Background
“….there could be more than 30,000 people
kept in this state (chained or shacked or pasung). ''It's terrible. It's a
situation that should not happen, not only in terms of psychiatric diseases but
in terms of humanity,"
-Indonesia's Head of Mental Health Department, Dr Irmansyah,
Chaining
or locking people with mental illness have been major concern in Indonesia,
specifically in rural areas. Families and society at large do not understand
what and why it happened, how to treat them, or when certain medications or
training should be given to people with mental disabilities. The lack of
education and economic capability drove families and communities in rural areas
to choose easy way out: physical restraint such as chaining or locking which
are widely known as pasung. According to early research on pasung phenomenon, the
primary reason people are applying this method is the dangerous behavior shown by people with mental illness. The great
majority of these people had diagnosis of Schizoprenia[1].
Sadly, its medications are not well accommodated in Indonesia and there is not
many expert can be found to help government in overcoming this problem.
Government
has been trying to improve mental health situation in Indonesia. On 1977,
Ministry of Internal Affairs has issues Decision No: PEM/29/6/15, November 11th
1977 which stipulated citizens to stop practicing pasung towards people with
mental illness and to encourage them to go to mental health institution
instead. Article 149 Law No. 36 Year 2009 regarding National Health required
all people with disabilities to be given medications and treatments by
Government, Local Government, and the whole society. Despite the law that
protects the rights of people with mental illness, pasung phenomenon still exists and the government’s goal to “Indonesia
Bebas Pasung 2014 (Free from Restraints)” was not succeeded. Many people with
mental illness are still being restrained. Several cities such as Surabaya[2],
Blitar[3],
and almost all cities in East Java[4]
are reportedly failed upon the program. Several areas such as Riau[5]
and Banten provinces[6]
just declared to run the “Free from Restraints Project” by the end of 2019
following the Health Minister instruction during national work planning[7].
However, West Java province allegedly not ready yet to implement the program[8].
There
are many factors that contribute to the failure of the intervention program: challenges to implementation of mental health
care in primary-care settings[9];
the low numbers and few types of workers who are trained and supervised in
mental health care[10].
It is worsened each year because people’s mindset stay the same: they tend to
believe that people with certain mental illness such as Schizoprenia were
possessed by the devils and there was nothing they can do about it except putting
them in horribly small place where they eat, sleep, pee, and defecate.
Mission
The
mission of this project is to educate the families and the communities about
mental illness therefore they can treat people with mental illness in the
compliance with human rights standard.
Objectives
Objectives
from this project consists of:
1.
People
with mental illness are able to live without chain or locked in a room
2.
People
with mental illness are able to live in harmony with the family and community
with small chance to relapse.
a.
The
family has a comprehensive knowlegde and attitude about people with mental
illness: the cause, trigger, medication, expressed emotion, misleading cultural
beliefs, etc.
b.
The
Neighboorhod or community has a comprehensive knowlegde and attitude about
people with mental illness: the cause, trigger, medication, expressed emotion,
misleading cultural beliefs, etc.
3.
Village
cadres are well-trained, are able to, and are willing to do the follow up of
the project
4.
To
create generic model of intervention for pasung
case
Goals
The
Goals of the project is to treat people with mental illness as a free human
being and help them improve their mental health condition. At the end, we aim
them to be able to blend with society and live their life akin to other people
in their community.
Project Details
Summary:
Free
the Chain project will focus on one
family as the pilot project located in Yogyakarta as recommended by the expert on this issue in Indonesia due to
the solid network in the city. The program will provides serial workshops for
people with mental illness, the family, and the community. Additionally, the
program will involve village cadre as the successor obligated to do follow-ups.
The involvement of village cadre will be the most crucial issue since most of
the previous programs were failed in the terms of conducting the follow up and
evaluation.
Free
the Chain project will engage “three musketeers” of mental health professional
(psychiatrist, psychologist, and social worker) that rarely collaborate in
Indonesia. The collaboration of the three mental health professionals is
expected to create comprehensive intervention from medication, psychological
therapy, as well as counseling. The program will also involve other
stakeholders such as NGO, asylum, local government, and local community such as
Komunitas Peduli Skizofrenia Indonesia (Indonesian
Schizophrenic Care Community or KPSI) and neighboring community to ensure the
sustainability of the program. The goal of the program is not only to set
people with mental illness free from chain but also to ensure the well-being
and the quality of their life in the society.
