Mental Health Patients Being Chained to Walls

Cianjur is a rustic region in the verdant landscapes of West Java in Indonesia. It was here that 75-years-old Engkos Kosasih lived with his 50-years-old daughter. The woman was imprisoned in a small room–windows boarded up so firmly that it would take some time for the eyes to adjust to the darkness. Her crime? She suffered from mental illness.

I locked her up about 15 years ago. Someone cast a spell on her. She became destructive, dug up other people’s crops and ate raw corn from the plant. I was ashamed and scared she’d do it again,’ the old man told Human Rights Watch.

“Her husband left her and married again. I consulted five faith healers but that didn’t work; nobody can heal her. We couldn’t take her to see any doctor for help because I didn’t have any money.

“First I tied her wrist and ankles together with cables but she managed to untie herself so I decided to lock her up because the neighbours were scared.

“She goes to the toilet in the room. Nobody cleans it; we just leave it there to dry. We don’t give her a bath. Nobody has entered the room in years. We give her food twice a day through a hole in the wall. She tore up her clothes so she’s naked now.

“A lot of children shout at her, sometimes they throw stones at her. She took one of these stones and started digging up the cement floor to escape. She sleeps in the dirt.”

After years of isolation and being bounded, she had lost the use of her legs and had resorted to crawling on the floor. She has since been released.

©Erminia Colucci

It is not a custom that is unfamiliar in these parts. The practice, known as pasung, sees mentally ill people shackled by ropes, chains, or other forms of restraints for prolonged periods.

James Leadbitter, who also goes by the moniker “the vacuum cleaner”, is an artist and mental health activist who worked on a project about a community in West Java called Istana KSL, which liberates people from pasung.

“Living with a mental health disability is hugely challenging. To be essentially tortured means that they also have to deal with their journey of recovery as well as the trauma of being tortured. Some of the residents we met at Istana KSJ may never recover and were just being cared for in a safe way.

“One person we interviewed had been through a particularly terrible experience. He had been confined in a bamboo cage for years and then in a well for weeks. A holy man had tried to drown him until he screamed. When he screamed out he was considered “better”. However, this man has now returned to work part time because of the care given to him by Istana KSJ.”

In Indonesia, mental health is still grossly misunderstood and it is often associated with curses, spirit possession, immoral behaviour, or other superstitions.

Dr Erminia Colucci is a Senior Lecturer at the Department of Psychology, School of Science and Technology, Middlesex University London and an Honorary Senior Research Fellow at the Centre for Cultural and Global Mental Health, The University of Melbourne, She is funded by ESRC Global Challenges Research Fund to do work in Ghana and Indonesia, which focuses on mental health practices. Her film, Breaking the Chains, is an ethnographic photo/film-documentary that explores pasung.

“The belief behind restraining people in this way stems from inadequacy of the mental health system; unaffordable, ineffective and difficult-to-access treatments; uncoordinated (if not conflicting) therapeutic approaches i.e. traditional/spiritual vs. biomedical interventions; and a general lack of reinforcement and implementation of human rights and health legislations,” she said.

“Because of their restricted mobility and extremely poor hygiene and diet, people exposed to pasung develop mental and physical disabilities, injuries, and diseases, in addition to difficulties in developing social skills. The emotional burden of seeing your basic human rights breached is enormous. Some of these people will spend the rest of their lives in pasung and die under restriction, which happened to three of the people in my documentary.”

Despite pasung being banned in 1977, Human Rights Watch reported that there were almost 19,000 mentally ill Indonesians still constrained in claustrophobic and small spaces.

“Legislations are not sufficient on their own to stop practices that are rooted in strong cultural and religious beliefs–that, coupled with the lack of resources and adequate alternatives. However, positive developments have been made in Indonesia in the last decade, when compared to other countries with similar practices where very little is happening at the government level,” Dr. Colucci explained.

“There is now a recognition that it will take time and much more resources and investments in mental health care and public awareness for pasung to disappear.”