After being shackled by his family for six years, 32-year-old Gede Ariawan was finally released on Tuesday by the Suryani Institute for Mental Health.
The institute founder, LK Suryani, said that based on observation by volunteers, the condition of the mentally ill patient had gradually improved.
"The patient's condition has improved, so there's no need to shackle him again. His family should give him better attention," she said, adding that the institute's volunteers were ready to be contacted and to assist whenever his condition worsened.
Ariawan had been shackled by his family since 2006 because he ruined his neighbour's pelinggih (worship compound). His family said he was once treated at Bangli Mental Hospital but was returned home for a variety of reasons.
Since then, he had been shackled with a chain. He began receiving treatment from the institute in 2008.
In June 2008, when his condition improved, he was able to work on a construction project. He also helped his mother, a vendor at Banyuning traditional market.
However, since October 2011, during his recovery, he started to join his friends and drink tuak (palm wine) while waiting for his mother at the market.
His condition had worsened since then. He screamed a lot and ruined the Tugu Jro Gede belonging to his family. He was then shackled again.
"Actually, he had been treated with Sikzonoate injections. But the health officers were often late giving him the drug. At one time, he didn't receive the drug at all during the whole month," said Luh Yuni Swandari, one of the volunteers.
Ariawan smiled when he was released and welcomed by his mother, Made Bulan, and the other family members.
"I hope he will really get back to normal. I'm always worried about his condition," Bulan said.
Another patient, Gede Sumardana, was also visited by Suryani.
The 36-year-old man has been mentally ill for 12 years. His mother, Nyoman Widiarini, said the family had taken him to Bangli Mental Hospital four times.
"But his condition hasn't improved until now. After leaving the hospital he got better, but several days later he rampaged again. It seems that the drug doesn't work," she said.
She said that her son ran away from the hospital three times, but the hospital did not pay much attention.
Now, Ariawan lives behind bars in a designated house. His family has not been able to do much to make him better.
During Suryani's visit, he was given an injection to gradually improve his condition and to stop him from breaking things.
The institute's records show that there are still shackled mentally ill people in Bali. Luh Ketut Suryani, founder and chairperson of the Suryani Institute for Mental Health, said that the treatment of mentally ill persons had become a serious problem on the island due to a lack of both understanding and facilities.
"The government should be more serious in dealing with the inhumane treatment of the mentally ill," said Suryani, professor of psychiatry at Udayana University
The institute estimated that there were about 350 of 9,000 people with severe mental illness on the island who were shackled or confined by their own families. Most of them were living in impoverished villages in Karangasem in east Bali and Buleleng in north Bali.
Shackling and confinement of the mentally ill has long been practiced, with families locking away or physically restraining their own relatives. This barbaric practice was known to still occur for a variety of reasons in many low-income families in the country, Suryani said.
The majority of the families feel desperate as they have spent a lot of money and expended much energy on long and costly treatments for their mentally ill relatives.
Another reason for confining their relatives could be their own fear that the mentally ill relative would disturb people and cause trouble.
"For them, shackling and confinement is seen as the fastest and easiest way to solve the problem," the professor said.
Suryani, however, stressed that the most crucial matter was actually people's ignorance and misunderstanding of mental health problems.
"They think that mental health problems are incurable, while actually they can be treated medically, as well as spiritually, with support from their families to bring people back to their normal lives," she said.
The institute has been working hard on providing special treatments combining both medical and spiritual aspects in an attempt to eradicate shackling and confinement.
"The institute has provided special treatments to several mentally ill patients in their own homes. Around 30 per cent of the treated patients were able to return to living normally," she said, adding that they should receive continual treatment.
Bali has the ambitious dream of releasing all people being shackled by their families as part of the island's efforts to reduce the number of people with mental health-related issues.