P

eople suffering from mental illness in West Nusa Tenggara face not only years of stigma, but are also forced to stay in confined spaces with their hands or feet chained by their own families.

There were around 1,096 people with severe mental illness shackled in their homes in the province, according to data from the provincial administration in 2011.

Until now, nothing has changed as most are still confined with both their legs chained to wooden boards to prevent them from going anywhere.

Families decided to hide and chain their family members who suffered from mental illness because they were embarrassed by negative public stigma. Moreover, they were concerned that their ill family members may disturb others, the director of provincial run Mutiara Sukma Mental Health Hospital Elly Rosila Wijaya said.

The West Nusa Tenggara administration had so far recorded and handled 577 people who were chained in their own homes, however from the figure only 20 percent had been released.

“We could not free all of them from the chains as their families are reluctant to do so,” Elly told the Jakarta Post on Thursday in Mataram.

The shackle cases for people with severe mental illness have been found in all 10 regencies in the province, she added.

“It’s not easy for the family to release them from the shackles, especially for those who in the past had hurt someone or even caused death,” she added.

Despite public attitudes that confining them was right to protect mentally ill people from themselves and others, Elly said it was not the best way to treat people with severe mental illness. Chaining them could make their condition worse.

The provincial administration urged families to seek help from medical experts.

She said that Mutiara Sukma Mental Hospital, the only mental hospital in the province, has formed a three-pillar communication reference system (SRKTP) that allows patients to seek help within their residential area. Besides the hospital that serves as a provincial reference, all regional hospitals and community health clinics can now treat people with mental illness.

All health clinics in the province now have health officials who can provide counselling, as well as receive reports on people with severe mental illness who are shackled so that swift action can be taken. The health officials would also regularly check and give therapy to patients by visiting their homes.

Although the government banned shackled practices in 1977, families, traditional healers and institutions across Indonesia still use shackling, locally known as pasung, as a solution to deal with the illness.

Reportedly, there are 57,000 people in Indonesia with a mental health condition who are subject to being shackled or locked up in confined spaces at least once in their lifetime, with around 18,800 people currently shackled across the country.

Despite the government’s target of universal health coverage by 2019, with a population of 250 million people, Indonesia currently only has between 600 to 800 psychiatrists and 48 mental hospitals. More than half of the hospitals are situated in just four provinces.

Even so, patients in mental health facilities face problems such as overcrowding, poor hygiene and physical or sexual abuse, according to Human Rights Watch in 2016.

Meanwhile, Nova Riyanti Yusuf, a psychiatrist from Dr. Soeharto Heerdjan Mental Institution said the mental health support system should begin at the community level through people who receive training regarding mental illness.

“We also want psychologists and doctors to do early screenings at community health centers. So, it all starts from the bottom up. Don’t put everyone in the mental health institutions,” Nova said recently.