A graveyard of the living: the physical conditions of life for persons in pasung

Indonesia has among the highest rates of Pasung in the world. This widespread significant human rights issue (Hidayat et al 2020) is the phenomenon of restraint of people with mental illness in the home, usually by their family, in the absence of more compassionate and competent institutions to treat them or any formal system of evidence-based mental health care beyond the short-term support provided by large psychiatric institutions. Many people in Pasung live in deplorable conditions, yet there has been little research into the issue. Identifying the negative effects of community forcible seclusion and restraint is a difficult task that raises ethical, legal, and methodological concerns. The main objective of this photograph analysis is to look for the effects of seclusion and restraint on mentally ill people at home. This study analysed 135 photos of people in Pasung, to gain detailed insights into diversity of pasung characteristics such as geographical area, gender, age, family condition, influences of stigma and cultural beliefs, pasung type, and photos that conveyed content, context, and meaning related to Pasung for the person, their family, and the community. Lessons for how we address stigma and care for people with severe mental illness more broadly are indicated.