PASUNG physical restrain on people with Mental Health in Indonesia

1. PASUNG

The phrase PASUNG in Bahasa, according to Indonesian dictionaries, it is determined as a means to reprimand a person or imprison a person, it is a particular form of penalizing and restricting the action of a person or quit certain activity. PASUNG is the physical constraint and confinement of the psychologically ill people within community. It is accomplished and surrounded by many people all around the world especially in Indonesia. It is prevailing in the region in which the tsunami causes destruction in December 2004 and now it is in the restoration and reconstruction process, there was a conflict situation between the government and Ache free movement and because at that time country was facing some kind of instability. PASUNG has become a psychological ailment since it is induced in individuals who are clinically diagnosed as having psychological ill. Families, as primary care providers of their ill members, confront the limitations for giving care. PASUNG is clearly considered as an inhumane practice (Tyas, 2008).

It’s against the human rights to imprison a mentally ill person, it is against the laws of human and it is the right of every person to get the proper treatment from any kind of disease. The world health organization has passed legislation for the protection of the rights of the mentally sick people. Mental health legislation is passed for defending the privileges of individuals with mental disorders as well as for those individuals who are in an insecure area of the community (WTO, 2003). 

All mental people have the right to receive high quality treatments and care provided through responsive health care services. They should be protected against any form of inhuman therapy and elegance (WTO, 2003). Mental health legislation is concerned with more care and treatment. It provides a legal structure to address critical mental wellness problems such as access to care, rehabilitation, after care, full incorporation of people with mental conditions in the community, and the marketing of mental wellness in different areas of the group (HB, 2001).

2. Reasons of PASUNG

Why families of the mentally ill persons do PASUNG, there are some reasons for the PASUNG.

  • Depending on family

Mentally ill persons become totally dependent on their families for doing anything like eating, bathing, urinary, taking care, and for the fulfillment of other needs.. Due to dependency on the mentally ill person’s family members, families become careless and don’t bother for such kind of persons. Due to the high dependency over family,  imprisonment process is done for mental retards (GA, 1970).

  • Family rejects to take care

Mentally ill persons need a lot of care, as they are incapable to care for themselves even they don’t know what activities can harm them so families of such persons cannot provide care to them so they confine such persons. Family members might think that the person may wander off and may harm others that’s why they practice PASUNG (Minas & Diatri, 2008).

  • Remarkably high levels of traumatic events

Due to tsunami disaster, people of Indonesia have gone through a high trauma which cause them mentally distorted and destructive. These are thereasons that make  them a bit inhumane, so after the disastrous trauma PASUNG practices increased (Minas & Diatri, 2008).

  • Shortage of basic livelihood needs

From past few years, Indonesia was going through the recovery phase and restoration phase after the tsunami and shortage of funds and other basic livelihood issues were prevailing in the Indonesian economy. Due to the shortage of livelihood needs, people were not satisfied and survival competition took place. Dominant and independent people tried to dominate on the other ones. In this situation, mentally ill persons were negatively dominated and affected badly (Jakarta, 2010).

  • Disgrace & shame

Families feel shame and disgrace due to the mentally ill family member so they try to hide them from others and practice PASUNG.

3. Facts about PASUNG

  • No proper legislation

For the mentally ill persons there is no proper legislation in 25% countries of the world about the protection of their huam rights  which are 31% of the population of these countries including Indonesia. Some countries may have governance laws for such kind of persons (WTO, 2003).

  • Irresponsible government

The government of Indonesia doesn’t pay attention to the sector of the society consisting of mentally ill persons. This is the most neglected sector of the economy (Minas & Diatri, 2008).

  • Fewer hospitals & psychiatrists

In Indonesia there are only 33 hospitals for the mentally ill persons. The population is 16 Million which is dispersed over 1600 islands. The rate of the mentally distressed persons is increased but the number of hospitals is very little which is not fulfilling the requirement. In Indonesia, the number of psychiatrists has been just 500 which is  far less from te demand as per the psycho patients. Number of Hospitals and other health facilities are also so pitiable in Indonesia (Minas & Diatri, 2008).

