The Diskusi Kayu Putih held on March 15 2018 brought up the matter of human rights for the mentally ill and treatment of mentally ill people, specifically in Indonesia. The discussion was preceded with a screening of the documentary film Heaven for Insanity, directed by Dria Soetomo and produced by Orlow Seunke.
The film tells the story of Watmo, a man with an unspecified mental condition (possibly schizophrenia) who was forced into a traditional mental health treatment institution by the people around him. An acquaintance of Watmo describes him as a disturbance to the neighborhood. A worker at the institution stresses that they do not use medical methods to treat their patients. After a few weeks at the institution, Watmo is deemed mentally healthy once more, and given permission to return to his place of dwelling.
The case of Watmo is used as a triggerer and jumping point from which to delve into the matter of mental illness in Indonesia. The first sub-topic discussed was the practice of pasung or shackling, wherein family members of a mentally ill person restrains said person’s freedom, either by locking them in a confined space or in some cases literally chaining them to a bed. This is generally done as a quick and easy way to cope with the problem at hand (having a mentally ill person in the family) and prevent any shame upon the family.
While this may seem to solve the problem for said family, this practice obviously trespasses upon the personal human rights of the mentally ill person, and the general consensus during the discussion is that pasung is far from the best method of dealing with a mentally ill person in the family. Nonetheless, although pasung has been banned by the government since 1977, it still remains a common practice- a study estimates that 57.000 people have experienced pasung, and 18.800 were still enduring pasung as of 2016.
That being said, another problem appears when families attempt to treat their mentally ill loved ones by sending them to institutions meant to treat mental illness. Indonesia still severely lacks institutions with the proper capabilty to medically treat the mentally ill- only 48 exist, of which all are concentrated in four provinces. Psychiatrists, too, are mainly concentrated in Jakarta and other large cities. This is mainly attributed to the insufficient funding from the government towards developing mental health facilities. Another complication is the prevalence of “traditional” or unorthodox mental illness treatment facilities, which attempt to treat the mentally ill with non-medical methods.
As for the role of the government, Indonesia has signed the United Nations Convention on the Rights of Persons with Disabilities, which included treatment of the mentally ill. Within the convention it is stated that a mentally ill person has the right to refuse treatment, and consent from the patient is required before attempting any form of treatment. However, the current Indonesian law (UU No.18 Tahun 2014) states that forced treatment is allowed if the patient is deemed dangerous to themselves or to those around them.
The consensus during the discussion is that the current law is too vague regarding the definition of mental illness. Considering the wide range of mental illness and their various degrees of severity, this could prove dangerous as the law can be used as justification to forcibly commit someone to a mental health institution if enough people consider them a disturbance to the community, regardless of their capacity to make decisions or refuse treatment, as in the case of Watmo. Another troubling facet of the same law states that non-medical facilities are allowed to operate as long as the institution is considered competent by the local government. This is unsettling, as it gives legitimacy to scientifically unproven methods of treating mentally ill patients.
In conclusion, there are a handful of major problems surrounding the treatment and rights of the mentally ill in Indonesia. The vagueness of and inadequacy of current laws, as well as various dangerous circumstances faced by the mentally ill such as pasung and alternative mental health treatment institutions are still prevalent, and awareness needs to be raised regarding this issue. This correlates to the lack of funding by the government towards bettering the lives of the mentally ill, and ensuring their basic human rights. Our hope is that with this discussion, awareness within the public, especially students, can be raised, and knowledge regarding this pressing issue can go on to be more widespread.