Sejarah

History

History of the Establishment of RSJ Bogor

In order to fulfill the expectations of dedication and improvement of knowledge and services in the field of mental illness, based on an official letter from the cabinet in Indonesia ( ex Netherlands India ) to the inspector for asylum affairs in the Netherlands in September 1865, then followed by a report from the minister of colonialism to the Queen on 29 December 1865, Royal Decree No. 100 of December 20, 1865.

The content of the Royal Decree is that it agrees to establish 2 mental hospitals in Indonesia, but the second RSJ can only be established if the construction of the first RSJ is completed. Then, services in the field of mental illness should be improved and improved according to instructions from asylum inspectors in the Netherlands. The places to establish RSJ will later be determined by the Governor General in Indonesia.

On the basis of the Dutch Royal Decree dated 30 December 1865 No. 100 as well as the Governor's Decree dated 14 May 1867, the first mental hospital was built, namely the Bogor Mental Hospital. Construction began in 1876, while its inauguration was held on July 1, 1882. Dr. Bauer was appointed the first Director.

The decision to establish the first mental hospital in Indonesia faced many obstacles, both from the government and from Dutch intellectuals at that time, due to conflicting opinions, doubts about the success of curing mental illnesses and physical objections.

 

Barriers to Establishment

Those who opposed the establishment of mental hospitals argued that patients could be treated in a family setting and that if they needed treatment in a facility, this could be done by improving and adapting existing hospitals.

Another group that opposes the establishment of mental hospitals believes that the results of "curing" mental illnesses are only around 30%, so the usefulness of a mental hospital is doubtful.

Meanwhile, mentally disturbed patients are treated in general or army hospitals and also in prisons or police stations. The treatment method is more "confined and isolated", because mental patients are considered dangerous to those around them and themselves.

Such treatment facilities are equipped with iron bars in each room/ward and strong doors. Accommodation/treatment places for such patients are at the Chinese Hospital in Jakarta (ex Batavia) with a capacity of 90, in auxiliary shelters in Semarang with a capacity of 105² and in Surabaya with a capacity of 37 beds³.

These views and attitudes resulted in matters of mental illness (krankzinnigenwezen) being under the authority and supervision of the army health service.

 

Decision to Establish a Mental Hospital

The considerations for establishing a mental hospital are based on:

1. Although the 1862 census cannot be completely trusted, it can be concluded that there were still quite a lot of patients suffering from mental illness roaming the community.
2. Reports from several civil service (resident) officials, including those from Jakarta, show that since 1862 people with mental disorders have increased rapidly, in a period of 10 years from 123 patients to 921 being treated in Chinese hospitals. The Semarang Resident also proposed increasing hospital capacity to 250 beds.
3. That mental illness can be cured, if given proper attention and treatment.

For the purposes of this establishment, two people were appointed, namely:

1. Dr. FH Bauer, a psychiatrist who led an RSJ in the Netherlands and who was considered competent enough to pioneer the construction of the first RSJ in Indonesia.
2. Dr. WH Smit is a doctor in the Dutch Navy who has sufficient experience in Indonesia in dealing with psychiatric cases.

Before carrying out their duties in Indonesia, they were given the opportunity to tour and study R2SJ in the Netherlands, Belgium, Germany, England and France in the fields of development, maintenance, treatment and organization. Apart from that, Bauer was given a special assignment to study population problems in Indonesia and Smit to deepen mental illness from a practical and theoretical perspective.

Dr. AM Smit was given the task of studying more ways to care for people with mental disorders and FH Bauer was given the task of studying Indonesian customs (land en volkenkunde). Smit was sent to study in the Netherlands and also to several other countries in Europe to study the development of mental health services and their possible implementation in Indonesia. Don't forget to study legal aspects.

Dr. FH Bauer and Dr. AM Smit was the first person given the task of making plans to establish a mental hospital in Java. In 1868, Bauer and Smit tried to estimate the number of people with mental disorders on the island of Java and they stated that there were around 550 people. Of that number, around 300 sufferers were found spread across various military hospitals and prisons in very sad conditions.

