Luh Ketut Suryani, one of Indonesia’s 700 psychiatrists, is transforming the mental health field to address the country’s growing number of mental health disorders. Using an approach that combines traditional healing methods with modern psychology, Suryani is providing a cost-effective treatment option available to all sectors of society.
The New Idea
Over the past two decades, Suryani has been spreading mental health care across Indonesia by not only making it more accessible to citizens, but also by redefining and expanding the definition of a “mental health care provider.” Based on the simple premise that everyone can be a self-healer, Suryani has engaged a multitude of groups, including teachers, women, children, volunteers, senior citizens, and health workers, and has taught them how to cope with psychiatric issues. Perhaps most notably, she has successfully begun to partner traditional healers with modern psychiatrists to provide a holistic experience that includes community-based prevention, treatment, and rehabilitation.
Through Suryani’s organizations, the Suryani Institute for Mental Health and the Committee Against Sex Abuse, she has developed and expanded a number of initiatives designed to treat patients. Using her innovative method, which she coined the “biopyschospirit-sociocultural” approach to psychiatry, Suryani’s efforts combine meditation and spiritualism with modern psychological tools and practices. Local governments have adopted and replicated many of Suryani’s methods.
The number of reported psychiatric cases in Indonesia recently experienced a sharp increase. Many studies estimate that more than 1 million people between the ages of 15 to 34 commit suicide each year, which accounts for one suicide every 40 seconds. A 2007 study reported that the mental-disorder rate hovered around an alarming 11.6 percent nationally. Citizens suffering from mental health disorders often carry an enormous stigma and are subjected to discrimination and social exclusion. Due to the level of care required, many families physically restrain patients using chains, ropes, cages, or other confined spaces.
Psychiatric practice in Indonesia has traditionally centered on pharmaceutical treatments, rather than counseling and therapy. Many families, however, cannot afford even the limited and expensive drugs that are available. While traditional healers do present a potential solution, they are not yet a part of formal mental health services.
Despite the plethora of challenges surrounding mental health in Indonesia, primary health care providers still fail to prioritize the issue. Some doctors merely lack the skills and knowledge necessary to offer effective treatment. Patients, as a result, possess limited awareness about mental health disorders and perceive them as unpreventable and incurable.
Suryani’s strategy to expand mental health services across Indonesia relies on a multi-layered approach. On the one hand, her efforts aim to reintegrate traditional healers and partner them with the meager 700 psychiatrists working in Indonesia. On the other hand, citizens need to accept mental health as an integral part of local culture and care.
Suryani recently developed a referral system between traditional healers and modern psychiatrists, so that patients receive a holistic experience. Having been a traditional healer, Suryani understands the critical role that traditional healers play, as they are often the first level of support that patients seek. She deeply believes that traditional healers are an essential part of ensuring timely treatment and referrals; consequently, Suryani is currently working with religious leaders to engage and integrate more traditional healers.
To increase the demand for mental health services and ensure that disorders become less stigmatized, Suryani’s focus includes services that are especially applicable to citizen’s daily struggles. She targets groups that suffer from issues accompanying prenatal delivery and care, child abuse, aging, depression, as well as education. Suryani has extensively developed numerous initiatives to combat each.
In her efforts to aid the elderly and preserve their mental health, Suryani—since 1988—has been working to make senior citizens more socially active. Seniors form collaborative social groups, in which they manage activities, exchange information, and learn from each other. Suryani further links the groups with doctors and pharmacies to form partnerships that offer discounted services. More than 6,000 senior citizens have joined such groups across Bali.
At the same time, Suryani has developed a number of initiatives to treat children. As pedophilia became more common in the 1990s, for example, Suryani developed a spiritual hypnosis-assisted therapy to treat the post-traumatic stress disorders that ensued. In 2002, she established the Committee Against Sex Abuse, a citizen organization designed to provide children with treatment and rehabilitation as well as protection from sex offenders. The committee is comprised of police officers, volunteers, expatriates, and consulates. To provide preventative care, Suryani works with more than 5,000 elementary school teachers to offer child-development training.
In 2010, Suryani partnered with Indonesia’s School for Health Science and began teaching students about her innovative hypno-birthing method—a prenatal care experience combining meditation and relaxation to expecting mothers in an effort to ensure that the fetus is surrounded by feelings of peace, love, and happiness. Numerous studies have shown that the birthing process forms the basis of a child’s personality and ability to handle stress. Suryani and the School for Health Science are further partnering with Manuaba Hospital to apply the system in practice.
Through her organization, the Suryani Institute for Mental Health, Suryani has pioneered a community-based, affordable mental health treatment for the mentally ill, particularly for those who have been chained, confined, or jailed for multiple years. Her organization has not only provided more effective mental health services, but it has also served as an alternative to the inefficient and corrupt mental health system offered by the government. The program, furthermore, mobilizes families, communities, and local doctors; recovering more than 300 patients each year. Spiritualism, meditation, and acceptance are all among the practices espoused by the program.
In an effort to reduce the number of suicides and treat people suffering from depression, Suryani set up crisis centers in the districts of Karangasem and Buleleng. Leveraging support from the local governments along with her own resources, a center employs and trains a psychiatrist, field coordinator, staff members, and volunteers. They offer services via phone as well as in-person sessions, and always follow-up interventions by meeting with family and community members.
In cooperation with the Indonesian Psychiatric Association in Bali, Suryani also developed programs such as Understanding Yourself and the program for Balinese Women. Meditation sessions are organized for community members to foster discussion and share experiences. Such sessions enable people to confront, reframe, and cope with past traumas.
All of Suryani’s initiatives have collectively formed a full model of mental health care for Bali. Some of her innovative methods have even inspired provincial and national governments to replicate her models. For example, Suryani’s efforts have led to the government-led establishment of the Ministry of Health with Posyandu Lansia (Integrated Health Post for Senior Citizens) and Minister of Welfare with Karang Lansia (Integrated Community Leadership for Senior Citizens). Suryani is currently working with the provincial government to establish a senior center that can accommodate cross-generation communication and understanding. She also partners with radio and television stations to more effectively market mental health treatment.
Suryani was born in Singaraja, Bali in 1944 and raised in modest surroundings with six children. Her father was a nurse and an integral part of Indonesia’s struggle against the Dutch. Suryani’s mother was a successful business woman who supported the family’s finances.
Motivated by a strong will to treat her young sick mother, Suryani learned meditation when she was only 14. While many of her family members initially doubted her abilities, they were surprisingly convinced to see her mother cured. Suryani then began treating sick people in her community through meditation.
After graduating from high school, Suryani studied medicine at Udayana University in Bali, where she specialized in psychiatry. In 1982, she received her degree as a psychiatrist—a profession she chose out of an innate curiosity to understand her upbringing and its effects on her current personality. In 1988 Suryani attained her Ph.D. from Airlangga University, Surabaya.
While working as the head psychiatrist at Udayana University in Bali, Suryani introduced a more efficient standard operational procedure to manage mentally ill patients. The procedure decreased the treatment from one month to six days in the residency hospital. While the procedure was initially accepted and did result in numerous adjustments, the hospital chief of staff eventually rejected it and discontinued its use.
Through her academic and clinical practices, Suryani has been resilient in her attempts to bridge indigenous spirituality with Western psychiatry and psychology. While many have criticized her findings, Suryani’s approach is widely considered a breakthrough in the field of psychiatry. To further develop the field, Suryani retired from her position as the Head Psychiatrist at Udayana University and is now dedicating all her time to leading the Suryani Institute of Mental Health and the Committee Against Sexual Abuse.