Community-Based ”Pasung” Release Framework to Strengthen Pasung Handling System on People with Psychosis

Heni Dwi Windarwati1,2),  Budi Anna Keliat3), Raden I. Ismail4), Adang Bachtiar5)


1) Department of Mental Nursing, Faculty of Medicine, Universitas Brawijaya

2)Doctoral Program in Universitas Indonesia

3) Department of Mental Nursing, Faculty of Nursing, Universitas Indonesia

4) Department of Psychiatry, Faculty of Medicine, Universitas Indonesia

5)Deparment of Public Health, Faculty of Public Health, Universitas Indonesia



Background: Indonesia has the highest level of pasung for people with psychosis in the world. Nearly 60 thousand people with psychosis are illegally detained (‘pasung’) in fa­mi­­ly homes. Communities and families have a large role in developing global stra­tegies through the avai­la­bility of a community-based pasung release framework. The purpose of this study is to de­velop a pasung release framework that can be tested in accordance with the culture of the Indo­ne­sian people to strengthen local mental health services in the release of income.

Subjects and Method: This was a mixed method study carried out in East Java, In­do­nesia. This study consisted of 3 phases: (1) Explored community involvement through a sys­tematic re­view of the available evidence. A total of 25 people consisting of health workers, families, com­mu­nities, and people with schizophrenia, were inter­view­ed in this study; (2) Identified stake­hol­ders as well as the steps and their respective roles used in developing the foundation of the com­mu­nity-based pasung release frame­work. To explor­­ed the potential use of community in­vol­ve­ment in the release of pasung in Indonesia and identify priorities for a framework that is cul­tu­rally appropriate; and (3) Pro­duced a framework for community involvement in pasung release to be used in Indonesia by synthesizing evidence from all phases.

Results: Community involvement was the best way to realize a pasung release frame­work that was in accordance with Indonesian culture. Mental health services in pasung re­lease involving com­munity elements in low and middle-income countries could over­come the burden of mental health conditions through the development of commu­nity-cen­tered care models. However, such an approach had not been developed in Indo­nesia.

Conclusion: Community-based pasung release framework can be tested for use in mental health services, especially pasung release in people with psychosis in Indonesia.

Keywords:  pasung release, people with psychosis, pasung release framework, mental health

Correspondence: Heni Dwi Windarwati. Department of Mental Nursing, Faculty of Medicine, Universitas Brawijaya/ Universitas Indonesia. Email: Mobile: 082232­641­330.


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