Indonesia: People with mental disabilities in chains

March 28, 2016

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Human Rights Watch recently published a report on the inhuman and unlawful manners in which people with mental health conditions are treated in Indonesia, in institutions, faith-based healing centres and at home. Despite a 1977 ban on shackling – known as pasung – in Indonesia, the practice continues. More than 18,000 people with perceived psychosocial disabilities are tied down by chains to beds, cement blocks, or even in barns and sheds meant for animals. 

Overall, HRW found evidence of arbitrary detention, physical and sexual violence, forced seclusion and forced contraception, as well as involuntary treatment including electroshock therapy without anesthesia. Conditions differed depending on the type of institution. As a result of the widespread belief that mental health conditions are the result of possession by evil spirits or the devil, having sinned, displayed immoral behavior, or lacking faith, families typically first consult faith or traditional healers and often only seek medical advice as a last resort. Many people are being put away in traditional or religious healing centers, where personal hygiene is a serious problem as people are chained and do not have access to a toilet. As a result, they urinate, defecate, eat, and sleep in a radius of no more than one to two meters.

The report Living in Hell. Abuses against People with Psychosocial Disabilities in Indonesia examines these abuses and also examines the government’s shortcomings in addressing these problems.


Based on research across the Indonesian islands of Java and Sumatra, Human Rights Watch documented 175 cases of persons with psychosocial disabilities in pasung or who were recently rescued from pasung. It also obtained information about another 200 cases documented in recent years. The author of the report, Kriti Sharma, visited 18 mental hospitals, social care centers and private institutions run by faith healers or traditional healers and interviewed about 150 people across the islands of Java and Sumatra. In an interview published on the HRW website she said: 

“The worst case we found was a woman who was locked up for 15 years, defecating, urinating, eating in the room where she was kept. She was locked up because she had been raiding the neighbors’ crops. As the father was tired of having to pay for the damages, and the advice of traditional healers did not improve her condition, he decided to lock her up in her own house.” […] “The thought that someone has been living in her own excrement and urine for 15 years in a locked room, isolated, never seeing her friends, and not given any care whatsoever is just horrifying. There are just no words to describe what a person is going through if they have been s reduced to a state that is worse than for an animal, So many people told me ‘This is like living in hell.’ It really is.”

Access to mental health care

Ministry of Health data shows that nearly 90 percent of those who may want to access mental health services cannot. The country of 250 million people has only 48 mental hospitals, that are unevenly distributed over the provinces. In all of Indonesia there are just 600 to 800 psychiatrists, or one trained psychiatrist per 300,000 to 400,000 people. The few facilities and services that exist often do not respect the basic rights of people with psychosocial disabilities and contribute to the abuses against them, as this report has shown.

Human Rights Watch is urging the Ministry of Health to provide mental health medication in local health centers and support services for all who seek it. The organisation is asking the public to tweet about this case (hashtag #BreakTheChains) and send an email to Indonesia’s Health Minister, asking him to commit to provide voluntary services in the community and access to mental health medication that would help people with psychosocial disabilities live independently.

Access Living in Hell. Abuses against People with Psychosocial Disabilities in Indonesia. Human Rights Watch, March 2016 (available in English and Bahasa Indonesia)

More information about the campaign #BreakTheChains