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Indonesia no place for mentally ill people: Report

Indonesia is the second-worst place in the Asia Pacific region for people suffering from mental illness, according to a recent report

Hans Nicholas Jong (The Jakarta Post)
Jakarta
Sat, October 29, 2016

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Indonesia no place for mentally ill people: Report

I

ndonesia is the second-worst place in the Asia Pacific region for people suffering from mental illness, according to a recent report.

The Asia-Pacific Mental Health Integration Index, released by the Economist Intelligence Unit (EIU), ranks the level of effort of 15 countries across the Asia Pacific region in implementing effective mental health policies.

Indonesia ranks 14th out of 15 countries in the study. Only Pakistan scored lower.

“Indonesia fell into a band of lower-income countries — including India, the Philippines, Vietnam and Pakistan,” EIU managing editor Gareth Nicholson said.

The report, commissioned by Janssen Asia Pacific, notes that human rights challenges remain in Indonesia and that best estimates indicate that only 10 percent of those with a diagnosable mental illness receive evidence-based care.

Access to mental health care is still severely lacking in the country, the report says, with only 800 psychiatrists and 400 clinical psychologists for a population of more than 250 million.

Eight from a total of 34 Indonesian provinces do not have mental hospitals, and fewer than 2,000
of the country’s 9,500 primary health care centers provide mental health care.

The government seems to be doing too little to improve the nation’s mental health care, with budget funds allocated to the purpose now standing at a meager 1 percent of the country’s overall health budget.

“This is too low and makes it difficult for the government to implement real programs,” said psychiatrist Nova Riyanti Yusuf, who co-authored the report and chaired the working committee drafting the mental health bill in the House of Representatives.

One of the reasons why the budget for mental health care is low was the absence of reliable data on the prevalence of mental illness in the country, she said, adding that a national mental health institute needed to be created to produce such data.

The poor state of mental health care has led to a cry-for-help phenomenon, where people suffering from mental illness seek alternative methods to ease their problems, such as turning to religious cults, instead of seeking professional help.

The country has recently seen a rising number of people, including celebrities and renowned academics and politicians, fall victim to fake spiritual gurus, such as the Dimas Kanjeng Taat Pribadi cult in East Java and the Gatot Brajamusti cult in West Java.

“So psychiatrists are not on the front line [of providing mental health care],” Nova said.

Within the four categories that make up the Index — environment, opportunities, access to treatment and governance — Indonesia scored higher than other lower-to-middle income countries on “access to treatment” but ranked last for “governance”, which includes human rights issues and efforts to combat stigma, and also last for “opportunities”, specifically job market opportunities for people suffering from mental illness.

With regard to governance, the report noted that Indonesia significantly modernized its mental health legislation through by passing Law No. 18/2014 on Mental Health, which deals with, among other issues, the mental health care system, resources for mental health care delivery and mental health examination.

Yet, two year after its enactment in 2014, only one implementing regulation has been put in place.

The government is running behind schedule as the law stipulates that the implementing regulations must be in place no later than one year after the law’s enactment.

The lack of implementing regulations has hindered the country’s progress in reaching out to those in need of mental health care.

Nova argued that by neglecting people with mental illnesses, Indonesia would have to bear the economic consequences, with the report confirming that mental illness placed a burden on Asia Pacific economies.

Even among the best performing economies — Australia and New Zealand, mental illness knocks 3.5 percent and 5 percent, respectively, off their GDP. “Instead of empowering people with mental illness, they become a burden,” Nova said.

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