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Almost 19,000 people suffering from serious mental disorders are being kept in chains or pillories because of the country’s limited psychiatric facilities and the stigma attached to such illness, a top official said on Friday.

“Chaining or pillorying mentally disturbed people is the worst reflection of the shortage of health facilities, and we think that in Indonesia there are still around 18,800 people chained or pilloried,” said Irmansyah, the director for mental health at the Health Ministry.

Restraining their movement often is the only way out for families of people with mental health problems, he said, as they usually either have no access to health services or cannot afford them.

According to the Mental Health Atlas released by the World Health Organization last week, Indonesia is among the countries with the lowest ratio of psychiatrists among the population.

Irmansyah pointed out that Indonesia only had 1 psychiatrist for every 3.3 million people. The country also has only 48 mental hospitals with a total capacity of 7,700 beds.

However, the WHO estimates that at least one million Indonesians are suffering from grave mental disorders and that some 80,000 of them need to be treated in a hospital.

Because of the limited medical infrastructure, “only 3.5 percent of mental health sufferers have access to treatment,” Irmansyah said.

He added that even in cases where treatment would be available, families of patients often were reluctant to find professional help for loved ones because of the severe social stigma.

The official said that pillorying someone was a violation of up to nine laws, including the Law on Human Rights, the Law on the Protection of Children, the Law on Household Violence and the Law on Health. The government therefore has set a target to eradicate the degrading practice of chaining or pillorying mental health sufferers by 2014, Irmansyah said.

He added that the Health Ministry was preparing a Law on Mental Health that would firmly state the rights of people with mental problems.

“We have to remind all that no matter now grave the mental health problem suffered by someone, we still have the Jamkesmas and Jamkesda schemes,” Irmansyah said, referring to the national Health Insurance Scheme and the Regional Health Insurance scheme.