Neglected Lives: Mentally Ill Patients in Jakarta

Posted: Wednesday, March 24, 2010 by Bintang in Labels: , ,

By Samiaji Bintang/Aceh Feature, Indonesia

Hi, my name is John… John Lennon,” says the old man while shaking my hand. He welcomes my visit to Panti Sosial Bina Laras Cengkareng, West Jakarta, one of the mental health centers run by local government. The man is bald, thin and dirty. He plays guitar and likes to sing The Beatles’s songs everyday. I sense a bad smell of his body while watching his ‘performance.’

“He never speaks Bahasa (Indonesian language), and we never know his real name up to now. Also he seldom takes a bath,” says Ihud Saputra, head of the center.

‘Mr. John’ suffers from manic depression or bipolar affective disorder with alternating bouts of mania and depression. He is among hundreds of mentally ill patients in the center that looks more like an asylum. Like ‘Mr. John,’ most of the patients suffer severe mental disorder, such as schizophrenia, manic depression, post-traumatic stress disorder, and obsessive-compulsive disorder.

Originally intended for 400 patients, the government-run facility is crammed with 600 inmates. They are packed into a dozen confinement rooms or cells. As I go into the cells, the air is thick with flies and the stench of feces and urine. Some are naked, others are emaciated or showing oozing lesions, curled up on the floor of the cells.

Over 85 percent of the patients no longer have any relatives. Most are abandoned by his/her family. There are so many stigmas when it comes to mental health. Instead of helping, most of the Indonesian community perceive the patient as ‘crazy’ or ‘madman’ that should be kept away.

Despite the center’s growing number of patients, its funding is very limited because of the weak economy; $1.5 is spent on each patient per day. A doctor stops by the center only once a week for two to three hours; he has numerous other similar institutions to attend to.

“With the current prices of staple food, it's hard for us to provide nutritious meals,” Ihud argues.

Recent data from the Jakarta social agency revealed that 181 people died between October 2008 and May 22, 2009, at four centers in Daan Mogot and Cengkareng, both in West Jakarta, and Cipayung and Ceger, in East Jakarta. For six months, three patients every four days died from tuberculosis, diarrhea and malnutrition at the centers. They suffer from malnutrition since the centers have few officials who are responsible for feeding the patients. Since standards of care are poor and there is failure to protect the basic human rights of people with mental illnesses, the mortality rates at the centers are very high.

“We lack nurses and sufficient stock of medicines. Meanwhile most general hospitals decline to accept or care for mentally ill patients who suffer physical diseases like tuberculoses, diarrhoea and malnutrition,” Ihud says.

The government took immediate response to remedy the crisis in the centers. However, the response is local and piecemeal. “It does not deal with any of the long-term determinants of the problem,” says Irmansyah, dean of Department of Psychiatry, University of Indonesia.