At their suggestion, an additional building was built at the army hospital in 1871 to become the Psychiatry Department and was led by Dr. AM Smith himself. The addition of a new section of the army hospital in Surabaya was led by Dr. Van Deinse. Bauer and Smit also proposed establishing two new mental hospitals, namely in Bogor and in Lawang, Malang.

Equipped with the knowledge he learned in Utrecht, Smit believes that mental hospitals are equipped with spacious grounds, allowing sufferers to move freely and carry out positive activities, for example gardening. At that time, people with mental disorders had to be admitted to a mental hospital before a court was required.

When the Dutch Colonial Government came to power, the agency responsible for mental health problems was handled by the Dienst van het Krankzinnigenwezen, which was led by an Indonesian inspector, namely R. Tumbelaka, who was the first and last person in the Dutch Colonial period. Subsequently, this agency was closed and merged with another unit, namely Dienst van Gezondheid, where mental health matters were handed over to a general practitioner, namely Dr. Fischer and accompanied by a psychiatrist, namely Dr. Prins. At that time there was also a division of authority, that all Doorgangshuizen was handled by this agency, while Verpleegte Huizen and Kolomies were under the supervision of the province.

A view was also expressed that mental illness is a special part of the health sector, and knowledge about mental illness in Indonesia is minimal and needs to be improved.

Based on reports from a British colony, it was stated that the influence and interference of the army in dealing with mental illness was strange and obstructive. In connection with this report, it was considered by the inspector for mental illness in the Netherlands that the influence of the army should be removed from mental illness matters and that this matter should be a separate section.

In mid-October 1866 Bauer and Smit left for Indonesia and arrived on February 4 1867 in Jakarta. The two doctors then researched several possible locations for establishing 2 RSJs (the 1st must be completed first) with the requirements that the location for establishing the RSJ must be:

1. Located close to the Government center in Jakarta.
2. Close to Post Road.
3. Must be capable and suitable to care for 400 mental patients.

 

Determination of Location of Mental Hospital

After conducting an investigation, Bauer and Smit proposed a place close to the cities of Bogor and Malang, also considering that these two places are famous for their cool climate. The selected location in Bogor is the Bloeboer land which the Director of P & K ( ex Onderwijs van Eeredienst en Nijverheid ) can approve. To solidify this choice, the Council of Indonesia ( Read van Indonesia ) issued an official letter on March 4 1866 which was then followed by the Governor General's Decree on May 14 1867.

Bloeboer land, which is government land, is cultivated by many particular people, so on the land there are rice fields, coffee and chocolate (cacao) plantations, cattle farms, bamboo gardens, etc.

To provide compensation to land cultivators requires quite a lot of money. In order to save on expenses, it was decided to only acquire land as necessary with the consideration that the land would be sufficiently protected from infiltration/peeping by outsiders. Thus, a location was chosen with natural boundaries formed by the Cisadane and Cikema rivers. The land area is ± 117 hectares.

 

Bogor Mental Hospital Construction Process

Before starting construction preparations, Bauer and Smit were advised to visit shelters in Semarang and Surabaya to gain insight. An experienced engineer is assigned to those who calculate the construction costs and technical implementation of the RSJ in question.

During construction, it was emphasized that the director's house must be located in the RSJ complex so that it would be easy to carry out supervision. The 1st RSJ will later function as a central holding facility.