  • National health budget

The national health budget of Indonesia is the 3.2 % of the budget and the budget for the mental disorders is only 1.1 % of the 3.2 %. This is a very small part of the budget which is allocated for the mental health of the psycho persons (Puteh, et al., 2011).

  • Economic conditions

Low income group of people mostly  are the victim of  PASUNG. Lower income group families are financially distracted and they don’t have proper means of income sources so they can’t fulfill the needs of the whole family. Economically poor man neglect its duties and responsibilities towards others mostly (Puteh, et al., 2011).

  • Costly treatments

Treatment for the mental diseases is very costly, lower class and middle class families cannot afford the treatments. Poor and most of the rural spiritual families who cannot afford the treatments considersuch kind of diseases as a spiritual punishment. But in today’s globalized knowledge world situation is  not  like this (UN.org, 2012)

  • Millennium development goals

Millennium development goals are set for the achievement of the higher economic conditions. In the millennium development goals, no goals are set for the recent year up to 2015 about the mentally sick patients in Indonesia (Diatri & Minas, 2009)

  • UN strategies

United Nations strategic goals don’t contain health improvement of mentally sick patients. These all facts are very alarming about the PASUNG and the metally ill patients. For the removal of this activity, actions must have to be taken and this matter has to be considered (UN.org, 2012).

4. Removal of PASUNG

To PASUNG measures have to be taken to remove this cruel activity which is same as inhumane. To stop this practice, everyone has to make its contribution who is related to the mentally ill person.

  • Family awareness programs

Family awareness programs must be started in Indonesia about the PASUNG  member of the family. Affection and the feeling of care must be arisen in the family about the poisoning of the family member. Other ways of the care should be communicated with the family as well such as treatment support in terms of finance (Allard, 2010).

  • Community and stakeholders impact

The community must be supportive to the mentally ill person or any person suffering from the mental diseases by avoiding discouraging behavior and other related persons will badly affect the mental health of the patient. It is important because support to the families of the patient mentally ill persons lead to a healthy community.

  • Government measures

The government of Indonesia should take some measures for the removal of this dilemma. Government must reserve some funds for the removal of discrimination to the ill and ill mind people of the country as they also are the citizens. The can be cured and be helpful for the development of the country after getting good health and sound mind.

  • Educate people

It’s the responsibility of educators to educate others to support the mental patients. it’s the social responsibility of whole society  to be kind towards the person who doesn’t know about his betterment. The government of Indonesia should also take some actions and should improve the education standard of the people. As the education level will raise the living style and  will also improve education in this particular field.

  • NGOs and other organizations

NGOs and other non-profitable organizations which are working for the betterment of the community also take the responsibility to reduce this dilemma.

In London charitable funds have been implied to sector of mental retards and for the improvement of their health and significantly positive results have gained (Diatri & Minas, 2009). Nongovernmental organization in Poland during 2005 also organized mental health programs and achieved the goals in the late 2008. Their purpose was to improve the mental health of the psycho patients. “Schizophrenia- open the doors” was the name of the program. Such programs must be started by the NGOs of Indonesia to help the PASUNG (Puteh, et al., 2011).

5. Strategies for the removal of PASUNG

Some of the strategic goals must have to be employed for the reduction of the PASUNG activity. Some of the strategies are below

  • Education programs:

Education programs must be initiated  for the awareness about the mental health and diseases. These programs must provide knowledge about the treatments and information about the diseases, its causes and effects and most importantly creater awareness among people about the behaviour towards the patients. Such programs must be telecasted ontelevision, broadcasted in the radios and must be published in the magazines and other newsletters. Religious groups and other Islamic councils of the Indonesia should create awareness campaigns and awareness lessons to promote the knowledge about the inhumanity and the dilemma of PASUNG. Informational programs will create a knowledgeable environment which will remove the hatred towards the mentally sick persons. Lack of education cause the seriousness of this problem.

