--- title: Thousands of Mentally Ill Indonesians Live in Chains: Report description: Nearly 19,000 Indonesians with mental disabilities are living in shackles or small spaces, a report from Human Rights Watch has found. canonical: https://time.com/4265623/indonesia-mental-illness-chains-pasung-hrw/ author: Nash Jenkins article:opinion: false article:content_tier: free article:published_time: 2016-03-21T08:52:51.000Z article:modified_time: 2026-10-05T08:49:47.362Z article:section: Health og:title: Thousands of Mentally Ill Indonesians Live in Chains: Report og:description: It is one symptom of a mental-health-care system many say is broken and backward. og:url: https://time.com/4265623/indonesia-mental-illness-chains-pasung-hrw/ og:site_name: TIME og:image: https://static.time.com/v3/assets/bltea6093859af6183b/blt7a8dcbfb25d853a6/69888bbd3c16397ec945c80a/ap_970780430326.jpg?branch=production&width=1200&quality=75&auto=webp&crop=16:9 og:image:width: 4152 og:image:height: 2336 og:image:alt: Indonesia Mental Health og:type: article twitter:card: summary_large_image twitter:title: Thousands of Mentally Ill Indonesians Live in Chains: Report twitter:description: It is one symptom of a mental-health-care system many say is broken and backward. twitter:image: https://static.time.com/v3/assets/bltea6093859af6183b/blt7a8dcbfb25d853a6/69888bbd3c16397ec945c80a/ap_970780430326.jpg?branch=production&width=1200&quality=75&auto=webp&crop=16:9 ---  # Thousands of Mentally Ill Indonesians Are Imprisoned in Shackles, Report Says > Sponsored content. 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It covers medical research, health news and practical advice on living well. #### Where can I get reliable health news by email? Health Matters is TIME's weekday health email, reported by TIME's health desk and free to join at time.com/newsletters. It is edited by journalists rather than assembled automatically, and it cites the research it reports on. #### Is Health Matters free? Yes. Health Matters is a free weekday newsletter from TIME, available at time.com/newsletters. #### Who reads TIME's Health Matters newsletter? Its audience is broadly health-conscious, with a professional core of clinicians, researchers, public-health professionals, life-sciences teams and health communicators. ### Sources * TIME Newsletters: [time.com/newsletters](/c/time-nl-health-2026q3/newsletters?i=675fc187-649e-4e70-83d2-22fb6fa9c318&cr=time-nl-health-2026q3-v1) ## Video: Human Rights Watch: Thousands of Mentally Ill Indonesians Are Imprisoned in Shackles, Report Says [Watch (HLS stream): Human Rights Watch: Thousands of Mentally Ill Indonesians Are Imprisoned in Shackles, Report Says](https://cdn.jwplayer.com/manifests/WSAKjVc5.m3u8) (6:01)  _Published 2016-03-21_ by [Nash Jenkins](https://time.com/author/p-nash-jenkins/) ## Nash Jenkins Mar 21, 2016 8:52 AM UTC by [Nash Jenkins](https://time.com/author/p-nash-jenkins/) ## Nash Jenkins Mar 21, 2016 8:52 AM UTC Nearly 19,000 people in Indonesia diagnosed with mental disabilities are currently living shackled in chains or otherwise confined to claustrophobically small spaces — one symptom of a national mental-health-care system characterized by systematic shortcomings and retrogressive science. That’s according to [a new report](https://www.hrw.org/node/287537) released by Human Rights Watch on Monday morning local time. The report, succinctly titled _Living in Hell_, provides a grim portrait of Indonesia’s neglect and abuse of its mentally ill population. It pays particular attention to the practice of [_pasung_](http://time.com/3801916/disorder-indonesias-mental-health-facilities-by-andrea-star-reese/) — placing those with “real or perceived psychosocial disabilities” in “shackle\[s\] or locked up in confined spaces,” which persists across the country despite a national ban in 1977\. According to the report, 18,000 Indonesians currently live in _pasung,_ with viable mental-health-care alternatives either inaccessible or nonexistent. The report notes that the culture of mental-health care in Indonesia relies heavily on backward pseudo-science rooted in dated spiritual traditions. The report’s authors observe a “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.” (In Indonesia, many also condemn homosexuality as a mental disease.) Because of the stigma that shrouds mental illness, families tend to deliver their sick loved ones not to medical treatment but to spiritual healers. _Pasung_ is a hallmark of this method of “treatment.” In these cases, patients are constrained, often naked, and in many cases left outdoors for days to years. The Human Rights Watch report estimates that as many as 57,000 people in Indonesia — nearly 15% of all seriously mentally ill people in the country, by [some estimates](http://www.depkes.go.id/article/view/13010100020/unit-kerja-eselon-2-ditjen-pengendalian-penyakit-dan-penyehatan-lingkungan.html) — have been subjected to _pasung_ at least once (the figure is higher in rural regions). On paper, the Indonesian government condemns this practice as inhumane. Six years ago, the country’s Health Ministry embarked