Thursday, March 22, 2007
The Jakarta Post, Jakarta
The government has continued to pay little attention to the issue of mental illness despite the broader and prolonged impacts of trauma following with the recent string of disasters to hit the country, psychiatry experts have said.
Head of the Department of Psychiatry at the University of Indonesia, Irmansyah, said Wednesday that the government should pay more attention to post-traumatic stress disorder (PTSD).
He said several traumatic events, such as riots, terror attacks, plane crashes, train wrecks, earthquakes, tsunamis and severe wind storms had left many Indonesians traumatized.
"We are not only fighting a lack of knowledge about mental health problems, but also stigma about the disease," he told The Jakarta Post.
Mental health theory shows that around 10 percent of those who experience a traumatic event will likely develop PTSD. The diagnosis of the disorder can take some time and it can often worsen to become a chronic, lifelong problem.
"The problem is that society does not recognize mental illness as a disease. We would be so ashamed to acknowledge that we have any kind of mental health problem," said Irmansyah.
He said that even though the World Health Organization (WHO) classified mental illness as a kind of disease, it was hard to get this idea across in Indonesia.
Irmansyah said the country's current high suicide rate showed the failure of the health system in detecting mental disorders in their early stages. "The shooting in Surabaya and the mother killing her children and herself in Malang are only the tip of the iceberg," he said.
The impacts of mental illness can be tremendous in society. Many social problems are correlated with mental health problems.
"An extreme example is the riot in Makassar in 1997, which was triggered when a mentally disturbed Chinese man killed a local girl," said Irmansyah.
Research has shown that in Indonesia, mental diseases decrease the nation's overall productivity by some 13 percent. However, budget allocations for mental health make up less than one percent of the government's health budget.
Last year, the University of Indonesia, together with several organizations affiliated with the Mental Health Advocacy Group, attempted to convince lawmakers of the importance of a mental health law, to no avail.
"We used to have a mental health law, which was established in 1962, but it was replaced by the 1992 Health Law because mental health was seen as a part of overall health. Within the enactment of the 1992 law, articles from the previous mental health law were supposed to have been enacted as government regulations, however this has not been done," said Irmansyah.
Irmansyah said that the country has only some 550 accredited psychiatrists, putting the ratio of psychiatrists to patients at 1:500,000. The ideal ratio is 1:30,000.
Mental health care is also not recognized in the national health insurance system. "For mental health problems, the medical treatment is often consultation. We need a system that recognizes such consultation as a form of medical treatment," said Suryo Dharmono, also of the University of Indonesia's Department of Psychiatry.
"This is evidence that the government does not really care about the problem. We are focusing on morbidity and forget that mental illness does not always result in fatality, but also has a destructive, long-term impact. We rarely count such a loss," he said.
Suryo said the University of Indonesia would initiate the nation's first medical psychiatric clinic this year, dedicated to handling addiction and trauma, among other problems.(02)