People with psychosocial disabilities in Indonesia are often shackled or forced into institutions where they face abuse, Human Rights Watch reported. Courtesy: YouTube/HumanRightsWatch.

CHAINED to a room by their wrist or legs, they rarely leave or are allowed to move.

Forced to eat, sleep and go to the toilet in one small room this is the shocking plight of mentally ill people confined to a life of “pasung” or chains, across Indonesia’s institutions.

Those who can’t receive treatment are chained at home with desperate families unable to help or afford the correct treatment for their loved ones.

A shocking new report by Human Rights Watch has revealed the brutal reality for people suffering with mental illness across Indonesia.

According to HRW’s report, Indonesia: Treating Mental Health With Shackles, more than 57,000 people with psychosocial disabilities (mental health conditions) have been subjected to pasung where they are shackled or locked up in confined space — at least once in their lives.

Researchers found people with psychosocial disabilities 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, including mental health care.

Once locked up, people are then subjected to abuse and denied proper treatment, HRW found.

Shockingly, those in institutions not only faced physical and sexual violence but were also subjected to involuntary treatment, including electroshock therapy, seclusion, restraint and forced contraception.

Report author and disability rights researcher at Human Rights Watch Kriti Sharma said the shackling of people remained illegal in Indonesia yet the brutal practice was widespread.

“People spend years locked up in chains, wooden stocks, or goat sheds because families don’t know what else to do and the government doesn’t do a good job of offering humane alternatives,” she said.

HRW researchers visited 18 institutions across the islands of Java and Sumatra which included mental health hospitals, social care institutions, and faith healing centres.

The organisation documented 175 cases of people who are currently shackled, locked up, or were recently released.

According to their estimates around 18,800 people are currently subjected to pasung.

Shackling was officially banned in 1977 but according to HRW, some people remain in chains often for years at a time and in some cases by their own family.

One father interviewed by HRW researchers told them he chained his daughter, who has a psychosocial disability, after she destroyed her neighbour’s crops.

He said he took the action after being advised to do so by faith healers.

Shockingly after she tried to escape her parents tied her hands behind her back and she stayed there for 15 years, eating, sleeping and defecating, before she was released.

Another woman, Asmirah, 22, suffers with a psychosocial disability and told HRW she was forced to live in a religious healing centre in Brebes.

“Imagine living in hell, it’s like that here,” she said of her time at the centre.

HRW acknowledged the government has tried to take action on the issue with an anti-shackling campaign but progress has been slow.

The country also has a serious shortage of psychiatrists, having between 600-800 for its entire 250 million people and only 48 mental health hospitals.

Those that do exist are not only inadequate but contribute to the abuse against them, the HRW report found.

Spending is also an issue with mental health receiving just 1.5 per cent of the annual budget.

Another issue was the relative ease with which people could be forcibly admitted to an institution under Indonesia law with researchers interviewing 65 people — none of whom entered on their own accord.

SHOCKING CONDITIONS

The length of stay at an institution or health centre was also a concern, researchers found.

The longest documented case was seven years at a social care institution. More alarmingly they found one patient had spent 30 years at a mental hospital.

HRW also expressed serious concern about the standards at such centres.

It said overcrowding and hygiene were a serious issue with pests such as lice common and diseases such as scabies rife.

In one centre on the outskirts of Java, HRW found 90 women in a room designed for one third that number.

“In many of these institutions, the level of personal hygiene is atrocious because people are simply not allowed to get out or bathe,” Ms Sharma said.

“People are routinely forced to sleep, eat, urinate, and defecate in the same space.”

“The thought that someone has been living in their own excrement and urine for 15 years in a locked room, isolated and not given any care whatsoever, is just horrifying.

“So many people told me, ‘This is like living in hell.’ It really is.”

TREATMENT

HRW found people were forced to take herbal therapies, or treated with prayer or massage.

The report also found electroconvulsive therapy was without anaesthesia and without consent.

Others were even subjected to forced seclusion for relatively minor offences such as failing to follow orders.

Women were particularly at risk after being exposed to predatory guards or sharing an area with men.

NOT AN ISOLATED PROBLEM

Such shocking treatment of mentally ill people and women in particular is not unheard of and certainly not unique to Indonesia.

A Human Rights Watch report in 2014 found women with disabilities are routinely locked up and abused in India.

It’s report, Treated Worse than Animals’: Abuses against Women and Girls with Psychosocial or Intellectual Disabilities in Institutions in India, catalogued a wide range of abuses.

It found women who were forcibly admitted to government institutions and mental hospitals were subjected to isolation, fear, and abuse, with no hope of escape.

The 106-page report detailed how women also had inadequate access to general healthcare, forced treatment — including electroconvulsive therapy — as well as physical, verbal, and sexual violence.