Indonesia Free from “Pasung” (Physical Restraint)
Transcript of Indonesia Free from “Pasung” (Physical Restraint)
Indonesia Free from “Pasung” (Physical Restraint)
Diah Setia Utami Director of Mental Health
Ministry of Health, Republic of Indonesia
BACKGROUND OF MENTAL HEALTH PROBLEMS IN INDONESIA
Current Situation of Mental Health
• Severe mental disorder was nearly 0,5% (>1 million people) (Basic Health Research 2007)
• Treatment gap in Indonesia is more than 90%. Survey in Leuwiliang West Java showed psychosis treatment gap was 96,5%.
Current Situation of Mental Health (cont’d)
• Prevalence of perinatal depression is 20%-30%
• Common mental health issues in the community: 1. Depression disorder
(15.5%), 2. Generalized anxiety
disorders (12.1%) 3. Post- traumatic stress
disorders (8.5%).
*Collaboration research in West Java, 2011
Current Situation of Mental Health (2)
• Mental health problems due to natural disaster: prevalence of depression & anxiety disorders was about 40% post disaster (Irmansyah et al, FKUI; FK Unpad Jabar, 2010).
Current Situation of Mental Health (3)
Student brawl / Other mass
violence
Migrant workers & Human trafficking
Mental Health Services (1) • 51 Mental Hospitals are available in 27
provinces: – 22 provide subspecialistic services
(Pediatric Psychiatry and/or Drug Dependence)
– Total bed capacity: 7700 (rate 3.31 per 100.000 population)
• 8 provincies do not have mental hospital
• 3 provincies do not have psychiatrist
Fasilities of Mental Health Services (2)
• 61,3% of PHC in Indonesia (around 9000 PHC) provide basic* mental health service (Health Facilities Research, 2011).
• The majority of primary health care doctors and nurses have not received sufficient & official mental health training in the last five years.
• 252 (33%) general hospitals (government) have mental health services, especially outpatient services
* Early detection, home visit, essential psychopharmacotherapy
Provinces : 34 MHH: 50 (34 Goverment, 17 Private ) 8 has no Mental Hospital (Kepulauan Riau, Banten, Kalimantan Utara, Gorontalo, NTT, Sulbar, Maluku Utara dan Papua Barat)
PROGRAMINDONESIA FREE FROM
“PASUNG”
Pasung problems
Estimation of people who
were restrainst physically were
18.800
Data from 21 Provinces : • 4205 reported
cases: 82% received treatment
Factors of Restraining People with Mental Disorder
• History of chronic and relapsing disease
• Lack of access to mental health services
• Family burden • Low respond towards
pharmacotherapy • Financial issues • Lack of knowledge and understanding
on mental health
2010 - Socialization - Providing regulation
- Problem mapping
2011 - Strengthening HR
- Drug distribution
- Multi-sector commitment building
2012 - Strengthening services
- Community empowerment
2013 Monev in 33 provinces through: a. Basic Health
Research 2013
b. Specific questionnaire on pasung
2014 Remapping for future policy
ROADMAP of INDONESIA FREE FROM
PASUNG
13
Objectives • To achieve pasung (restraint) free
situation for people with mental disorders in Indonesia, through: 1. Implementation of human rights-
based approach in treating people with mental disorders
2. Increasing mental health knowledge of stakeholders
3. Providing quality mental health service in the community
Objectives (cont’d) 4. Availability of sufficient mental
health budget at all level: national, provincial and district level
5. Availability of multi-sector collaboration and coordination in mental health efforts
6. Implementation of mental health efforts monitoring and evaluation
Reported and Treated “Pasung” 2010 – July 2013
16
383
1139
1388 1295
238 (62,14%)
990 (86,92%)
488 (60,77%)
1178
0
200
400
600
800
1000
1200
1400
1600
2010 2011 2012 2013
Reported Treated
(82%)
* Data July 2013
Future Plan • Monitoring and Evaluation • Re-scheduling of “Pasung” Roadmap • Providing: guideline, regulation,
evaluation tools • Advocacy to the stakeholders • Capacity building for the health
profesionals
Thank You
Thank You