  • Improved governmental policies

The government of Indonesia is taking some measures towards this dilemma. It should also revise its policies and should make some amendments and make some measures for the improvement for the health of psychologically sick persons. Government must take some improved measures and should start programs for the health care. Hospitals and other psychic houses must be established by the government and the cost of the treatment must be reduced for the improvement of health care (Viora, et al., 2006).

Governor of Indonesia said that he has allocated 11.2 $ million for the improvement of health of

 mentally sick persons. He also said that the goals for the improvement of health must be achieved with the help of the local governments and other related members (Jakarta, 2010).

  • Implementation of international mental health strategies

Indonesia needs to implement the international mental health advices and strategies and should also implement the goals which are set by the international mental health development organization. The world health organization has made some legislations for the improvement of the health of the nations so Indonesia needs to follow those acts and must set some benchmarks for the improvement of the health of its nation and for the removal of  PASUNG (UN.org, 2012)

  • Anti discrimination and anti stigma projects

Anti discrimination and anti stigma projects and advisory services must be designed in  Indonesian society for the reduction of PASUNG. These advisory services must make awareness among all not to discriminate the mentally sick persons from other, this may cause the stigma of those people and leads to the isolation (HB, 2001).

Scotland and many other European countries started anti discrimination and anti stigma programs by the WHO from 2005 to 2010 and in 2008 during an Edinburgh conference it was declared that the approaches: “taking actions against stigma across Europe” will be implemented (Viora, et al., 2006).

Indonesian should also implement such strategies and should make its nation aware of the dilemma caused by the discrimination and stigma of the mentally sick persons (UN.org, 2012).

  • Research and analysis

Annual Research work should be done by the Indonesian government and Indonesian nation and should make the nation aware of the facts and figures about the increasing dilemma of PASUNG. The research will make all the nation aware about the alarming situation and will accelerate and motivate the nation to take precautionary measures (Allard, 2010).

6. Conclusion

PASUNG is an inhumane, atrocious and merciless practice. It must be removed from the society ofIndonesia and from the globe. It is against human rights and human practices. Pasung is wrong, families should feel shameful and guilty while practicing it. Families and other community members should support mentally ill persons and should not discriminate and separate them from others. Government must take some actions for the removal of this dilemma. It is disastrous towards the society. This neglected sector must be protected by the WHO and other health organizations (Tyas, 2008).

7. Bibliography

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Diatri, H. & Minas, H., 2009. the fourth International Stigma Conference: Stigma and discrimination, evidence for action. Institute of Psychiatry. Pasung: A consequence of insufficient mental health services in Indonesia.

GA, E., 1970. Restraint in the treatment of the mentally ill in the late 19th century.. Aust N Z J Psychiatry, 4(1), pp. 201-205.

HB, B., 2001. The Villagers’ Reactions Towards Craziness: An Indonesian Example.. Transcultural Psychiatry, 38(3), p. 275.

Jakarta, 2010. RI to abolish ‘pasung’ practice by 2014. [Online]
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Puteh, I., Marthoenis, M. & Minas, H., 2011. Aceh Free Pasung: Releasing the mentally ill from physical restraint. International Journal of mental Health Systems, p. 5.

Tyas, T. H., 2008. PASUNG : Family experience of dealing with “the deviant“ in Bireuen. Nanggroe Aceh Darussalam, Indonesia.

UN.org, 2012. [Online]
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Viora, E., Maramis, A. & Keliat, B., 2006. Mental health model of care programmes after the tsunami in Aceh, Indonesia.. Int. Rev. Psychiatry.

WTO, W. H. O., 2003. Mental Health Legislation and Human Rights. [Online]
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