If you're suffering from mental health illness, you may have heard the following statements: "Cheer up... get over it... suck it up"; "There are other's worse off than you!"; "But you have so much going for you."
Adverse, unhelpful remarks are common because mental health issues are invisible and difficult to communicate. Comparing depression to feeling a bit under the weather; or hunger with the extreme starvation experienced by anorexics is like equating a small paper cut to a broken leg. Since mental health issues are not tangible or visible they are often characterised as symptoms of a spoiled and entitled generation of whimpering Westerners, who do not grasp how privileged and lucky they are.
This, of course, is entirely misguided as mental health issues are a wide spread subject which has the potential to affect all regardless of class, race, gender, or ethnicity. According to a disturbing Human Rights Watch report, which reveals the shocking mental health care in Indonesia, it is clear that mental health does not discriminate. The report revealed the deplorable poor care that many Indonsians suffering from mental health problems receive. During the past decade, Indonesia has endured natural disasters, bombings, and political violence which have clearly left their mark, bringing issues of trauma, pain and a mental health crisis.
Mental Health illness is not regarded a real and serious illness. Across Indonesia, there is a prevalent misconception that mental health illnesses are the repercussions of sinful or immoral behaviour, a lack of faith or merely a symptom of the possessed. Consequently, those in need are finding answers and help from faith or traditional healers, who have no medical background or experience and are ill equipped to provide sufficient support. In religious centres, men and women are reportedly chained next to each other. The report interviewed a woman called Tasya, suffering from psychosocial disability, who claimed "When I take a shower, the men, the staff watch me,"... "One male staff member touched my vagina this morning. He was doing it just for fun." The much needed medical support they need is regarded as a last resort, not taken seriously.
Yet, even if they were to seek psychiatric help or medication, many will find it impossible to access it, 90% of those who want to contact mental health services are unable to do so. Indonesia is home to 250 million people, yet there are just 48 mental hospitals and more than half of these establishments are located in just four provinces of Indonesia's 34 provinces. Unbelievably, in all of Indonesia there are just 600 to 800 psychiatrists that equates to one trained psychiatrist to 300,000 to 400,000 people. The few facilities and services that do exist are poorly kept and can contribute and worsen conditions.
Under Indonesian law it is relatively easy to admit a person with a psychological illness or disability to an institution. The Mental Health Act (2014) allows a family member or guardian to admit a child or an adult with a mental health illness without their consent to a mental health or a social care institution. Most admitted to mental health institutions are not there voluntarily.
Almost 40 years after Indonesia banned the practice of shackling people with mental health conditions, shockingly nearly 19,000 are still living in chains, or are locked up in institutions, where they are susceptible to abuse. The study found that the method of pasung, which involves shackling or confining people with psychosocial disabilities, was banned in 1977, enduring stigma and a chronic lack of mental health care and community support services reveals it is still widespread.
People subjected to the torturous pasung can have their ankles bound with chains or wooden stocks for hours, days, months or even years. They are often kept outside, naked, vulnerable and forbidden to wash. Recent figures from the Indonesian government suggest that more than 57,000 people in Indonesia have endured pasung at least once, while an estimated 18,800 are currently chained or locked up.
The report calls on the Indonesian government to put mental health on the agenda by putting an end to the brutality of pasung, ordering vigilant inspections of state and private institutions, and establishing regular monitoring of institutions. I believe that the report is wake up call to recognise that mental health care needs to be treated appropriately and swiftly. However, it also made me realise how grateful I am, in spite of some of the questionable aspects of mental health care we receive in the UK, at least we have support readily available. I am grateful today for the NHS, without them I doubt I would have survived and endured my mental health illness.
Mental health issues are definitely not first world problems because the benefits, stability and access to services of the first world are irrelevant to mental health. Obviously those with greater wealth can access better medication, private counselling and a range of treatments for mental health illness, but, the car you drive, the house you live in or amount of cash in your bank account is immaterial when you are trapped in your own mind by the pain and turmoil of mental health illness.