BANGKOK (Thomson Reuters Foundation) – Indonesia has outlawed the shackling of people with mental illnesses under a new law confronting a traditional practice in which patients may have their ankles bound in chains or are kept in stocks.
Indonesian lawmakers passed the Mental Health Law last week, said mental health expert Dr Hervita Diatri, who welcomed the new legislation as a more comprehensive approach to mental health treatment.
The country’s most severely mentally ill patients are sometimes so aggressive that their families and communities, in the absence of basic mental healthcare, resort to a practice called "pasung", binding their ankles or keeping them in wooden stocks for months or years.
Many mental health sufferers are abandoned or given minimal care, sitting in their filth and suffering muscle wasting.
Diatri said there were an estimated 57,000 Indonesians in pasung, some of whom are kept in isolation. A "pasung-free" programme started in 2009 in Aceh – the province with the second highest incidence of mental illness after Jakarta – has now been expanded to 23 of the country’s 34 provinces.
The Mental Health Law, which Diatri said took about five years to draft, addresses mental illness from different government ministries and sectors – from public health to police and security, to education and labour.
"This is a broad perspective of mental health - talking about treatment, prevention and rehabilitation," Diatri, a psychiatrist at the University of Indonesia medical school who helped draft the law, told Thomson Reuters Foundation.
"Talking about promotion and prevention, we hope to develop a mental health programme in schools with the Ministry of Education. In collaboration with the Ministry of Labour, we hope that every company and workplace will not only think about physical health, but also about mental health."
People who mistreat the mentally ill could face up to five years in prison under the new law.
"Through this, we hope we can regulate traditional and spiritual healers," she said by telephone from Jakarta. Such healers may recommend restraining mental health patients or other inhumane practices.
Health advocates welcomed the ban on pasung.
"Many have remained subject to inhuman treatment, including shackling and abandonment," Health Minister Nafsiah Mboi told The Jakarta Globe, adding that the new law was expected to end the discriminatory treatment of mentally ill patients.