Dealing with mental illness<\/p>\n
Yulia Wardani, Jakarta<\/p>\n
World Mental Health Day fell on Oct. 10 with little public and
\nmedia attention. This is unfortunate because of the severe amount
\nof psychological trauma the nation has recently suffered.<\/p>\n
On Dec. 26 last year, Indonesia suffered from a terrible
\nnatural disaster, an earthquake and tsunami in Aceh and North
\nSumatra that killed more than a 130,000 people and left hundreds
\nof thousands more grieving the loss of loved ones and the
\ndestruction of their old lives. The psycho-trauma of those
\nterrible events will scar the survivors' minds deeply; and it is
\nsomething they will never forget. But while they may not forget
\nmost will cope, especially if they are given help.<\/p>\n
The impact of natural disasters on individuals is substantial.
\nAside from the hardship of daily living, survivors may experience
\nphysical injuries and mental trauma from witnessing someone dying
\nor being injured, seeing dismembered bodies or body pieces, being
\ntrapped under debris, or being separated from their families.<\/p>\n
Survivors of disasters often experience a range of losses --
\nloved ones, their homes, neighborhoods, communities, and places
\nof worship. Although distressing for all, children may be
\nparticularly affected by the loss of their familiar environments
\n-- home, school, peers -- as they feel safe and secure when they
\nhave consistent and predictable routines.<\/p>\n
This can cause anxiety, fear, and a great sense of insecurity
\nand children's worries and fears manifest themselves through a
\nrange of reactions that generally vary with age.<\/p>\n
In 2010, as written in the Strategic Plan for Health
\nDevelopment, the ratio of mental health disorders in the national
\npopulation is predicted at 140:1,000 for people aged more than 15
\nyears old. This number is significantly greater than ratios for
\nphysical diseases, such as diabetes (16:1,000), cardiac and
\npulmonary disease (4.8:1,000) or strokes (5.2:1,000). However,
\nthe Ministry of Health estimates that mental health patients make
\nonly 1.5 percent of people who currently receive treatment in
\nhospitals.<\/p>\n
Let us trace where this large number of people with mental
\nillnesses come from. They often come from poverty, have little
\neducation because of a lack of access, suffer from a low quality
\nof health services -- all things that ensure they are not able to
\ncope with their problems.<\/p>\n
A socio-political situation where rights violations continue
\nto be perpetrated and where there is a tension between tradition
\nand modernity also influences the state of the nation's health.<\/p>\n
Meanwhile the movement for mental health development remains
\nat close to zero velocity. The National Health Department is
\nstill focused on the physical needs of the people. Nutrition,
\nimmunization and family planning are targets for development but
\nthere are no significant programs to increase mental health
\nawareness or treatment, although so many people are suffering.
\nThe government has made no clear moves to respond the needs of
\nmental health service providers, especially to promote good
\nmental health.<\/p>\n
Who should be responsible for the mental health of the nation?
\nI would argue that every person -- families, communities and
\ngovernments, both local and central -- should be involved in this
\ntask. But for this to happen we need conducive circumstances so
\nthat the approach is coordinated and not just an ad hoc,
\npiecemeal one.<\/p>\n
We must, of course, start a bold and wide-ranging campaign to
\nsupport basic shelter and survival needs of the millions of
\npeople in the devastated communities hit by the tsunamis and the
\nresulting trauma. With the help of media coverage, many national
\nand grassroots mental health organizations are already beginning
\nto provide emotional support and develop strategies and services
\nto address the immediate and long-term mental health consequences
\nthat are certain to impact thousands of individuals and families.<\/p>\n
We are urging all people to do whatever they can to provide
\nencouragement, support and resources that will be of assistance
\nto the people who suffer from mental illness. The many mental
\nhealth professionals and volunteers working tirelessly to help
\npeople cope with physical hardship and emotional trauma need your
\nhelp.<\/p>\n
The economic crisis, social upheavals and natural disasters we
\nhave suffered will create untold mental health consequences --
\nnot just for the survivors, or the aid workers, or the poor but
\nfor the entire nation.<\/p>\n
Even people who only witnessed the death and devastation of
\nthe tsunami on television will be emotionally affected. We know
\nthat only a relatively small number of mental health NGOs are
\nmaking efforts to provide support to families.<\/p>\n
This is a truly global natural and human disaster. Yet, the
\nmost important and continuing task to address the disaster's
\naftermath will fall on local volunteers and professionals living
\nand working in the affected countries. Their jobs will remain the
\nmost difficult and the most wrenching, long after the television
\nnews teams are gone and the world's attention moves to new
\nevents. Mental health professionals and volunteers, of all the
\nrelief workers, have some of the hardest and longest work ahead
\nof them.<\/p>\n
The writer is a lecturer on Psychiatric Nursing At STIK Sint
\nCarolus, Jakarta.<\/p>",
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