After the establishment of the 4th large psychiatric hospital at Sabang, it became clear that building these expensive hospitals and arranging for more beds did not solve the problem of an ever increasing demand of care for psychiatric patients. The annual discharge percentage was about 6 %, so there could be admitted every year only 420 new patients, while the real need was tenfold. This resulted in a large number of patients who because of their behavior were imprisoned. In order to reorganize the mental health care in the NI, three new types of psychiatric facilities were introduced in the 1920s:

• the psychiatric nursing home (Psychiatrisch verpleegtehuis) for long-stay patients. The health statistics of 1937 mention 6 psychiatric nursing homes (Palembang, Padang, Bandjermasin, Manado, Bangli and Soekolilo). The psychiatric nursing home at Manado (Sulawesi Utara) had a normal capacity of 34 beds, whereas per ultimo 1937 a number of 21 were present.

  The Rumah Sakit Jiwa Prof.dr. V.L. Raumbusyang at Manado is one of the health establishments of the province of Sulawesi Utara. It is classified as a category B hospital and is registered under number 7171035. The hospital has at the moment (2018) a bed capacity of 180 beds.
  The hospital has 344 employees. 51 are medical doctors, 2 psychologists, 159 nurses, 16 midwives, 18 pharmacy assistants, 44 therapeutical and technical assistants and 54 administrative and management employees.
  The hospital is established at the Jl. Bethesda no. 77 at Manado. The geological location is: latitude: 1,46 and longitude: 124,83.

  In former times there used to be a so-called “psychiatrisch verpleeghuis” (Psychiatric nursing home) at Manado.  The website of the hospital is: http://www.rsjratumbusyang.go.id.

• the psychiatric passage home (Psychiatrisch doorgangshuis) for the treatment of acute cases for up to six months.
  The health statistics of 1937 mention 6 ‘doorgangshuizen’ (Batavia (Grogol), Semarang (Tawang), Soerakarta (Mangoendjajan), Soerabaya (Pegirian), Medan (Gloegoer) and Makassar).
• Agricultural communities could take care of long-stay patients who did not need intensive nursing. An example of these ‘Landbouwkolonies’ was the experimental one at Lenteng Agoeng that was set up near the Buitenzorg Hospital for 200 ex-patients. The Salvation Army started a ‘Landbouwkolonie’ at Donggala (Sulawesi).See for a discussion on the organization of psychiatric healthcare in the Netherlands Indies the 1937 editions of the Geneeskundig Tijdschrift voor Nederlandsch-Indie (GTNI). Three authors (P.M. van Wulfften Palthe, J.C. van Andel and W.F. Theunissen) discuss the merites of the chosen system of 4 very large and expensive main hospitals and 12 secondary institutions. Van Wulfften Palthe (speaking as head of a psychiatric department of a central civil government hospital) and the directors of the large psychiatric hospitals have totally different points of view: vWP emphasizes that the present system is far too expensive and leads to continuance of the practice of keeping most psychiatric patients in prisons, as there is no place in the psychiatric institutions themselves.
  vWP argues that the present system ends in shoddy work. Hardly a home is established at Makassar (that in due course is completely crowded) or Bali wants its own institute and Sumatra’s Eastcoast cannot stay behind. “it looks as if we empty the ocean with a tea-spoon.”

See for an overview of the singularities of psychiatry in NI, the article by Hans Pols in the publication “Geneeskundig Tijdschrift voor Nederlandsch-Indie”. This              publication was translated in English: The Medical Journal of the Dutch Indies 1852-1942, A Platform for Medical Research. The article was entitled: ‘Psychiatry and the care of the mentally ill.’