JP/17/JIWA

JP/17/JIWA

Mental health still not a priority

Emmy Fitri
The Jakarta Post/Jakarta

Unlike campaigns for high-profile diseases such cancer and
HIV/AIDS, World Mental Health Day that fell on Oct. 10 got the
cold shoulder here -- even from the health authorities.

The lack of attention to the issue is a true reflection of the
lack of understanding of how mental health is closely linked to
physical health, and how an unhealthy mental state could lead to
a decrease in people's life quality.

Cliched, but real problems, like limited funds for mental
health care and perpetual stigmas on mental illnesses worsen the
situation in Indonesia.

Countries ranging from the U.S., Britain, Norway to Australia and
New Zealand enthusiastically promote mental health awareness on
that particular day -- and also in the following days and weeks.
Support for the campaign also came from the tiny Pacific island
of Palau, and also from Nepal.

In its official website, www.wfmh.org., World Federation of
Mental Health (WFMH) commented, "We like the support in the tiny
Pacific island of Palau, where the government prints a mental
health day message on government pay stubs for that week."

"We are also amazed to learn about World Mental Health Day
banners in Kathmandu (Nepal) than about the posters in London. We
are surprised when the first report after Oct. 10 arrives from
Benin in West Africa."

Some countries that are not very wealthy and that are also
preoccupied with a myriad of other problems still care about
mental health issues. That's possibly because they are conscious
of the fate that awaits them if they remain ignorant about this
issue.

According to the World Health Organization, at least one in
ten people worldwide have suffered from clinically significant
mental health problems during the past 12 months. And 30 to 50
percent of people with psychiatric disorders remain undetected
and untreated, even in rich countries.

At home?

Senior psychiatrist Professor Sasanto Wibisono spoke at length
about the background in understanding the situation here. But
succinctly, he concluded that "as a whole, rapid global
development has impacted on human mental health as it affects the
culture and lifestyle of people."

People have to adjust to new lifestyles and learn to adapt to
cultures that are not part of their upbringing, he said.

Corruption practices were not part of culture, Sasanto
claimed. People lose their grip on their life values and became
confused about what's wrong and what's right. "We see shifting
personal judgments on what used to be shameful, now becoming
something normal."

"Acculturation is a painful process for people who have
adjustment problems. Like it or not, even for those with a strong
ability to handle the process, they are also in limbo because we
will never know our limits. Life becomes so stressful," Sasanto
told The Jakarta Post.

Sasanto said that he did not know what was the most sensible
way to address the issue but he pointed out the urgency of
continuing to raise public awareness about mental health issues.

"And our education curriculum must be reformed because social
adjustment problems can stem from education failure," said
Sasanto, who is chairman of the Indonesian Psychogeriatric
Association.

Modernity versus sanity

Changing lifestyles -- coming together in a package with
'modernity' -- also completely alter the profile of physical
health, he continued.

"In the past we only knew infectious diseases, but at present
we see more and more people getting non-infectious diseases, like
cardiovascular disease, HIV/AIDS, diabetes and other diseases
that are a result of changing lifestyles."

Although he had no exact figures, Sasanto claimed that in
Indonesia -- with its current lingering socio-economic and
political problems -- one percent of its total 210 million
population may have mental health problems.

Mental health problems can manifest themselves in various
forms such as anxiety, depression and stress, and can also
manifest as physical health problems; what in the past the
medical fraternity referred to as psychosomatic diseases.

Because of this alarming situation, WFMH selected "Mental and
Physical Health Across the Lifespan" as this year's theme for
World Mental Health Day.

Sasanto's colleague, Irmansyah, said restlessness, anxiety and
depression were also commonly found in patients with chronic
diseases like diabetes melitus, cancer, cardiovascular disease
and HIV/AIDS.

"Unfortunately, most of the time these mental problems are
ignored, and even if found, are not properly treated," he said in
a statement made available to the Post.

There was rising co-morbidity between physical and mental
health, Sasanto also confirmed.

"In the case of a chronic diabetes melitus patient, for
example, he may not comply with the diet and other treatment
because he is losing hope. Feeling frustrated about the length of
the treatment can also be a cause."

"In extreme cases, we call it passive suicide."

In addition, bad behavior, constituting a crucial component
in mental health, became a prominent cause in eliciting physical
problems. Irmansyah said the smoking habit was a 'good' start to
causing heart disease, lung-related problems and even cancer.

Meanwhile, Irmansyah said a study in Australia showed that
people with chronic mental diseases like depression and
schizophrenia tended to die of physical diseases.

"People with mental health problems are usually ignorant of
their physical condition and this is made worse be the reluctance
of family to take their sick ones to the doctor," he said.

A person with depression also tended to show bad behavior like
eating disorders, smoking, and alcohol and drug abuse -- all of
which could lead to physical health problems, said Irmansyah, who
is a psychiatrist at the Cipto Mangunkusumo Hospital.

Both Sasanto and Irmansyah said doctors too must learn about
co-morbidity between physical and mental health, and hospitals
should start fostering multi-disciplinary teams to handle cases.

"We've started it already with some cases but the public too
must be aware of this issue so they know where to get help and
how," he said.

"Everything ends up with government willingness to see mental
health as an issue," Sasanto said.