This Ethics Alert is an update on the original story here.
The ethical problem with pasung, which is still a commonplace way of handling mental health patients, is that it is inhumane. All humans deserve the same things regardless of color, gender, sexuality, age, etc. This includes mental health status. It does not make you any less of a human just because your needs are different. To be chained up 24 hours a day for who knows how long is horrible. These people have no access to anything; they do not get to even wash themselves. There are cases reported of sexual assault, procedures done without consent or anesthesia, and physical violence. These people in chains are subject to all of this and more and cannot do anything about it. People need to be aware of this in order to stand up for the mental health patients that cannot do it for themselves.
It can be argued that isolating mental health patients and keeping them out of society will maximize the overall happiness of the population as a whole. Isn’t that a good thing, keeping as many people happy as possible? But you cannot ignore the humanity of the people with psychosocial disabilities. What about the happiness of these patients; does their life have so little importance that their voice can just be taken away? A person with physical disabilities is not given any less rights, there is an effort made to compensate for the disability. The same should be done for mental disabilities. Mental illness is a disease, not a moral failing that needs to be punished. The only way to make things more manageable is to provide education on why some people have mental disabilities and how to care for them and treat them.
It is unethical to treat humans as mere objects. You cannot just chain somebody up and expect that to be acceptable. Humans have the right to control over their own bodies. The treatment of the mentally ill in Indonesia is very inhumane and unethical. They cannot take care of their bodies. They have to urinate, defecate, sleep, and eat in the same spot for however long they are chained up. These people have no way to keep up their personal hygiene and they are not in control of the operations and treatments done to their bodies. They do not even give consent to have their bodies treated in this way or get electroshock therapy or any other treatments performed on them. These patients are secluded and isolated and mistreated in a way that no human deserves, no matter what the situation.
Families do this to their own family members. They send them to mental health facilities that do not treat them humanely because the family does not know how to care for them and it is an interruption to their daily life. The sad thing is, if the institution does not keep them locked up, the family will just lock them up themselves. When some people were freed from pasung due to the banning of it, families just locked them up in their own houses since they did not know what to do with them. A father locked his daughter up for 15 years and she was in the same situation as being chained up in an institution. She received no access to people and could not keep up her personal hygiene, and lived in the same room for many years.
The situation in Indonesia is one that has to be addressed and taken care of. Mental health facilities need to be educated, the government needs to be educated, and families need to be educated. The key here is education about the reality of having a mental illness. Facilities need to be given the right materials and means to care for the mentally ill. Humans have thoughts and feelings and rights, which cannot be taken away due to mental health status. You cannot treat people as objects and take away their humanity. People are not property and cannot be treated as such. These people need to be cared for and nurtured, not subject to abuse. Living in hell on a daily basis is unacceptable.