The reasoning behind this practice is rooted in fear and a lack of knowledge. Family members are often frightened of the person who is struggling and have no adequate way of helping or caring for them. This led me to believe that the resources available for mental health support were very limited and not widely accessible.

While the issue of pasung is present, there was so much more about Balinese psychological approaches that I had yet to learn. The complex relationship between psychology and spirituality is what I found to be especially important.

It is true that a lack of widespread knowledge surrounding mental health can lead to misunderstandings. At the same time, it can also result in alternate ways of processing periods of emotional struggle. Many people I spoke to on the Indonesian island explained that whenever they feel overwhelmed or that their emotional well-being is suffering, they turn to temple visits or water purification ceremonies as a way to process these feelings.

In Bali, I had the chance to visit two psychiatric facilities. The first was Kopi Kental, a government-funded institution with no online presence where patients are mostly elderly and living in cramped spaces. There is no emphasis on talk therapy or spiritual practice; treatment is medication-based. The facility, which relies only on volunteers, is overcrowded and often has to turn away patients because it simply cannot accommodate them.

The second facility I visited was very different from Kopi Kental. The privately run Suryani Institute approaches mental health differently, using a combination of talk therapy, medication and spirituality to help their patients.

This approach does, however, carry certain risks. When mental health is seen solely through the lens of spirituality, serious conditions might be misunderstood or dismissed. Some people may believe that prayers or rituals are enough and consequently delay medical treatment that may be urgently needed.

This means that there is no single best approach when addressing mental health struggles. Effective treatment requires an understanding of the individual and their cultural background. The Suryani Institute leads the way in demonstrating how Western and local Balinese practices can work together. This gives me hope that progress will continue and that meaningful support will reach those who need it in Bali.

Leaving the island, my understanding of mental health felt far more complex than when I arrived. I still believe in the importance of medication and therapy, but I also recognise the value of patience, community, kindness and spirituality as part of healing. Bali challenged the idea that there is only one “right” approach to mental health. It reminded me that sometimes healing begins not only with a prescription, but with connection.