Stressful lifestyle spurs mental illness
Debbie A. Lubis, The Jakarta Post, Lawang, East Java
Sixteen-year old Tania was so excited when a group of journalists visited her, "Mister, I like you, I love you. I like you miss, you are beautiful".
At first, she talked a lot about herself but suddenly she became furious when a guest praised her hairdo. "You shut up lah miss. I don't give a shit about the money, just sign the contract," she said in a Singaporean accent.
Tania got the mental problem while she worked as a housemaid in Singapore.
But in a minute she became nice, telling everybody in English and Indonesian about her opinion on the country, her father's philosophy, and her boy friends. She also showed her poems and drawings.
"My father said that I have to be like a coconut tree whose parts are useful for others. I want to show the world that Indonesian children can be smart too. I love Indonesia very much. I don't like Singapore," she said. But within five minutes she yelled: "I hate Indonesia. Indonesians are stupid. Singapore is a small country but wealthy".
After working in Singapore for one and a half months, Tania was sent back by her manpower agency to her hometown in Kediri, East Java, without being paid. She sustained bruises. Her family then took her to a mental hospital to get special treatment.
"Her arm tremors are just a reaction to the medicine we gave this morning. As a patient suffering from manic depression, she needs medicine to stabilize her moods," Maria A. Widyastuti, a psychiatrist at state-run Radjiman Wediodiningrat Mental Hospital said.
In another ward was a 82-year-old schizophrenic patient. "I'm happy to see all these people coming up to me smiling, because it's very quiet here. I'm a forgotten person. Nobody has visited me before," she spoke in Dutch.
Heybloom, aka Albertina van Oostenbrugen, was from the Netherlands and abandoned by her family 60 years ago after she suffered "a major breakdown".
According to the World Health Organization, some 400 million people worldwide suffer from mental or neurological disorders, or psychosocial problems such as those related to alcohol and drug abuse and other mental disturbances including mental retardation.
In Indonesia, one in every five people suffer from such disorders, according to Minister of Health Achmad Sujudi.
WHO attributed the rise in depression to factors including more stressful lifestyles, poverty and violence. It says that Alzheimer's disease, a debilitating dementia which hits the elderly, is expected to increase as people live longer.
Mental disorders, from mild to severe, are not rare -- if often hidden -- among the general population. This is perhaps not surprising, with many people out of work and lacking the will to look after themselves, let alone their families.
Many of those who are addicted to drugs have what is called a "dual-diagnosis" -- they are also suffering from some form of mental illness.
People infected with HIV, the virus that causes AIDS, often suffer from depression after knowing they may have a terminal illness, but also as a result of discrimination that many experience, even from their own families.
Based on a 1995 household survey, 264 out of every 1,000 people suffer mental problems, with most patients aged above 14 years suffering from emotional distress (140 out of every 1,000).
Puskesmas (community clinics) recommend patients with severe mental illnesses go to any of the 33 mental rehabilitation centers or hospitals nationwide.
Widyastuti said that mental illness is noticeable from a variety of symptoms including stomachache and headache. Sometimes patients come to the hospitals with eating disorders, feel they have no energy, tire easily, suffer from insomnia, are forgetful and lack confidence.
She said that people with acute psychiatric disorders were self-harming, suffering from depression, obsessive-compulsive disorders and disillusioned.
WHO statistics show that some 6 million Indonesians have mental problems, 5.5 million of those do not receive proper treatment or medication.
According to G. Pandu Setiawan, the hospital's director, stigma and discrimination are the biggest obstacles facing mentally ill people today.
He said people often don't consider psychological disorders an illness and it was almost universal that shame, secrecy and fear prevented patients or their families from seeking help.
"People think of mental hospitals as a scary place where scary people are kept. That way of thinking has to change," said Pandu, who is also a psychiatrist and the president of the Indonesian Psychiatric Association (PDSKJI).
He said the mentally ill tended to settle down in hospital but become disturbed again once they were returned to the outside world.
"They need someone they can talk to ... That way, if their symptoms worsen, someone will notice ... We must not let such patients become isolated," he said.
Speaking at a news briefing to commemorate the 100th anniversary of the hospital, Pandu said there were thousands of mentally ill people who were homeless and neglected, wandering the streets due to a lack of proper treatment.
Indonesia now has 8,150 beds available and 430 doctors for psychiatric, mental and nervous illnesses.
Pandu urged the government to provide more experts and human resources in the psychiatric field to cover the country's more than 360 regencies.
"Today, there is one psychiatrist for every 500,000 people in the country. It's not enough to handle the patients," he said.
In general, treatment for a mentally ill person costs between Rp 1.2 million and Rp 1.5 million per month, excluding additional therapy.
Poor patients at Radjiman Wediodiningrat Hospital receive financial support from the government or donors.
The hospital plans to open some business units to raise funds before it opens its doors to become a profitable company next year.