Carers shackle the mentally ill again as pandemic forces them back indoors.
Virus forces return after patients enjoyed better care, attitudes
LOCKED up in a tiny hut with barely enough space to lie down, Rauf is a prisoner to his mental health issues and carers whose only way of coping is to shut him away.
While not unique to Indonesia, padlocks, shackles and chains are often used to cover for a lack of mental health care in the world’s fourth most-populous nation.
But the Covid-19 epidemic has exacerbated the problem, forcing many people back into chains after they were freed following a change in attitudes, and access to medication and better care.
Rauf, 40, spent decades in shackles until a few years ago, when he was finally allowed to wander on his own – usually to his favourite place, a crowded market.
The virus has forced the return of old methods, however, and he is once again shackled and locked in a cramped backyard hut where he eats, sleeps and defecates.
“We don’t want him to be infected by the virus as we learned that things are now getting worse,” said Hasni, Rauf’s aunt who looks after him in Polewali in West Sulawesi.
She also worries that virus lockdowns could restrict Rauf’s access to medication, and fears he could
harm himself or others.
Locking up people with mental health conditions used to be common in Indonesia – particularly among families who could not cope or afford appropriate care.
Foreign tourists in Bali would often be shocked to discover someone chained to a tree in an otherwise picture-perfect village.
A national campaign helped thousands to gain better access to
mental health treatment and medication, and experts believed they had turned the corner -- until the virus struck.
“This is the tragedy with the pandemic that it is happening in so many countries including across Indonesia,” said Kriti Sharma, a senior disability rights researcher for Human Rights Watch (HRW).
In a report released yesterday entitled Living in Chains: Shackling of People with Psychosocial Disabilities Worldwide”, HRW documented hundreds of thousands of people – some as young as 10 – being confined for years.
Psychosocial disability – when a mental illness interferes with a person’s ability to function – can arise from any mental health issue if it impacts their life severely enough.
Cases of shackling were either gathered by field workers, reported by locals, or shared by relatives unable to cope.
“It is a practice that is widespread, brutal and an open secret in many communities,” Sharma said.
Indonesia’s health ministry -which has registered nearly 300,000 people as experiencing mental health conditions – said it had recorded more than 6,000 “shackling” cases in the first half of the year, a rise of more than 1,000 on the whole of 2019.
“The number could double if the pandemic continues,” said Siti Khalimah, the director for mental health affairs at the ministry.