The Stigmatisation of Mental Health in Indonesian Culture

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If you’ve lived in Indonesia for long enough, you will be no stranger to the unspoken list of taboos in this country, from eating with your left hand to anything sex-related. Many of these are well-intentioned and dictate the conventions of politeness in a public setting, usually so ingrained in our society that most don’t even bother to question them. However, aversion to much more relevant and pertinent topics has largely contributed to a lack of education which worsens the stigma, and among these is the concept of mental health.

Having lived in Indonesia my entire life, I’ve grown to notice the exact prevalence of this issue in both everyday life and national news media outlets. A lack of empathy for those who struggle with mental health is glaringly evident in the way some teachers in both Indonesian and international schools would often treat students’ social anxiety as a mere excuse, or parents insisting that their children should just “cheer up” despite the very real possibility of them having a mental disorder. They’re often shunned or even treated as the punchline of jokes; it is almost impossible to count the number of times I’ve heard someone use “autistic” (autis in Indonesian) and “stupid” interchangeably to the point where no one thinks twice about using that term anymore. If you’ve been around for long enough, you’d know what I’m talking about.

But why is this? What could have caused such blatant and casual ableism to still run rampant in Indonesia’s society even today, and how did we get here?

Given these things, it should be no surprise that Indonesia has had a rocky history with mental health in the past. Originally believed to be demonic possessions, black magic or the like, mental health was rarely treated as a critical issue and more as a taboo in Indonesia’s religious society; one of the expected responses to someone raising logical mental health concerns is to simply “pray more”. Even to this day, psychosocial disorders such as depression, schizophrenia, and bipolar disorder are being misunderstood by the general public as divine retribution for not being “religious enough”—as I’ve heard from recounts of personal stories both online and in real life—rather than what they are: uncontrollable conditions in the brain that fundamentally transform a person’s behavioural and cognitive patterns, among other things. There is a certain way in which people would talk about the mentally ill, describing them as caricatures of their illnesses to justify their lack of empathy towards them when there is already a perfectly plausible explanation for their conditions.

With a misconception as detrimental as this, it is only natural that a lack of education around the topic would be twisted into something much more sinister.  In Indonesia, this took form in a practice called pasung, or shackling; much like the name implies, it involves shackling down people who display signs of psychosocial disorders with chains, throwing them into inadequate and cramped warehouses for fear of the people’s lives around them. According to a report made by the Human Rights Watch, most cases of pasung take place in local villages and rural areas, even on the outskirts of Jakarta, and commonplace among those experiencing psychotic or schizophrenic disorders. Although this inhumane practice was banned by the government in 1977, it still continued throughout local communities until programs like Free from Pasung (created in 2010) started pushing for a more thorough eradication—as of 2016, the number of those who experienced pasung at least once in their lifetime totaled at around 57,000.

However, it is worth mentioning that most cases of pasung were done by families who felt as if they had no choice—and after understanding the extent of the stigma around mental health in Indonesia, it isn’t hard to see why. Fear-mongering through these superstitions and spiritual myths causes the general population to ostracize the mentally ill and see them as dangerous rather than people needing help. Consequently, this strips away their empathy when they realize that mental illnesses can reside in anyone at all, whether it be in loved ones or strangers. It doesn’t help that as of last year, there are only 600-800 psychiatrists in 2500 clinics nationwide, meaning that mental health support is difficult to find as well in this country.

The practice of shackling is just one extreme outcome that has emerged from the fervent stigma surrounding this issue. Although it is less likely to occur in bustling cities like Jakarta, the mere existence of such a brutal practice happening in the first place is alarming enough. It illustrates how seemingly harmless actions and beliefs from the community are able to put an already marginalized community in even more danger, and these include placing mental disorders as the butt of jokes or demonizing mentally ill people. Even if they are meant to be meaningless “fun”, there is no doubt that they will only contribute to the stigma further, even more so considering that the only time mental health is discussed within our community seems to almost always be in a negative light.

Recently, however,  a growth in technological advancements seems to be bringing more education and awareness for this topic worldwide. People are gaining access to online sources that include a less subjective and more scientific outlook on mental health. For example, Indonesia’s national newspaper, Kompas, now has its own mental health column; a partnership between UNICEF and the Center of Indonesia Medical Students’ Activities (CIMSA) has produced online sessions and discussions with the aim of supporting those with mental health issues during the pandemic (held bi-weekly on their Zoom and YouTube). More and more people are realizing that mental health may not be as black and white as it appears, and while this is not nearly enough, it is a promising start into an unforeseeable future where a majority of the population might be more willing to lend their hands to those in need of help.

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