The dangers of shackling in people with mental disorders

People with mental disorders should get medical intervention as early as possible. Just delaying it will make things worse and make handling difficult. Moreover, if you have to live in pasung without treatment, the condition of people with mental disorders will get worse.

In Indonesia, there are still many cases of people with mental disorders (ODGJ) who do not get good treatment and are instead shackled.

Dangers of shackling in people with mental disorders (ODGJ)

People with mental disorders (ODGJ) who do not get medical treatment and instead put them in shackles can worsen their condition.

Pasung that shackles people with mental disorders will automatically make them isolated. He will feel abandoned, inferior, hopeless, and can generate revenge.

"Mental disorders can progress to worsening during confinement, possibly coupled with torture or other human rights violations," wrote the WHO on its website which describes mental disorders and imprisonment.

In the Journal of Mental Nursing STIKES explained, shackling means that mental disorders are left without proper treatment. The longer it is not treated, the brain damage will undoubtedly get worse.

"You don't have to be left alone for long or in shackles, for about three years the brain gets more damaged and has an impact on other damage," wrote the journal.

This condition will reduce the potential for therapeutic response and reduce the patient's capacity to be able to carry out normal functions. There will be recurrences and eventually resistance to medical therapy.

The study also conveyed the dangers of shackling in people with mental disorders, not only in their disease but also in their physical condition.

Physically, development will be disrupted until it stops developing. In some cases the patient is no longer able to walk.

In the limbs there will be atrophy, which is a condition of loss or reduction in the size of one part of the body. For example muscle atrophy, muscle mass decreases and shrinks. The most severe effect of this condition is paralysis.

Reasons for shackling people with mental disorders and the negative stigma

At the end of 2019, the Central Java government handled 511 cases of shackling in people with psychiatric disorders. That is only what is recorded and it is possible that there are more that have not been touched.

Kriti Sharma in her report for Human Right Watch released in 2016 reported that there are approximately 57,000 people with mental disorders living in shackles. Whether it's traditional pasung using blocks, chained, or locked in a room.

A small percentage are lucky to be released by the health or social services. The rest are still living in pasung, some even to the end of their lives.

In the past, shackling for people with mental disorders was usually done by installing wood made like handcuffs.

The wood is attached to the feet to limit the space for movement, even to the point of being unable to perform self-care activities such as bathing and defecating.

Today, shackling occurs more frequently by attaching chain cuffs to both legs and locking him in a room separated from the rest of the family.

As quoted from the RISKESDAS health system research bulletin in 2013, anthropological research on shackling in people with mental disorders in Indonesia describes several reasons for families to do shackling.

The reason for the family to carry out shackling to their family who has mental disorders is to avoid the bad effects that will be caused.

This is because ODGJ often commit violence and act aggressively that endanger people and objects around them.

Another reason is the absence of health facilities in the area. Families are forced to do pasung to family members who are ODGJ because they cannot reach health facilities. Either because of the remote location or because of economic problems.

Apart from that, there are other reasons, such as having an ODGJ family that is a disgrace or a wrong understanding of mental disorders, for example a lack of faith, possession, and other assumptions.

Mental disorders are things that are not easily known. Many biological and psychological factors influence each other.

This factor cannot stand alone, but becomes a unit which together causes mental disorders.