Human rights of persons with mental illness in Indonesia: more than legislation is needed

Abstract

BackgroundAlthough attention to human rights in Indonesia has been improving over the past decade, the human rights situation of persons with mental disorders is still far from satisfactory. The purpose of this paper is to examine the legal framework for protection of human rights of persons with mental disorder and the extent to which Indonesia's international obligations concerning the right to health are being met.MethodsWe examined the Indonesian constitution, Indonesian laws relevant to the right to health, the structure and operation of the National Human Rights Commission, and what is known about violations of the human rights of persons with mental illness from research and the media.ResultsThe focus of the Indonesian Constitution on rights pre-dated the Universal Declaration, Indonesia has ratified relevant international covenants and domestic law provides an adequate legal framework for human rights protections. However, human rights abuses persist, are widespread, and go essentially unremarked and unchallenged. The National Human Rights Commission has only recently become engaged in the issue of protection of the rights of persons with mental illness.ConclusionMore than legislation is needed to protect the human rights of persons with mental illness. Improving the human rights situation for persons with mental illness in Indonesia will require action by governments at national, provincial and district levels, substantial increases in the level of investment in mental health services, coordinated action by mental health professionals and consumer and carer organisations, and a central role for the National Human Rights Commission in protecting the rights of persons with mental illness.

Exploring the potential use of patient and public involvement to strengthen Indonesian mental health care for people with psychosis: A qualitative exploration of the views of service users and carers

“…However, in the current study carers coalesced in their concerns that any increased emphasis on involvement in Indonesia should not overburden carers or detract from Governmental or societal responsibility for the care of people with mental illness. This may be reflective of an ongoing lack of mental health service provision in Indonesia more generally despite improvements to mental health care since the mandatory provision of basic community mental health care and improvements to human rights following the establishment of the National Commission on Human Rights in 1993 . Whilst involvement appears to hold potential value to Indonesian mental health services, it is unlikely to be a panacea without consideration being given to these wider contextual factors further highlighted by study participants through concerns about lack of organizational readiness to implement PPI.…”

“…A recent Human Rights Watch investigation into the treatment of people with psychosis revealed significant human rights violations in Indonesia, including arbitrary and prolonged hospital detention, involuntary treatment and tens of thousands of people being illegally chained up (‘pasung’) in unsanitary conditions, both in the community and in hospital settings . Such violations persist despite improvement to mental health care in Indonesia since the provision of basic community mental health care, improvements to human rights generally following the establishment of the National Commission on Human Rights in 1993 and recent changes to international covenants and domestic law which now provide an adequate legal framework for human rights protections …”

Mental Health in South Asia: Ethics, Resources, Programs and Legislation

“…More than legislation is needed to protect the human rights of persons with mental disorders (Irmansyah et al 2009). In some instances, instead of protecting the rights of persons with mental disorders, legislation may take away their rights.…”

Implementing an innovative intervention to increase research capacity for enhancing early psychosis care in Indonesia

“…Presently, up to 40% of people with psychosis do not receive any form of psychiatric treatment (Idaiani et al, 2014) and most do not receive any psychosocial interventions as these are largely unavailable and undeveloped for this population (Prasetiyawan, Viora, Maramis, & Keliat, 2006). A confluence of factors contribute to the shortage of mental health services including a lack of progressive policy and governmental commitment, leadership, financing and insufficient professionally trained mental health workers (Irmansyah, Prasetyo, & Minas, 2009 2015). Indonesia has an extensive primary healthcare system (puskesmas) with each subdistrict having one community health centre linked to a series of smaller centres throughout the district.…”