Most of us care about our health, but we often forget or ignore our mental health. If we have a physical disease we will immediately seek treatment from a doctor. However, if we get depressed we often do not want to see a psychiatrist for any reason.
Presumably, we are afraid of the mental illness stigma, or think that seeing a psychiatrist means announcing our mental disturbance to the people around us. This condition has also been seen in China, where the prevalence of mental health disorders is high, but only 8 percent of affected individuals seek professional help.
The stigma of mental health illness still clearly exists around us. It shows in our attitudes toward people with mental disorders, even though such disorders often have biological, chemical and genetic origins.
Mental health illnesses are amenable to treatment because many of them are caused by neurological disturbances.
Unfortunately, the myth that mental illness is a lifelong, hopeless and shameful condition still influences our behavior toward people with mental illnesses.
In Indonesia, people with mental health illnesses often fall victim to inhumane treatment. They are caged in small cells behind houses, chained to beds, stoned by neighborhood children, hidden by families, and in some cases their feet are clamped between stocks so that they can’t move around.
Besides that, if they do not get treated at an asylum, they are sometimes taken to traditional healers who abuse them and place them in appalling and isolated conditions, in some cases with only a hole in the floor for urine and feces. Even if they do receive treatment at an asylum, medical personnel often do not treat them with dignity, respect or protection.
In the case of relapse, a psychotic episode, or getting angry with other people, many people tend to treat mentally ill people harshly without consideration. Two patients with mental illness were recently burned by people in Tangerang two months ago, meaning that their human rights were not protected.
The police, who are expected to protect people with mental health illnesses, sometimes just laugh at them. Moreover, families tend to neglect people with mental health illnesses.
Families are often ashamed to admit them as members of the family, and try hide them, and seek help from traditional healers and priests because they assume that they are possessed by demons or have had a spell cast upon them by someone.
Eventually these families run out of energy, patience and funds to take care of them, and hence let them go from family life. As a consequence, the number of mentally ill people on the streets has increased, while the government, particularly the Social Affairs Ministry, can not always provide care for these people in asylums and place them in homes.
There are many factors as to why mentally ill people are often treated badly. First, many have not received clear information about mental disorders and how to treat them. As a consequence, many mentally ill people only get comprehensive treatment after their condition has worsened.
Mental disorders can be treated with drugs such as antipsychotics and psychosocial treatment. From research carried out in China published in September in the Archives of General Psychiatry, combining antipsychotic medication with the psychosocial treatment led to better outcomes in early-stage schizophrenia.
Hence, once people learn to recognize and treat the symptoms of this mental disorder earlier and go to psychiatrists immediately, they will get better results.
Second, the stigma and myths about mental illness still exist, so mentally ill patients are sometimes treated badly by the people around them. The third factor concerns the financial problems of families who have mentally ill family members. Sometimes, they go to traditional healers and priests and finally, and then when they finally decide to take the mentally ill patients to a psychiatrist they don’t have enough money to buy the medication and pay for the treatment.
In addition, mentally ill people such as those with schizophrenia depend on medication for as long as they live to prevent a relapse. That is why families should buy antipsychotic drugs continuously. For specific conditions when they must take the mentally ill people to hospital, they could not pay for the treatment without health insurance, especially for those from poor families.
Thus, with an increasing prevalence of schizophrenia, bipolar disorder and other psychotic disorders, there should be efforts to resolve these problems.
The government should care about mental illness. They could work with printed media, TV and radio stations to inform the public about mental health disorders to eliminate the stigmas associated with them.
This information could make more families take mentally ill patients to receive the right medication. The government should increase its health expenditure to provide psychiatric services such as the addition of facilities in asylums and the availability of free medication for their patients.
Many Asian and African countries only allocate 1 or 2 percent of health expenditure on psychiatric services. The government should therefore pay for neglected mentally ill people on the streets to receive appropriate treatment as their human rights should also be protected. The number of psychiatrists, psychiatric nurses, psychiatric social workers, and psychologist should be increased to provide better mental health services.
Moreover, mentally ill people need support from their families, friends and the community. Psychosocial treatments are very important in getting a better outcome. Psychosocial treatments consist of family intervention, improving social competence with social skills training, and reducing symptoms with cognitive behavioral therapy (CBT). Mentally ill patients must be helped in their social and occupational functions, so that they can be more independent and get their confidence back again.
The availability of social support groups such as Perhimpunan Jiwa Sehat (the Indonesian Mental Health Association) and Komunitas Peduli Skizofrenia Indonesia (Indonesian Schizophrenia Community) could help the mentally ill and their families get information about mental disorders and psychiatric services.
These supporting groups could work with the government in campaigns to combat the mental health stigma in society.
World Mental Health Day will be commemorated on Oct. 10. This event could serve to improve our awareness of mental health and remind us to treat mentally ill people better, while considering issues of ethics.
We can see that mental health illnesses can be cured, so combating the stigma, increasing psychiatric services, and improving support from families, friends and the community could reduce the burden and make it easier for mentally ill people to have a better quality of life.
The writer is a student at the School of Medicine, Gadjah Mada University, Yogyakarta.