The development budget is handled by the Ministry of Finance, while the Department of P & K has authority over the operation of the RSJ and the Department of Public Works ( ex Burgerlijke Openbaro Werken ) has authority over the technical development. For the first shelter cost, it was initially estimated by an engineer that it would cost Fl. 1,803,105,- plus Fi. 127,203,- for land acquisition. After making several changes, the construction cost becomes Fi. 1,341,254,- apparently even this cost was still considered too high, so after several considerations and re-management which took quite a lot of time, it was finally determined that:

1. To DROSSAERS & Co, which is based in Jakarta and which is considered a trustworthy contractor both in terms of bona fides and technical capabilities, was given the task of building the men's section consisting of bagsal class I, II, and restless III and quiet III, as well as a pavilion, selazar , work rooms and dining rooms for European employees along with water pipes. The contract is closed on the basis of FI financing. 568,561,- and construction must be completed within 27 months.
2. For land acquisition, a fee of ± FI is provided. 85,000,-
3. For RSJ employee salaries, max. FI. 83,712,- / year.
4. For FI maintenance and feeding costs. 192,709.25,- / year.

The personnel used in operating the RSJ consist of 35 Europeans and 95 employees of Indonesian and Chinese descent. Among the personnel there are 3 doctors consisting of 2 Europeans (Dr. Bauer and Dr. JW Hofmann as assistant 1st doctor), and a Javanese doctor (Dr. Semeru). With the establishment of the first RSJ, it is estimated that it will be possible to save the costs of exploiting mental patient care, because all psychiatric patients from Chinese hospitals in Jakarta and most of the patients in auxiliary shelters in Semarang can be transferred to RSJ Bogor.

Based on R2SJ observations in Europe by Bauer and Smit, plans are also being taken to provide gardens, courtyards and agricultural land in addition to the construction of RSJ Bogor. Most mental patient wards that will be built are still equipped with strong iron bars. It later turned out that the treatment method at that time was custodial, namely as a place of shelter and isolation, without prioritizing distribution and development of the patient's ability to adapt to society.

After all the work was completed by Drossaers & Co , the Director of P & K used the Bogor RSJ ( ex Krankzinnigengesticht te Buitenzorg ) inaugurated on July 1 1882. At the first stage, the Bogor RSJ could only be occupied by male patients.

The expansion of RSJ Bogor for the women's section was carried out by architect Ch. A. De Leau on the basis of a letter of agreement dated 28 November 1895 at FI's expense. 118,633.²

 

History of RSJ Bogor after its founding

An important event in the history of psychiatry in Indonesia was the arrival of Eil Kraepelin in 1904. He stayed for 3 weeks at Buitenzorg Mental Hospital (Bogor). At that time he was considered a world figure, as well as a researcher who began to differentiate between dementia praecox, which later became known as schizophrenia , and manic-depressive disorder, which later became known as bipolar disorder.

Kraepelin focused his observations on differences in symptoms and prevalence in Europeans and natives. The conclusions put forward have a great influence on the way psychiatrists think and have even become the forerunner to the development of studies regarding the influence of culture on a person's mental health. Later this science became known as Transcultural Psychiatry. One of the findings was that the prognosis for mental disorders in natives was better than in those from a European background.

Kraepelin's views greatly influenced the way Dutch psychiatrists viewed psychiatry and then encouraged them to write extensively about psychiatric syndromes which were considered specific to local culture. For example amok, latah, and koro. This is still visible in the international classification of mental disorders and is recorded as culture bound syndromes (culture-related mental disorders).

The capacity of 400 turned out to be not enough, because from year to year the number of patients treated continued to increase and reached a figure of 2203 just before 1942 during World War II.

In the period 1942-1945 RSJ Bogor was partly used as a shelter for Japanese soldiers and partly as a quarantine place for infectious diseases. Many buildings were damaged during that period.

In the period 1945-1950, the period of the physical revolution in maintaining independence, not much attention could be paid to the fate of the Bogor RSJ.

Between 1950-1969 only a few building repairs could be carried out, in fact the destruction process proceeded faster than the repairs. It was only during the Repelita period that, little by little, significant improvements and changes to the buildings/wards occurred.

The current building area of RSJ Bogor is as follows:

1. The ward and office area is 21,656.75 m².
2. Official House 11,455.25 m².

The RSJ Bogor land that has been certified is 61.6320 hectares, while that controlled by the Regional Government is 56 hectares. The results of the latest RSJ Bogor land measurements show that the de facto land area is 133.5601 hectares.

