In Bali, a mission to help mental health and schizophrenia patients

BALI — “Schizophrenia is not crazy”, 45-year-old I Nyoman Sudiasa proudly declares.

Powerful words from someone who, up till four years ago, didn’t realise that he had been living with the disorder for over a decade.

Sitting under the Bali sun, he recalls how his symptoms surfaced at age 27. 

“I felt something strange in me. I began to get nervous, feel anxious and suspicious of others, including my wife. I felt that everyone around me was always watching me and I felt so depressed,” he said.

His wife, Ms Ni Putu Sri Ayu Astuti, became distressed as she struggled with his mood swings, mistrust, and inability to hold down a job.

The emotional and financial strain almost caused her to leave him but she persevered for the sake of the children, and because her family convinced her to stay.  

Despite numerous visits to the hospital, Mr Nyoman and his wife were left baffled as to what was causing the changes in his behaviour and his ability to think and reason.

It was only when he met psychiatrist Dr I Gusti Rai Wiguna, that he finally found an answer to the mystery causing him and his family so much anguish — schizophrenia, an extreme mental health condition that affects an estimated 21 million people worldwide. 

A MEETING THAT CHANGED LIVES

Encounters with individuals like Mr Nyoman made Dr Rai realise that more needed to be done to support people living with mental health conditions, which is a highly marginalised community.

He was especially moved to help when he discovered that one of his neighbours had locked their children in their rooms.

“There were two of them — one with schizophrenia and the other child had severe mental retardation. Both were confined in their rooms and I saw that as my calling.”

The lack of understanding about mental health issues, compounded with cultural beliefs and customs, has led to what is locally known as “pasung” or shackling. 

Many individuals with mental disorders have been found in appalling conditions while being chained up in rooms, and they often lose the ability to walk because their muscles atrophy.

A Human Rights Watch article reported that such cases dropped from 18,800 to 12,800 between 2016 and 2018, due mostly to concerted efforts by the Indonesian government and outreach groups. But more needs to be done. 

With the help of artist-activist Budi A K Kabul, Dr Rai started Rumah Berdaya in 2015, a community where people with schizophrenia could gather, learn to express themselves, and be taught a new trade with the help of volunteers. 

Its 76 members learn crafts skills like painting, incense-making, silk-screen printing, coconut oil production, and baking, which helps them generate an income for themselves. Many of them rely on costly medication to treat their symptoms, so the added income helps ease some financial stress on their families. 

Having started some of these programmes, Mr Budi sees the more long-term benefits, beyond the financial support.

“There is a very positive impact when our members’ products are sold. It raises their confidence levels. That’s because they feel their work is appreciated by the public despite the fact that schizophrenia has a stigma in society,” he says.

IT TAKES A VILLAGE

An equally important part of Rumah Berdaya’s mission is to foster better interaction between its members, their families and the public. This is particularly crucial when it comes to understanding the complexities of shackling.

Dr Rai, who has dealt with shackled patients, cautions against solely blaming the family: “I know that the family is also a victim. If they had a choice, they would not shackle a family member”.

Often times, the family locks them up to protect them from harming themselves or getting lost. Despite the government banning the practice in 1977, the issue still hasn’t been eradicated, putting some 14 million people who suffer from mental disorders at risk.  

Hope is in the air, however, as Dr Rai and Mr Budi continue their outreach efforts to “bridge the gap between family, the individual and what society can do to help”. They continue to engage with government officials, hospitals and health care workers to further discuss how best to care for people with schizophrenia.

Mr Nyoman, with the encouragement of Rumah Berdaya and his family, has started giving talks to local community groups. He is also one of four members to have been hired by the Denpasar City Social Service.

As the coordinator of Rumah Berdaya, Mr Nyoman believes his new employment “acknowledges that we can integrate with society in a more natural way.”

As loved ones, members and volunteers dance in unison to a popular folk tune, it’s easy to imagine a safer, kinder community if everyone heeds the advice of Mr Nyoman’s wife, Ms Sri Ayu: “To be patient, fully supportive and loving”.

“That kind of family support is very important for the healing process,” she adds.

This article first appeared in Our Better World.