Disorder: Indonesia’s Mental Health Facilities by Andrea Star Reese

from the series: Disorder
Andrea Star Reese
The following project was photographed between Jan. 2011 and Nov. 2012.

Galuh Foundation, located on the outskirts of Jakarta, is licensed by Indonesia’s government. No one is turned away if they cannot pay. Galuh receives enough rice, noodles and cooking oil for two months from the local government, the totality of all current government support. Medications are not available.

Pasung is the Indonesian term for restraints or restrained. It is used to refer to shackles, but can also refer to being locked in a room or confined in a shed or animal pen.

From January 2011 through the end of 2012, I spent time photographing people in Indonesia being held in homes, shelters, schools and hospitals. Many had not been seen by a psychiatrist or diagnosed with mental illness, stress or a physical condition that might explain symptoms or behaviors they exhibited.

Pasung, banned in 1977, is the widespread traditional response to mental disturbances like these. People resort to pasung when they cannot afford care, fear medications, want to avoid the stigma attached to a diagnosis of mental illness, or most commonly, feel it is necessary to protect family, community and the disturbed individual.

Effective regional programs continue to be rare and underfunded. Common obstacles for Indonesians include access to care, cost of treatment, and the lack of widespread dissemination of basic information. Indonesia’s local and regional officials recognize the important role existing private and licensed shelters can play, despite their current inadequacies.

Differing figures reported by the government indicate that Indonesia has about 600 to 800 psychiatrists—half based in Java, and half of that 50% practice in Jakarta. Some still use only one diagnosis and one prescription. Needed prescriptions can be unavailable for months due to shortages. Patient compliance and lack of family support can also lead to treatment failure. To further complicate efforts for reform, the Department of Health oversees mental hospitals while shelters for the mentally ill are the responsibility of a separate department.

And furthermore, Shamans and traditional healers continue to remain the popular choice of mental health care throughout the country. For Indonesians, it is better and cheaper to attribute confusing or abnormal behavior to spiritual weakness, spells, or possession. There is no stigma attached to being under a spell or possessed.

Mental illness is a disease that can be treated successfully; as my project demonstrates, inadequate access to the medications and treatments commonly available though out much of the world has devastating consequences. The largest may be that many people don’t even know that they can get better.


Andrea Star Reese is a documentary photographer based in New York. A selection from her series Disorder will be exhibited at the 2013 Visa Pour L’Image Photojournalism Festival held in Perpignan, France from August 31st to September 15th. 

In addition to publication, photographs from Disorder will be used for education, training and as part of community outreach programs in Indonesia.


Related Topics: , , , , , , ,

Latest Posts

2014.  Gaza.  Palestine.  Schoolchildren head to class at the Sobhi Abu Karsh School in the Shujai'iya neighborhood. Operation Protective Edge lasted from 8 July 2014 – 26 August 2014, killing 2,189 Palestinians of which 1,486 are believed to be civilians. 66 Israeli soldiers and 6 civilians were killed.  It's estimated that 4,564 rockets were fired at Israel by Palestinian militants.

Inside Gaza with Photographer Peter van Agtmael

What photographer Peter van Agtmael encountered in Gaza changed the way he worked.

Read More
WASTELAND PERMITTED USE: This image may be downloaded or is otherwise provided at no charge for one-time use for coverage or promotion of National Geographic magazine dated December 2014 and exclusively in conjunction thereof.  No copying, distribution or archiving permitted.  Sublicensing, sale or resale is prohibited.     REQUIRED CREDIT AND CAPTION: All image uses must bear the copyright notice and be properly credited to the relevant photographer, as shown in this metadata, and must be accompanied by a caption, which makes reference to NGM.  Any uses in which the image appears without proper copyright notice, photographer credit and a caption referencing NGM are subject to paid licensing.        Mandatory usage requirements: (Please note: you may select 5 branded images for online use and 3 images for print/unbranded)1. Include mandatory photo credit with each image2. Show the December cover of National Geographic somewhere in the post (credit: National Geographic) unless using only one image3. Provide a prominent link to: http://ngm.nationalgeographic.com/2014/12/superfund/voosen-textat the top of your piece, ahead of the photos 4. Mention that the images are from "the December issue of National Geographic magazine” GOWANUS CANALNew York, New YorkPollutants: polycyclic aromatic hydrocarbons, polychlorinated biphenyls (PCBs), mercury, lead, copperYear listed: 2010Carved from a tidal estuary 160 years ago, the Gowanus Canal is Brooklyn’s industrial artery—and a deeply polluted waterway. Even so, it’s frequented by herons, seagulls, crabs, and canoeists. Defying local fears of economic stigma, the EPA listed the canal as a Superfund site in 2010. It hopes to start dredging contaminated mud in 2016.

Photojournalism Daily: Nov. 24, 2014

Mideast Israel Palestinians

The Best Pictures of the Week: Nov. 14 – Nov. 21

Follow

Get every new post delivered to your Inbox.

Join 19,275 other followers