The development of mental health services in Indonesia follows developments in Europe in general, especially the Netherlands. In the land of windmills itself, the field of mental health underwent reform in the 19th century, to be precise in 1830. About three decades later, this reform finally had an impact on the regions or territories of the Dutch colonies, including Indonesia.

However, don't expect mental health services in Indonesia at that time to be as "advanced" as in Europe. Treatment or care for people with mental disorders is provided as is. The thing that was most widespread at that time was shackling or isolation, which was considered one of the effective efforts to "treat" people with mental disorders. The aim is very simple, namely so that people with mental disorders do not disturb the social environment or the surrounding community.

This condition can be understood considering that information and outreach regarding the importance of mental health was very minimal, especially due to the lack of mental hospital facilities, medical personnel and psychiatrists at that time. The existence of regional, cultural and linguistic differences of course also greatly influenced the Dutch East Indies government's efforts to overcome mental disorders which were starting to flourish in its colony, Indonesia.

 

 

Resolution of May 21, 1831, First Milestone in Mental Health Services

This condition continued until finally on 21 May 1831 the Dutch East Indies Government made a resolution which was considered quite influential in the process of transforming mental health services in Indonesia. In the resolution of 21 May 1831 No. 1 Article 1 states that "every major hospital in Weltevreden (Jakarta), Semarang and Surabaya will be provided with rooms to treat people with mental disorders".

From then on several large hospitals provided mental health services. In 1848, the Army Hospital in Semarang built a special ward for people with mental disorders, prioritizing scientific methods in treatment. In Semarang, in the Peterongan area, as well as in Jakarta, Chinese Hospitals were also established to accommodate people with mental disorders, especially those of Chinese ethnic origin.

However, people with mental disorders continue to increase. On this basis, the Dutch East Indies government built several other hospitals. The plan is for the mental hospital to be built on a large plot of land far from the crowds. The aim is not only for the safety and comfort of the local community, but it is also hoped that it can become a therapeutic place for sufferers to freely carry out activities such as gardening or farming. However, unfortunately, due to the high costs, the government ultimately failed to build a hospital specifically for mental disorders. Instead, in Surabaya, a general hospital was built, providing a special ward for people with mental disorders.

There was even a proposal to bring in a doctor from the Netherlands who would specialize in psychiatry. Later, the Dutch psychiatrist was able to develop his knowledge according to the language and culture in Indonesia. At that time, the Dutch Colonial Government established a mental hospital around Semarang, with a capacity of 800 beds, in addition to a small colony system such as in Gheel which acted as an auxiliary mental hospital ( hulpgesticht ).

 

RSJ Bogor, the First Mental Hospital

As time went by, Lawang Mental Hospital was founded in 1889 as the second mental hospital which was officially opened on June 23, 1902. Subsequently, two mental hospitals were reopened, namely Magelang and Sabang in 1923.

In addition to providing mental hospital facilities, mental health services also established doorgangshuizen or intermediate care, verpleegtehuizen or inpatient homes for mental disorders, and colonies or accommodation for people with chronic mental disorders. This fact was explained by Dr. RJ Prins in De Krankzinnigenverzorging in Nederland Indie Gedurende de Laatste Vijf en Twintig jaar, 1936 (Treatment of Mental Disorders in the Dutch East Indies in the last 25 years). Doorgangshuiz in Solo was opened in 1919, Grogol Jakarta in 1924, in Semarang and Surabaya it was founded in 1929, while outside Java doorgangshuizens were also established.

Doorganghuiz has a function as an acute care place, which is expected to last no more than 6 months, while waiting for the completeness of the patient's documents to fulfill treatment for admission to a mental hospital, namely from the local government and the court. However, there are obstacles to sending sufferers to mental hospitals so that the door gangshuizen becomes full.

