Indonesian and Western Perspectives on Shackling the Mentally Ill

BACKGROUND: Mental illness has become a serious problem in Indonesia. Many people with severe mental disorders remain untreated or drop out of the care service system and eventually end up being shackled. Although attention to human right in Indonesia has grown, physical restraint of people with mental disorders remains prevalent. This study aimed to compare the Indonesian and Western perspectives pertaining to shackling the mentally ill. SUBJECT AND METHODS: This was a systematic review. The data were mined from news, research and studies pertinent to restrained mentally ill patients. Literature was searched from Google scholar, BMC, BMJ, and the Cochrane library. The key words used in the English language were “shackling and schizophrenia”, and “restraint and mental illnesses”. The Indonesian words included “pemasungan gangguan jiwa”. Searches were conducted until August 2015, resulting in 45 articles that consisted of 36 research articles and 9 non-research articles. Two of the 45 articles were duplicate. RESULTS: The theme of shackling in Indonesian perspective consists of: (1) Misguided perception of families and communities on people with mental illnesses (PMI); (2) Family and community treatment of PMI; (3) Lack of continuity in service programs between psychiatric hospitals, com-munity health centers, and communities. The theme of shackling in Western perspective consists of: (1) The impacts of restraint and shackling; (2) Restraint and shackling prevention; (3) There are no studies on the advantages of physical restraint. CONCLUSION: Research and news obtained from Indonesian articles consist of misguided perception pertaining to PMI and their treatment. Western articles include the impact of shackling PMI and prevention. It is essential to empower communities to raise awareness on mental illness and to provide correct information on treatment and the obligation to prevent shackling the mentally ill persons in Indonesia. Keywords: shackling, restraint, schizophrenia, mental healt