Chaining and shackling of people with psychosocial disabilities

Domain XVI · Historical, discredited & harmful

What it is

Chaining and shackling (in Indonesia called pasung) is the practice of chaining people with real or perceived mental health conditions, or locking them in sheds, cages, cells or rooms, sometimes for weeks, months or years, with no way to challenge the confinement. HRW documented it in 60 of the 110…

Format

• Campaign: in October 2020 HRW, with advocates with lived experience and anti-torture groups, launched the global #BreakTheChains campaign.
• Recognition and history-taking. Goal: notice that confinement or chaining is part of the client's or family's history, without leading questions. Format: ordinary assessment, with an interpreter where needed. Move on when the client has been able to say what happened at their own pace, or has…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is there physical contact? Was it explained beforehand, and do you feel free to say no or stop at any point?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve fasting, a special diet or 'detox'? Have you discussed this with your doctor?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• exposure risks to the client or family; advocacy fatigue.
• withdrawal from community and faith; isolation that raises risk.
• repeated retelling that re-traumatises; reports beyond your competence.
• services that are themselves coercive; gaps in rural or diaspora communities.
• the leader taking control of decisions; confidentiality breaches in tight communities.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.