First class service building for European patients in Bogor Mental Hospital. Source: "The Naturalization of Psychiatry in Indonesia and Its Interaction with Indigenous Therapeutics". Source
ON his trip to Bogor in 1894, a Dutch psychiatrist, JW Hofmann was surprised to find a native suffering from a mental disorder in pasung. Feeling sorry and moved, Hoffmann wrote a protest article entitled "Krankzinnigenverpleging in Neerlandsch-Indie" (Soul Care in the Dutch East Indies) which was published by De Indische Gids. Hoffmann protested against the Dutch East Indies government that did not provide mental health services to the natives.
Hoffmann's writings opened up debate among Dutch psychiatrists. Hoffmann urged the Indian government to provide mental health services to the natives. "I beg to do something about the sad situation experienced by indigenous people suffering from mental disorders ... But do it in a cheap and practical way, "Hoffmann wrote.
Starting in the Netherlands
The treatment reform of mental illness in the Netherlands began in the 1830s. It began with the development of mental health care in Europe. French medical expert Philippe Pinel wrote about the possibilities of healing a psychiatric patient in a mental hospital (RSJ) and attempting to return him to the community in 1801.
Previously, European mental health care at the end of the 18th century treated patients by chaining. Pinel managed to change that way in the Bicêtre Hospital and Salpêtrière Hospital. He replaced the chain with a tie jacket.
While in Europe mental health care continues to be discussed more seriously, in colonial countries the care of mental health patients is still handed over to military hospitals. The policy to treat mental patients in military hospitals was inseparable from the method of Professor Brugman of Leiden University who ran military medical services in the Netherlands in 1795. Governor General HW Daendels copied the method of Professor Brugman by submitting all medical matters, including mental health, to military hospitals.
The military hospital built in 1832 accommodates mental illnesses in one small department. The majority of patients are former Dutch soldiers, they are likely to have Post-Traumatic Stress Disorder (PTSD) which many soldiers suffer from. However, more and more patients are arriving.
In 1862, the colonial government conducted a survey to find out the condition and number of people with mental disorders in colonial countries. FH Bauer and WM Smit, two doctors who were given this assignment, found 586 patients with severe mental disorders often became angry and potentially endangered the community. Of that number, 252 of them have been included in military hospitals in major cities. Their report on the conditions and treatment of people suffering from mental disorders in the Dutch East Indies was published in 1862 and made a scene in the Netherlands.
In addition to conducting surveys, Bauer and Smit also visited several countries to see how to deal with mental disorders. Both suggested that the Dutch government be responsible for patients with dangerous mental disorders. However, people with non-dangerous mental disorders do not need to be supported in mental health services.
The results of Bauer and Smit's report smoothed doctors' desire to build mental health services specifically for Europeans whose main goal was to provide more humane institutions with more beds and cots.
"Indeed, the project to improve mental health services in the Netherlands East Indies from the beginning was indeed to restructure it according to international criteria in its time. In Bauer and Smit's report we see the foundation of the birth of modern psychiatry in Indonesia, "wrote Nathan Porath in" The Naturalization of Psychiatry in Indonesia and Its Interaction with Indigenous Therapeutics ".
In 1881, the government opened the first mental health service in Bogor under the name Hetkrankzinnigengestich Buitenzorg (now Dr. H Marzoeki Mahdi Hospital). As the initiator, Bauer and Smit chose Bogor because it was considered the most appropriate principle of inpatient therapy for psychiatric patients who had to be isolated from the community: close to the city center, Batavia, but still quite beautiful and remote.
Although the main purpose of the establishment of the Bogor Hospital was to treat Europeans, the colonial government was forced to change it after Hoffmann protested the policy through writing in 1894. Hoffman's writing again made a stir as reported by Bauer and Smit.
Since Hoffmann's writing, the Bogor RSJ received indigenous patients. Indigenous people who are aware of mental health no longer think that their relatives are caused by drowsiness or possessions. They can surrender their family's mental health to those who are more skilled. In addition, the Dutch government also accommodates free indigenous people with mental disorders that endanger the environment.
"Mental health services were first built in 1881 and continue to develop afterwards. In the 1900s, with the Ethical Policy, discussions about mental health became far more vocal, "said Sebastiaan Broere who examined the history of Magelang Hospital for his thesis.
At the beginning of the 20th century, doctors complained about the increasing number of new mental disorder patients while the new RSJ was available in Bogor. Increasing numbers of patients prove that awareness of mental health is increasing in the Dutch East Indies.
The government then built several new hospitals, such as in Malang (1902), Magelang (1912), and Sabang (1922). In the 1930s, the Netherlands already had four mental health services in the colonies. All of these hospitals, wrote Hans Pols in "The Psychiatrist as Administrator: The Career of W. F. The United States in the Dutch East Indies", can accommodate approximately 9,000 patients. Meanwhile, in large cities dozens of psychiatric clinics stand, making it easier for people who want to seek treatment.
The close access to mental health services has a big influence on the level of awareness of the surrounding community. This also explained the data collected by Broere that most of the Magelang Hospital patients came from major cities, such as Surakarta, Yogyakarta, Magelang, and Semarang.
While city dwellers are aware of mental health, those who live in villages and are far from mental health services still have to languish in confinement, as well as pasung. "Patients with mental disorders will remain confined or put in their villages unless mental health institutions are nearby," Broere wrote in the In and Out of Magelang Asylum.
This article is quoted in historia.id in the Indonesian version