Detailed Aspects:
1.
Human
Resources and Allies
-
Group
members
This
project will be hosted by YSEALI awardee, Justitia Avila Veda and Regisda
Machdy in association with Pijarpijarpsikologi.org as media partner.
-
Co-Host
There
is a possibility to co-host the project with several NGOs and community such as
KPSI, Handicap international, and others NGOs focusing on mental health issues
and civil rights.
-
Volunteer
Recruitment
We
are open to recruting volunteer if it is needed.
2.
Financial
Resources and Budgets Details
This project will be funded by
YSEALI grant. There is a possibility to propose for funding to others donor
such as fundings from Ministry of Social Welfare, Ministry of Health, HiVOS,
etc. The allocation of the budgets can be seen below:
Project
|
Details of the Need
|
Price
|
Amt
|
Total
|
Total $
|
Publishing
Program
|
Printed
Proposal
|
IDR 7,000
|
20
|
IDR 140,000
|
$10
|
#1
Workshop
|
Seminar kit
|
IDR 3,000
|
50
|
IDR 150,000
|
$11
|
Snack and
Beverages (include committees)
|
IDR 30,000
|
60
|
IDR 1,800,000
|
$129
|
|
Modules
making
|
Professional
help
|
IDR 1,000,000
|
1
|
IDR 1,000,000
|
$71
|
#2
Workshop
|
Seminar
kit
|
IDR 3,000
|
20
|
IDR 60,000
|
$4
|
Snack and
Beverages (include committees)
|
IDR 30,000
|
30
|
IDR 900,000
|
$64
|
|
Family
Visit
|
Transportation
(car rental + driver)
|
IDR 700,000
|
15
|
IDR 10,500,000
|
$750
|
Workshop
for community
|
Snack and
Beverages (include committees)
|
IDR 30,000
|
60
|
IDR 1,800,000
|
$129
|
Seminar
kit
|
IDR 2,000
|
50
|
IDR 100,000
|
$7
|
|
Mental health
professionals fee
|
Psychiatrist
(3 months)
|
IDR 10,000,000
|
1
|
IDR 10,000,000
|
$714
|
Psychologist
(3 months)
|
IDR 10,000,000
|
1
|
IDR 10,000,000
|
$714
|
|
Social
Worker (3 months)
|
IDR 10,000,000
|
1
|
IDR 10,000,000
|
$714
|
|
Village
cadre (1 year)
|
IDR 3,000,000
|
3
|
IDR 9,000,000
|
$643
|
|
IDR 55,450,000
|
$3,961
|
3.
Technical Executions
Pre-Event
1.
Board
Meeting
The Board will conduct a meeting
to discuss about the program, funding, technical execution, and other crucial
aspects of the event.
2.
Sponsorship
and Allies Networking
The board members will start
screening all possible sponsor and allies, whether it is NGO, mass media, youth
activity center in university, etc. the board members will start approaching
them, offer them the proposals, and pursue the agreement between The Board and
the other parties.
3.
Publishing
and Promoting the Program
Committee will make promotion
materials to be spread on the mass media, social media, posters, and our
partner’s platform.
4.
#1
Workshop on existing issue and previous program evaluation
Workshop that engaging three
mental health professionals, local government, mental health activist,
community, and NGO to address the problem properly.
5.
Modul
making
Along with the expert, project
leader will create the three moduls for the victim, family, and neighborhood.
6.
#2
Workshop on professional judgment of intervention plan modul
Invite back the stakeholders to
give professional judgement of the three moduls.
7.
Selecting
Family target
Family target must be sub-village
resident family who chained or locked at least one family member in their house.
Geographical condition also becomes one of the consideration since the pilot
program will promote the victim to has a vocational or clerical job. Experts will help project officer in defining
the family target criteria while local leader will give family recommendation
according to it.
Event
After
selecting the family, the whole project team will diagnose and do profile
assessment toward both family’s and people with mental illness’ background. The
result of the assessment will define the next steps as can be seen below.
Complete
explanation of the steps:
1.
Building
rapport to family
Build relationship with the
targeted family and ask the willingnes to participate in the program. From this
step, Project Officer and the experts will gather information about both the
family and the person with mental illness.
2.
