Indonesia is a nation consisting of thousands of islands. It is estimated to have over 19 million people with psychosocial disabilities. The actual number of Indonesian’s needing treatment is unknown; there is no recent relevant data for that. It has about 48 mental health institutions and roughly 700 psychiatrists. While the new Mental Health Law of 2014 mandates that every province must have at least one mental health hospital, more than half of the psychiatric hospitals are in four of the country’s 34 provinces, while eight provinces have no psychiatric hospitals at all.
Pasung is the Indonesian term for shackling. It can also refer to being kept in chains, stocks or locked in a room, cell, or pen. Initially banned in 1977, pasung is the widespread traditional response to mental disorders throughout Indonesia and it is an act of desperation. The most recent available government data states that 18,800 people are living in pasung in Indonesia.
Throughout Indonesia, there is also wide-spread belief that mental illness comes from a lack of faith or sinful behavior; that it may be caused by mystical spells cast by ill-wishers and ill-doers or by possession by evil spirits and the devil. As a result, families typically first consult faith-based healers that rely heavily on prayer or traditional healers that deal with spirits and magic. According to Dr Pandu Setiawan, the former Director General of Mental Health under the Department of Health, even when mental health care is easily accessible, because of beliefs like these and the shame attached to the sigma surrounding mental illness, families commonly seek medical advice only as a last resort.