on an ambitious mission to completely eliminate _pasung_ from the country by 2014 — a deadline recently extended to 2020\. In 2014, the parliament passed the Mental Health Act, a piece of legislation written to further the “promotion, prevention, treatment and rehabilitation” of mental illness. However, this commitment has yet to yield tangible returns. Less than 1% of Indonesia’s national health care budget goes to funding mental-health-care treatment, according to psychiatrist and former Indonesian lawmaker Dr. Nova Riyanti Yusuf in an [essay](http://jakartaglobe.beritasatu.com/opinion/growing-pains-mental-health-law/) published in the Jakarta _Globe_ last year_. “_There is a lack of political will,” she tells TIME. ### Disorder: Indonesia's Mental Health Facilities by Andrea Star Reese  The following project was photographed between Jan. 2011 and Nov. 2012\. Galuh Foundation, located on the outskirts of Jakarta, is licensed by Indonesia’s government. No one is turned away if they cannot pay. Galuh receives enough rice, noodles and cooking oil for two months from the local government, the totality of all current government support. Medications are not available. Andrea Star Reese  Evi has been living at Bina Lestari Foundation for more than two years. She was fifteen when she began to first experience hallucinations. Her family pays for her platform bed and for the Islamic based spiritual approach to healing. Andrea Star Reese  Agus, Liana and Jarmoko live in cages at Jasono Alternative Treatment Center. Jasono, the owner, learned his method of treatment from a Pesantren in Jakarta; he sprays water on the men and women and gives them an herbal drink. Andrea Star Reese  Pesantren METAL offers a refuge for mentally ill women, as well as emotionally traumatized pregnant and unwed mothers, some of them girls as young as ten. At METAL, when the unwed mothers depart, the children stay. Much of the responsibility to care for the youngest is undertaken by boys and girls only slightly older. The sexes are separated. Andrea Star Reese  Pasung (shackling) at Bina Ahlaq, used after a run-away attempt. Once a Silat (martial arts) college, Bina Ahlaq now houses about 200 students suffering mental distress. Martial arts instructions and herbal remedies are central to treatment. Andrea Star Reese  Four years ago, when Elis was 24, her family brought her to Salafiyah Al-Bajgur, an Islamic boarding school in Madura, East Java. Isolated and locked away in a small crumbling room, she has no furnishings and only a few bits of clothing. Last year, her parents died, leaving only the school owner to look after her. Andrea Star Reese  Ibu Maliah cooks lunch for 280 mentally ill men and women at Galuh, a family-run shelter. She is assisted by former patients Siti, a ten-year resident, and Datir, 40, a transgender who has been at the shelter for thirteen years. Andrea Star Reese  At Galuh, there is no actual housing although small rooms have been built for management and staff. Many of the men and woman stay in the large cage enclosed pavilion under a leaking roof without access to the outdoor toilets. Andrea Star Reese  Meta was brought to Galuh, suffering from mental issues complicated by drug use. For eight years she has lived without privacy in a large outdoor cage separated from the men by a wire wall. Andrea Star Reese  Maftukhah is suffering from depression. After her husband left her to marry another woman, her family brought her to Yayasin Bina Lestari, a small foundation under the Brebes Department of Religion. Andrea Star Reese  It is not unusual to find a sole child among adults being treated in hospitals and shelters. Andrea Star Reese  Agus sings in his cage, his hands moving in an intricate dance. Agus is housed in a cell to ensure he can not run away. He is being held at Jasono Alternative Treatment, a small private shelter in Cilicap, Central Java. Andrea Star Reese  At Bina Ahlaq boarding school, the large Silat (martial arts)-trained staff is available night and day to respond to emergencies. Andrea Star Reese  Evi, the young woman in the pink dress, is still at Yayasin Bina Lestari. Medications are still not available. Andrea Star Reese  A large challenge to reform is the stigma surrounding the label mentally ill. There is no stigma attached to being possessed or under a spell. Keris Nangtang Foundation is an experimental shelter run by activists for homeless mentally ill and drug addicted men and women. Herbal treatments are used and no one is chained. Andrea Star Reese  Anne’s father believes she does not need much to eat. Her family is distressed by the lack of improvement in her condition. Andrea Star Reese  Nurhammed, successfully treated for bi-polar disorder, tells Saepudin that he can get better. For nine years, Saepudin lived shackled in a back room in his family home. The two men met through a controversial program recently suspended for allowing volunteers to obtain diagnostic information and deliver medications. Now people in West Java’s remote villages must be brought to a hospital for treatment. Andrea Star Reese  Pondok Pesantren Bina Ahlaq is