Diagnosis
and Profile Assessment
Diagnose the condition and set
individual plan following the modules
Psychiatrist will diagnose the
victim of pasung whether she/he needs
to be recovered in asylum and discuss it with the other experts.
3.
To
the Asylum
If the person with mental illness
needs medical prescribes and further treatments, we will send him/her to the
Mental Asylum and report the assessment result as the guidance. Sending the
person to the asylum doesn’t stop the project because it still needs follow
ups. The follow ups should be done by the whole team because Mental Asylum will
not likely to do it. This is the same
mistake all govermental projects always did and became the sole reason why it
was never succeeeded.
4.
Series
of workshop for the family
Series of workshop on the cause
of mental illness, trigger, medication, expressed emotion, relapse, false
cultural beliefs, stigma, etc., for the family. The workshop will be conducted
according to the modules.
5.
Series
of workshop for village cadres
Series of workshop on the cause
of mental illness, trigger, medication, expressed emotion, relapse, false
cultural beliefs, stigma, etc., for the village cadres. The workshop will be
conducted according to the modules.
6.
Back
to the Village: Social Adaptation
Person with mental illness who
went to asylum is now back at home. He/she will learn how to socialize with
either family or society. Experts and psychologist will explain to the family
what kind of treatment was given to the people with mental illness.
7.
Vocational
Training
Person with mental illness will
be given training to encourage their ability to blend and socialize with family
and the community. The training could be very simple, it depends on the
family’s background. If the family is farmer, person with mental illness can be
trained to harvest rice for the example.
8.
Skill
Assessment of Village Cadres
Considering the importance of
village cadres’ role in this project, evaluation towards their skills is
necessary. All the experts will gather to do assessment by asking them to
answer questionnaire.
9.
Follow
up
The
last but not least, village cadres need to do the follow ups by checking the
medications given to the person with mental illness, progress in his/her
behavior, condition in the family, etc. Village cadres will fill up some forms
on certain period of time, it could be weekly or monthly, depends on the need.
Post-Event
1.
Project
Officer Evaluation
Project Officer will conduct an
evaluation about the program and it involves evaluation from both the victim,
family, neighborhood, and the village cadre
2.
Submitting
report to other stakeholders
After doing the evaluation, project
officer will start write the report to submit to other stakeholders such as
sponsor, donor, co-host, allies, etc.
3.
Follow
Up
The project officer will do
follow-up towards the village cadre and the family.
[2] http://www.rri.co.id/surabaya/post/berita/139067/sosial/dinkes_
target _jatim_bebas
_pasung_2015 belum_terealisasi.html
[4]“Program Bebas Pasung Tidak
Direspon Bupati dan Walikota”, Jaring News, http://jaringnews.com/hidup-sehat/umum/52951/program-bebas-pasung-tidak-direspon-bupati-walikota accessed on October 18th
2015.
[5]“Provinsi Riau Canangkan Program
Bebas Pasung”, Detak Riau News, http://detakriaunews.com/news/berita-provinsi-riau-canangkan-program-bebas-pasung.html accessed on October 18th
2015.
[6]“Program Banten Bebas Pasung 2019
Dicanangkan”, DPRD Provinsi Banten, http://dprd-bantenprov.go.id/post/detail/program-banten-bebas-pasung-2019-dicanangkan.html accessed on October 18th
2015.
[7]“Kementerian Kesehatan Ajak
Pemuda Wujudkan Indonesia Bebas Pasung”, Berita Satu, http://www.beritasatu.com/kesra/183215-menkes-ajak-pemda-wujudkan-indonesia-bebas-pasung.html accessed on October 18th
2015.
[8]“Jawa Barat Tidak Berani
Canangkan Bebas Pasung”, Gala Media News, http://m.galamedianews.com/bandung-raya/7583/jabar-tidak-berani-canangkan-bebas-pasung-.html accessed on October 18th
2015.
[9] Saraceno, B., van Ommeren, M., Batniji, R., Cohen, A., Gureje, O.,
Mahoney J., Sridhar D., & Underhill C. (2007). Global Mental Health 5:
Barriers to improvement of mental health services in low-income and
middle-income countries. The Lancet , 1164-1174.
Draft IDE Program Bebas Pasung
Reviewed by regismachdy
on
November 23, 2016
Rating:
Reviewed by regismachdy
on
November 23, 2016
Rating:
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