinship, is one of the countries where shackling is rampant. People are locked up and forgotten by their own family, who use a method that has already been banned for almost 40 years.

It'€™s difficult to find the exact number of shackled people in Indonesia, mostly because they are meant to be hidden in the first place. Indonesia'€™s riskesdas (basic health research) data in 2013 estimated there were 56,000 shackled people across the country, mostly in remote villages.

A family may decide to shackle their mentally ill relative due to a lack of knowledge about treatment, limited access to mental health support financially or geographically, or social pressure when a mentally ill person is considered dangerous to the community.

Nevertheless, we are starting to move forward toward a brighter situation. In 2011, the Health Ministry set the goal '€œToward a Shackle-Free Indonesia 2019'€.

Unfortunately, a lack of funding and expert staff has resulted in slow progress, especially in the mental health governing system. At this rate, it is feared that the desired goal will not be achieved.

There are several steps that should be taken to clear the barriers, to make the goal reachable. First, government support and commitment is needed.

The government should allocate a higher budget to reinforce the program. Currently, the government has allocated only 1 percent of the state budget for mental health, far below WHO'€™s recommendation of 6 percent.

The House of Representatives passed in July the mental health bill, five years after the draft was submitted. As a consequence, the government has promised to provide better treatment to the mentally ill, including those in shackles. This can be translated into more funding, medication and experts.

Second, we should show empathy to families with mentally ill relatives, instead of blaming them for the shackling. Most of the time, mentally ill people cannot seek treatment themselves.

This is why family support is an important pillar in the treatment of schizophrenia. When a family can'€™t afford or access proper treatment, they may resort to shackling.

In the real world, there is a gap between an ideal treatment (prescribed medication) and actual treatment (shackling). We need to recognize and facilitate the disparity. The problems may stem from ignorance, financial constraint or cultural barriers. Once we identify the problem, it is our responsibility to facilitate this in order to access the ideal, desired treatment.

Finally, it is necessary to end the stigma regarding schizophrenia in the community. We can start by substituting the term '€œcrazy'€ or '€œlunatic'€ for '€œpeople with mental illness'€.

You can contact the nearest health center if you know of someone being shackled in your area. We want the community to understand that schizophrenia is a treatable disorder, just like all other treatable diseases.

This will probably take a very long time, and definitely need good coordination between the government, medical experts, the media and the community. Unfortunately, this harmonious coordination is what we are lacking. Nevertheless, we must remember something: the mentally ill are suffering. They need help. They need us to recognize their condition.

By shackling the mentally ill, we are not only restraining their feet. We are restraining their productive years, their chance to be treated and their freedom as human beings. Shackling is a serious violation of human rights; therefore we must stand up to end shackling for any reason whatsoever.