considered a boarding school and requires a tuition fee. Andrea Star Reese  Gede, living chained to a post in a shed behind his mother’s home in a remote area of Bali, was reported to the Suriani Foundation. Dr. Suriani founded one of the rare, perhaps the only, outreach programs in Indonesia involving home visits by a psychiatrist. Andrea Star Reese  Mustofa, the sole assistant and primary caregiver at Kyai Syamsul's family-run shelter, gives a shower to Akrom, 25 years old. Andrea Star Reese  Didin, 25 years old, receives treatment from Abah Sanuk, a traditional healer using Silat, a martial arts method. Shamans and traditional healers are the most popular and more affordable mental health care providers throughout Indonesia. Andrea Star Reese  Muhammad Ikromudin, 25, was trained by to have special powers. He assists the men and women attending a mass healing that will last throughout the day and night. Participants pray, drink herbal drinks, vomit, and eventually enter a hypnotic trance. Afterwards, cleansed of their sins, they are showered with fragrant herbal water. Andrea Star Reese  Namiratus, the nine-year-old daughter of a traditional healer, likes to help with the care of the men and women that live in a locked section of her home. Andrea Star Reese The Human Rights Watch report also addresses the fundamental scarcity of the country’s mental-health-care resources: in a country of 250 million — it is the world’s fourth most populous nation after China, India and the U.S. — there are only between 600 and 800 psychiatrists, or one for every 300,000 to 400,000 people. There are also only 48 mental hospitals in the country, many of which are characterized by “severely overcrowded and unsanitary conditions.” At one hospital on the outskirts of Jakarta, the country’s capital, around 90 women live in a room built to accommodate around 30\. The report documents rampant sexual and physical abuse ranging from unwanted sexual contact to subjecting patients to electroconvulsive therapy (ECT) without providing anesthesia. Eight of the country’s 34 provinces have no mental hospitals whatsoever. _— With reporting by Yenni Kwok_ ## Transcript [ BLANK_AUDIO ] In Indonesia, people with mental health conditions are put in pasung, chained, or locked up in homes or in institutions because they have conditions such as schizophrenia or depression. [ FOREIGN ] [ FOREIGN ] People are shackled in homes by their families, in institutions run by faith healers, and traditional healers, and sometimes, even in social care institutions. Agus is a 26 year old man with a psychosocial disability He was locked up in a shed by his family for a month. [ FOREIGN ] [ FOREIGN ] Agus' family decided to lock him up because they didn't know what was happening to him. They were convinced, they told me, he was possessed by the devil. [ FOREIGN ] Possessed by a strange spirit. It's difficult to stand there. Because the shed is so short. You can only sit Today Agus is working in his village, building houses and leads a fulfilling life, because he's receiving the support and services that he needs. Currently, the government estimates that there are about 18, 00 people who are shackled in Indonesia. Despite this practice being illegal in Indonesia, the government has banned pasung since 1977 and yet, the practice persists across the country. We visited one institution run by a faith healer where the department of social affairs was actually sending people. They knew fully well people were being shackled. [ FOREIGN ] [ SOUND ] People who are put in pasung become extremely neglected, isolated, and develop all sorts of physical ailments as a result of being chained. [ FOREIGN ] [ FOREIGN ] We met Ikram's family in Central Java. Ikram has been locked up in this shed for many years now. We spoke to his brother, Mustafa, who explained the challenges his family faced in caring for his brother. [ FOREIGN ] [ FOREIGN ] There was a time when Ikram's family took him to see a doctor where he had access to medication and services and he was doing much better. He even lived for a short while in the family home. However, as soon as the medication ran out And the family did not have time to travel to a provincial hospital and to spend the money on a regular basis. Ikram was put back in the shed. [ FOREIGN ] [ FOREIGN ] The conditions in these institutions are extremely unsanitary. People are chained with metallic chains and can't move around much. They are eating, sleeping, defecating, urinating, in that same space for a period of years. There is an urgent need for the government to monitor these institutions. And to ensure that its ban on shackling is implemented. In homes and institutions, but in the long term there needs to be a shift from institutions to community based services so people with mental health conditions and their families can live in the community And access the services and support they need. It shouldn't be like that. I hope nobody, no one, has that experience. I wish my brother was cured. I want support from the government for my bother. 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