Since 1903, gezinsverpleging has been known in Bogor, namely an effort to entrust people with mental disorders to the families of mental hospital nurses. However, it turns out that this policy has many weaknesses, including poor treatment, and even extortion and neglect of sufferers. That is why, in 1925 by Dr. This travaglino gezinsverpleging is eliminated.

To channel sufferers of mild mental disorders and calm from mental hospitals, in 1919 Travaglino planned to establish agricultural colonies and work places for them. Unfortunately, this plan was not implemented because the government prioritized the establishment of doorgangshuizen and verpleegtehuizen. People with mental disorders from outside Java are sent and treated on the island of Java.

Realizing this, Prof. Van Wulffen Palthe (as head of the CBZ Psychiatry Section, now RSCM) took the initiative to establish the first private colony in Lenteng Agung in 1935, which, among other things, received assistance from various plantations. The person who manages the colony is Dr. Soejoenoes. There, gezinsverpleging was implemented and this effort was successful.

Mental hospitals continue to be built, including in Cisarua, Bandung, Magelang, Solo and outside Java, including in Makassar, Manado, Medan, Sabang and Padang. There are also homes for mental disorders (verpleegtehuizen), including in Bangli (Bali), Muntok (Bangka), Banjarmasin, Pontianak and in Samarinda. In fact, the veropleegtehuizen was planned to be led by an orderly (verpleegster) or native doctor.

For people with mental disorders who find it difficult to recover, treatment is transferred to colonies for people with mental disorders, namely Petengahan in Singkawang, Tamban in Banjarmasin, Soblimbing in Kotabaru, Pakem in Jogjakarta, Kubu in Bangli, and Praya in Lombok.

In accordance with the development of Psychiatry abroad at that time, namely in Europe and the United States, the trend of the number of sufferers being treated in mental hospitals was increasing. The number of doctors, especially psychiatrists, is felt to be insufficient. So, Dr. Theunissen in Lawang, Malang and Dr. Travaglino in Bogor began educating mental health nurses.

However, according to Dr. Latumeten, the first Indonesian psychiatrist (1928), most people with mental disorders did not receive proper treatment. Worse yet, many indigenous people who were considered to be suffering from mental disorders were left in shackles. Meanwhile, the psychiatric department in the general hospital that existed at that time was more intended for Europeans only.

 

Japanese Colonization Period

In the period 1942-1945, when the Greater East Asia war was raging, Indonesia was under occupation by the Japanese army. At that time the number of people with mental disorders being treated had decreased a lot. This does not mean that many recover from mental disorders, but rather that their treatment is very poor. Lack of funds for food and medicine causes an increase in the death rate among RSJ residents. As a result, the number of RSJ residents decreased sharply in 1944.

It didn't stop there, the suffering of the RSJ residents became even more severe because the arrival of Japanese troops "forced" them to leave the RSJ. The army from the land of the Rising Sun needed large, sturdy buildings that could be obtained quickly, so the choice fell on mental hospitals. Many sufferers were simply released or grouped together in certain areas. This grouping led to the discovery of people with mental disorders from Indonesia in Malaya (now Malaysia) or the Philippines. In Bangli, Bali, people with mental disorders from Burma (now Mianmar) were found.

That's why when the allied troops carried out air attacks to conquer the Japanese troops, many mental hospitals were targeted. The Sabang Mental Hospital, which once had 1,300 beds, was completely destroyed because it was bombarded by allied air forces.

 

National Center for Mental Health

Based on the Decree of the Minister of Health of the Republic of Indonesia Number HK.01.07/MENKES/741/2022, RSJ dr. H. Marzoeki Mahdi Bogor currently holds the status of a National Center for Mental Health. RSJMM is a national referral center for all mental illnesses. Apart from that, RSJMM also has adequate facilities, infrastructure and human resources to provide comprehensive mental health services. Currently, apart from providing mental health services, PKJN RSJMM Bogor also provides non-mental services such as Internal Medicine Clinic, Lung Clinic, Heart Clinic, Children's Clinic, Dental and Oral Polyclinic, ENT Clinic, etc.