The Jakarta Post
Pita, a Jakarta resident who asked to use a pseudonym for this article, said anxiety had kept her from sleeping for several days at a time during the pandemic. Social distancing prevented her from gathering with her friends and going out, which had helped her cope with her stress before the outbreak.
She said she felt bad for reaching out to her usual therapist, who was busier than usual during the pandemic. She could either make a video call or meet her therapist in person at Mintoharjo Naval Hospital (RSAL Mintoharjo), a COVID-19 referral hospital, to obtain her psychological test results. The latter was a riskier choice.
She initially hesitated to do an online consultation because of the lack of privacy in her home, where she lived with her siblings, but she managed to obtain the results on Monday on a video call.
“The internet connection is slow and there are only a few psychiatrists. And even if it is online, it is also a matter of compatibility. I’ve found one that I am comfortable with after talking to six others,” Pita said. “It’s complicated."
Pita is one of many who have felt the pinch of Indonesia’s longstanding shortage of clinical psychologists and psychiatrists, exacerbated by the COVID-19 outbreak despite patients’ need for regular access to mental health care.
According to the World Health Organization (WHO), access to mental health treatment is critical. Failure to take people’s emotional well-being seriously during the pandemic, the organization says, will lead to long-term social and economic costs to society.
“There is no health without mental health,” said Indonesian Clinical Psychology Association (IPK) chairwoman Indria Laksmi Gamayanti, quoting the WHO. “When mental health is ignored, there will be a decline in productivity and people’s character development.”
Indria said Indonesia was already lacking clinical psychologists before the COVID-19 pandemic, but the current surge in virus-related inquiries had stretched mental health resources further. She said the deficit-stricken national health insurance (JKN) program had yet to include clinical psychological services in its scheme despite high demand for it.
The 2018 Basic Health Survey (Riskesdas) shows that 7 in 1,000 households in Indonesia have members who experience psychosis or schizophrenia. In addition, about 6 in every 1,000 households have members below 15 years old who are enduring depression.
No national data is currently available about the number of mental health workers and patients during the pandemic. However, past data shows that Indonesia lacks the mental health resources to cope with the country’s needs.
With a population of about 250 million in 2016, the country had only about 773 psychiatrists – approximately one for every 323,000 people, the Health Ministry told Tempo in 2016. The figure is a far cry from the WHO’s recommendation of having one psychiatrist and psychologist for every 30,000 people.
An article in The Conversation in 2018 argues that the country needs 7,500 mental health workers to provide sufficient psychiatric services for its population, basing the figure on the WHO’s benchmark. They estimated that the country could only meet 16.3 percent of its needs.
The WHO warned last month that the world could risk a “massive” increase in mental health issues in the coming months if nations neglected investment in such services.
“It is now crystal clear that mental health must be treated as a core element of our response to and recovery from the COVID-19 pandemic,” WHO chief Tedros Adhanom Ghebreyesus said.
To alleviate the burden, the Social Affairs Ministry, the Indonesian Professional Social Workers Association (IPSPI) and the Indonesian Social Work Consortium (KPSI) launched a set of psychosocial services on May 12. They include a 24/7 hotline for online consultation and regular webinars for mental health education.
"The psychosocial service programs can reduce the emotional burden on individuals and society. The proper handling of the community’s emotional condition will also help the community's readiness and endurance in the current situation," Social Affairs Minister Juliari Batubara said.
The government has introduced a psychological consultation service, called the Psychological Services for Mental Health (Sejiwa) program, to improve mental health during the coronavirus outbreak.
Counseling and development center Personal Growth CEO and founder Ratih Ibrahim said services like Sejiwa would not be effective without a sufficient number of clinical psychologists.
She encouraged universities to increase access to clinical psychology programs and to shorten the period of study needed to be a clinical psychologist. According to IPK chairwoman Indria, Indonesia only has 17 universities that offer psychology majors.
Ratih’s firm found that 33 percent of the 327 cases recorded on its free online counseling platform from March to May were related to COVID-19. Some 9 percent of the 23 complaints involving children aged 13 to 17 were COVID-19-related.
“Don’t underestimate the figures. If we generalize it to a larger population, the trend will likely be the same,” Ratih said.