Most of the patients do not even realize their symptoms. You cannot expect them to ask for help when they do not even feel sick. They come to primary health care facilities with various chief complaints, such as sleep disturbance, somatization symptoms predominantly appearing as stomach problems and deprived appetite. Covering up the mental health problem, those symptoms are treated for a long time without improvement.

The data from our Health Ministry shows increasing mental health patients from 18,000 patients in 2011 to 56,000 patients in 2013. Unfortunately, most are diagnosed when they have suffered for months or years, with severe depression or anxiety. Imagine how much loss they have experienced from mental illness intruding either their job or social life in their productive ages.

Delay in finding medical help exceedingly is caused by massive pressure from patients’ surroundings. They deny their own feeling and signs. Mental illness from their perspective is a big shame, a disease which should be covered up. Many tend to connect mental health problems with religiosity, those who suffer are seen to have frail connection with God. They assume mental health patients have lax personality as well.

In some cases I have met in primary health care, the mental health patients who at last have courage to reveal their condition, unfortunately get blamed instead of being supported. Moreover, they can be excommunicated from their surrounding as people assume they can be harmful for others and it impacts on the difficulty in keeping and seeking jobs. Overcoming this silent burden is our huge homework.

The government actually has made strides to protect patients with mental illness. Mental Health Law no.18/2014 is the ambitious foundation protecting mental health patients from being mistreated. Those provisions regulate the mental health system, facilitation for mental health patients, etc. A fundamental regulation like this is needed to protect them from violation of human rights, such as retaining or locking up practices.

The government may have made progress to decrease such cases, but other desolate violations like being bullied or fired after being diagnosed with mental illness (even at a mild level) are far more complicated to be monitored. The necessary actions should involve both the government and our citizens. More dissemination of information regarding the mental health law may alleviate the suffering of people with mental health issues as they can know they are supported to ask for medical help and protected from being discriminated.

Campaigns are needed to end misunderstanding among society, particularly for those who correlate mental health problem to religion, sin and karma. Public explanations that mental health has a wide range or specifications are needed as well, to prevent generalization of mental health patients as madmen, maniac or ”psycho”.

Nowadays young urbanites need to struggle to communicate directly without social media. For those with mental health issues, it means a lot to know they have someone paying attention, and that they are being listened to in their closest surrounding. Stop your social media connections for a while and take a look at people close to you who may have mental conditions, and see if you can suggest they seek help.

Further, do not mock people who start telling you their problems, even on social media where you think he or she will not read. Taking care of your friends and family instead of bullying them when they start sharing their problems is a scream for help. Bullying only makes them bury their pain and the result will fester afterwards. If you do not know how to help, just refer them to a professional. The earlier their sickness is treated, the better output.

Despite overwhelming cases on mental health disorders, we can overcome these problems with continuous counseling.

We need to be more caring of our closet surrounding and support those who may need professional consultation. Eventually, we are all human beings constructed from chemical hormone balance. In some cases, there will be imbalance inside us and it is really acceptable if it comes out as sadness, anxiety or other mental health symptoms, Moreover, those are diseases that need to be treated by professional like other diseases.

***

The writer is a general practitioner who is working at a primary health care center in West Jakarta and a private hospital in South Jakarta

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