Before The Chains Are Broken: Considering Spaces and Accessibility of Mental Healthcare in Java
Indonesia: Arts, Religion, and Social Change
Abstract
In 2010 the government of Indonesia initiated a “Free Pasung” movement to remove the physical chains of people who are in restraint because of their mental illness, or, patients in a state of pasung. In light of the program and national focus to “break the chains,” I became curious as to the systems of care in place for a patient once the chains are broken. The following paper is a product of three weeks of fieldwork divided between Jakarta and Yogyakarta, Java, Indonesia, aimed to address this inquiry. Through six semi-structured interviews with practicing psychiatrists, mental health specialists, and members of Parliament and the Ministry of Health in Jakarta, followed by two additional semi-structured discussions and two weeks of participant observation in government and private-operated systems of care in Yogyakarta, I hope to illustrate the state of mental healthcare in Java, and thereby complicate the notion of “breaking the chains” by analyzing the care that can be accessed once the chains are broken. Narratives from healthcare professionals, mental health specialists, patients and their families demonstrate the importance of contextualizing the practice of pasung. My findings reveal that beyond “breaking the chains” lies a need to consider the healthcare system in which the chains are applied.