BackgroundFor a decade, experts have suggested integrating mental health care into primary care to help bridge mental health Treatment Gap. General Practitioners (GPs) are the first port-of-call for many patients with mental ill-health. In Indonesia, the WHO mhGAP is being systematically introduced to its network of 10,000 primary care clinics as an add-on mental health training for pairs of GPs and Nurses, since the end of 2015. In one of 34 provinces, there exists an integrated care model: the co-location of clinical psychologists in primary care clinics. This trial evaluates patient outcomes among those provided mental health care by GPs with those treated by clinical psychologists in primary care.MethodsIn this partially-randomised, pragmatic, two-arm cluster non-inferiority trial, 14 primary care clinics were assigned to receive the WHO mhGAP training and 14 clinics with the co-location framework were assigned to the Specialist arm. Participants (patients) were blinded to the existence of the other pathway, and outcome assessors were blinded to group assignment.All adult primary care patients who screened positive for psychiatric morbidity were eligible. GPs offered psychosocial and/or pharmacological interventions and Clinical Psychologists offered psychosocial interventions. The primary outcome was health and social functioning as measured by the HoNOS and secondary outcomes include disability measured by WHODAS 2.0, health-related quality of life measured by EQ‐5D-3L, and resource use and costs evaluated from a health services perspective, at six months.Results153 patients completed the outcome assessment following GP care alongside 141 patients following Clinical Psychologists care. Outcomes of GP care were proven to be statistically not inferior to Clinical Psychologists in reducing symptoms of social and physical impairment, reducing disability, and improving health-related quality of life at six months. Economic analyses indicate lower costs and better outcomes in the Specialist arm and suggest a 50% probability of WHO mhGAP framework being cost-effective at the Indonesian willingness to pay threshold per QALY.ConclusionGeneral Practitioners supported by nurses in primary care clinics could effectively manage mild to moderate mental health issues commonly found among primary care patients. They provide non-stigmatising mental health care within community context, helping to reduce the mental health Treatment Gap.Trial registrationClinicalTrials.gov NCT02700490

The objective of this study was to understand the relationship between academic stress, emotional intelligence, and subjective well-being in college student. Hypothesis for this study is academic stress and emotional intelligence can predict someone’s subjective well-being. This study utilized a quantitative survey method. Participants of this study were 132 college students from different majors who lived in Yogyakarta, men and women, with ages  varied from 18 to until 30s. Measurement tools that utilized in the study were academic stress, emotional intelligence scale, and student subjective well-being. Data was analyzed using regression analysis. Academic stress and emotional intelligence were found to predict someone’s subjective well being (F=9.862; p<0.001).

Penelitian deskriptif ini bertujuan untuk menganalisis tingkat dukungan sosial dan ketahanan keluarga TKI dan pengaruh dukungan sosial terhadap ketahanan keluarga TKI. Metode yang digunakan yaitu pendekatan kuantitatif korelasional. Data diperoleh dengan menggunakan instrumen dukungan sosial yang diadaptasi dari House dan Khan. Instrumen ketahanan keluarga menggunakan Walsh Family Resilience Questionnaire (WRFQ). Penelitian ini dilakukan pada 156 responden keluarga inti TKI yang merupakan anak, atau istri, atau suami, atau Ortu dari TKI yang dipilih secara acak di Desa Darmaji Kecamatan Kopang Lombok Tengah NTB. Hasil penelitian ini menunjukkan: (1) Tingkat dukungan sosial yang diterima keluarga TKI mayoritas cukup baik. (2) Tingkat ketahanan keluarga TKI mayoritas cukup baik kecuali pada suami TKW, mayoritas ketahanan keluarganya rendah. (3) Keluarga TKI yang resilien terdapat sistem keyakinan yang kuat (mean paling tinggi). (4) Dukungan sosial dan ketahanan keluarga memiliki korelasi yang sangat kuat (R= 0,816) serta terdapat hubungan positif dan signifikan antara dukungan sosial dan ketahanan keluarga TKI (Sig F hitung = 0,00 < 0,05). (5) Analisis tambahan pada hasil uji beda, yaitu ketahanan keluarga TKI dipengaruhi juga oleh struktur keluarga TKI yang ditinggalkan dan besarnya jumlah remitan. (6) Aspek dan sumber dukungan sosial yang paling berkontribusi dan signifikan terhadap ketahanan keluarga yaitu; (a) Perspektif anak : dukungan istrumental dari luar sumber dukungan sosial penelitian ini. (b) Perspektif istri : dukungan instrumental dari lingkungan masyarakat. (c) Perspektif suami dan orang tua : dukungan penghargaan dari lingkungan masyarakat.DOI: http://dx.doi.org/10.17977/um021v3i22018p119

Mental health is a critical issue in Indonesia, since its population ranks among the top five in the world and the prevalence of common mental disorders is 11.6% of the adult population. However, the need to build an effective mental health-care system that is accessible to the whole population has only been recently addressed. The Aceh tsunami in 2004 brought to the forefront an unexpected window of opportunity to build a mental health-care system. Integration of mental health care into primary health care is a key strategy to close the treatment gap for people with mental disorders. Existing integration of psychologists into primary health care is a big step to meet the shortage of mental health-care specialists. As primary mental health care is an emerging field, the perspectives of Indonesian experts on Indonesian mental health care are needed to develop a curriculum for training psychologists to work in primary health care. In this study, data have been collected through semi-structured interviews with 24 Indonesian mental health experts, and three focus group discussions with 26 psychologists. Overall, experts agreed that to be able to work in primary health-care psychologists should have roles and training ranging from clinical to advocacy skills. Participants also agreed that psychologists should work in the community and contribute to primary health care as service providers and that strong collaborations between psychologists and other primary health-care providers are the key; these can be developed partly through referral and by respecting each other's unique strengths.