Actual challenges of mental health in Indonesia: Urgency, UHS, humanity, and government commitment

Abstract

Mental health has become one of the biggest challenges in the world. But in most of developing countries, including Indonesia, mental health issue has not been prioritized, compared to infectious diseases. This paper will describe the implementation of mental health policy in Indonesia and its challenges, as other developing countries may also learn about ways to deal with it. Mental health policies and regulations implementation in Indonesia are still followed by wide gap, related to its coverage and humanity problems. This paper is a literature review which examines implementation of Mental Health Law and its alignment with UHC and humanity in Indonesia since policies applied. Researches about mental health policy and economic impact of it in other countries are included, and evidences as reasons policy should be evaluated are provided. This research is aimed to explain reasons and ways government can strengthen mental health policy. Results showed Mental Health Law (2014) implementation in Indonesia had not been effective enough. Riskesdas, a national health survey conducted by Ministry of Health, found 14% of families who did confinement, with 31.5% did it in the last 3 months. WHO data in 2017 showed psychiatrist rate 0.31, mental health nurses rate 2.52, and social workers rate 0.17 (all per 100.000 population) confirming the lack of mental health resources in Indonesia. DALYs reached 2,463.29 per 100.000 population and suicide mortality rate 3.4 with no strategy related to suicide prevention found. Mental health is an important part of the complete state of health. Government should integrate mental health services into community-based services as a way to ensure universal coverage of mental health services. This will work as bottom-up empowerment, and it will solve problems of resources and stigma that obstruct the success of mental health program in Indonesia. This also supports family as caretaker of patients and reduce the possibility of relapse. Key messages Mental health can not be considered only as a peripheral issue in Indonesia, as it may also affect other aspects of society such as social and economy. Government should reform policy and regulation of mental health in order to achieve the complete state of health.

Changing Landscape of Mental Health from Early Career Psychiatrists’ Perspective in Indonesia

“…The Indonesian mental health system still needs to be continuously refined by improving the political commitment and leadership and increasing participation from various stakeholders to derive the Mental Health Act into a more practical form for optimal implementation. 5,16,17…”

Collaborative Care in Primary Health Care Focus on Management of Depression

“…The local government's role as policymakers; especially in health policies, can also contribute to the success of mental health. [35][36][37] c. Primary care physicians' practice patterns The third barrier is primary care practitioners' behaviors, which considers the detection and treatment of depression to be the responsibility of mental health professionals, as part of their clinical practice or depressive medication. 38 Unfortunately, in some countries, health workers that work in mental health primary services have multiple tasks in concern to their job, and do not focus on mental health services.…”

Barriers and facilitators to access mental health services among people with mental disorders in Indonesia: A qualitative study

“…This issue has also raised concerns in Indonesia following an increase in the prevalence of mental health cases. The higher incidence of mental disorders in the country highlights the need for policies and attention from the government and society (Rahvy et al, 2020 ). However, despite efforts to improve the mental health system, Indonesia still needs further progress in this area (Economist Intelligence Unit, 2016 ).…”