Mental Resilience of Our Teenagers
When President Joko “Jokowi” Widodo spoke about superior HR, my research even said, teenagers as Indonesian HR are vulnerable to suicide.
When President Joko “Jokowi” Widodo spoke about superior HR, my research even said, teenagers as Indonesian HR are vulnerable to suicide. In fact, suicide can be contagious.
The transmission process is certainly different from the transmission of infectious diseases. Suicide as a very personal decision can still be influenced by social impulses, including imitation. The transmission process is shown by the existence of imitation waves. Romantic literature, for example, often displays examples of suicide for romantic reasons. A very famous example is the work of a novel from Goethe in 1974. Werther, who is a hero in this novel, kills himself after being rejected by the woman he loves. Werther\'s fictional death was imitated by many young people in real life, resulting in the term Werther effect to describe suicide due to romantic imitations.
Imitation of suicide raises concerns. A National Institute of Mental Health (NIMH) study in the United States in 2017 showed that the television series Thirteen Reasons Why that was aired on Netflix caused a 28.9 percent increase in suicide rates among US teenagers aged 10-17 years. These results indicate that adolescents are very vulnerable to the media. This illustration does not mean suicide is only a problem in developed countries like the US. According to the WHO Global Health Estimates 2017, the highest global death due to suicide in low and middle income countries is at the age of 20 years. If the peak occurs at the age of 20 years, then efforts to prevent suicide should be done at the age of adolescents as a vulnerable group.
Prevention commitment
Responding to the severity of the problem of suicide, World Mental Health Day on 10 October 2019 took the theme "Promotion of Mental Health and Suicide Prevention". In the 2013-2020 WHO Mental Health Action Plan, WHO member countries are committed to working towards global targets to reduce suicide rates in countries by 10 percent by 2020. In the target indicator 3.4 of the Sustainable Development Goals it is affirmed, by 2030 there will be a reduction by one-third in premature deaths due to non-communicable diseases through prevention and treatment, and improve mental health and well-being. Indicator 3.4.2 is the suicide mortality rate by sex (deaths per 100,000 population). What about Indonesia\'s preparations to reach the target to decrease the suicide rate especially on adolescent vulnerable groups?
The components of the Human Capital Index (HCI) are closely related to the Sustainable Development Goals (SDGs). In addition to regulatory and institutional issues, inhibitors to the medium to long-term economic growth are aspects of human resources with low quality education and various health problems, including high prevalence of non-communicable diseases. According to the World Economic Forum 2016, the contribution of each non-communicable disease to the overall loss of GDP of Indonesia\'s output in 2012-2030 is 1) cardiovascular disease (39.6 percent), 2) mental illness (21.9 percent), 3) respiratory disease (18.4 percent), 4) cancer (15.7 percent), and 5) diabetes (4.5 percent).
Salah satu sesi kegiatan psikoedukasi yang membahas tentang kesehatan jiwa diselenggarakan di Jakarta, Sabtu (5/7). Kegiatan tersebut dilangsungkan untuk memberikan pemahaman dan kesadaran kepada publik tentang kesehatan jiwa.
Early detection of risk factors
A joint study by the Health Ministry in 2015 with respondents amounting to 941 high school and vocational school students aged 13-18 years in Jakarta got emotional problems of 20.51 percent, depressive symptoms 30.39 percent, and suicide ideas 18.6 percent. Schools were selected purposively to be often problematic, such as brawl. Based on these data, in 2018 I developed a research into the development of early detection instruments for risk factors for suicidal ideation in adolescents in high school/equivalent with A accreditation in Jakarta. Of the 910 samples, it was found that adolescents who had high risk factors for suicidal ideation were 125 (13.8 percent) and those with no risk were 779 (86.2 percent). The number, who have had serious suicide ideas in the past month, was 5 percent.
An instrument called an adolescent mental endurance instrument was produced where it has the ability as a predictor of adolescent suicide ideas. The instrument consists of the dimensions of belongingness, loneliness, hopelessness, and burdensomeness as strong risk factors which cause suicide ideas in adolescents. Students, who were detected to be at risk of suicide, had 5.39 times greater risk of having a suicide idea than students who were not detected to be at risk of suicide, after being controlled by the variables of age, school, gender, father\'s education and occupation, mother\'s education and occupation, parental divorce status, ethnicity, father\'s whereabouts, mother\'s presence, religious beliefs, depression, and stressors.
Psychosocial depression and stressors were not significant as predictors of adolescent suicide ideas in multivariate analysis. However, a series of psychosocial stressors was obtained from highest to lowest frequency, including active use of social media, achievement lower than expectations, peers say bad things, peers mock, often play online games, break up in love with boyfriends, parents fight, family financial problems, physical fights with peers, idols die of suicide, smokers, experience sexual harassment, friends die of suicide, alcohol consumption, family member die of suicide, and drug use.
Reflecting on these findings, the health vision of Joko Widodo-Ma\'ruf Amin to produce excellent HR and the Golden Generation of 2045 could meet a dead end if mental health development is not place at the mainstream. Even if mental health indicators are to be forced to enter the Indonesian SDGs road map, it can be attached to the target of 4 quality education. Dropouts are one of the outputs of adolescent mental health problems that are not detected.
Youth mental health program
At school, the Child Friendly School policy has been implemented by the Women\'s Empowerment and Child Protection Ministry, but cross-sectoral coordination should be expanded nationally. Programs at school include the School Health Effort with tools in the form of a My Health Report and life skills training. My Health Report contains periodic physical and mental health student data reports which, if a national dashboard is made, will become a source of big data information that is in line with the development of the world and has entered the era of the industrial revolution 4.0. Youth life resilience instruments for early detection of risk factors for adolescent suicide ideas can also be used in an upscaling way in the form of technological innovations that will touch more regions of Indonesia, especially urban areas that are more vulnerable to suicide.
However, until now the center has not been established after five years after the enactment of the law.
At the FKTP level there is a Minimum Service Standards policy. The special youth program at FKTP is the Youth Health Care Program (PKPR) with peer counselors. This is in line with the policy direction of the National Medium-Term Development Plan (RPJMN - 2020-2024) to increase access to and quality of health services towards universal health coverage with an emphasis on strengthening basic health services. Increasing promotion and preventive efforts must be supported by innovation and use of technology. Preparing Indonesia for disruption of health technology, Law No. 18 of 2014 concerning Mental Health has stipulated in Article 65 (3) that the minister appoints the Center for Research, Development, and Utilization of Mental Health Technology. However, until now the center has not been established after five years after the enactment of the law.
So far the nation\'s character has been eroded in adolescents and technological disruption has become a psychosocial stressor.
It is quite clear, the mental and physical health of adolescents should be monitored so they can maximize their talents. The government promises to build the Indonesian Talent Management Institute by identifying, facilitating, and providing educational support and self-development for Indonesian talents. However, Indonesia faces the challenge of disparity in access to self-development in the abundance of Indonesian cultural wealth. So far the nation\'s character has been eroded in adolescents and technological disruption has become a psychosocial stressor.
The abovementioned components are very important for the resilience of Indonesian teenagers, but family parenting continues to be the cornerstone of children\'s mental health promotion efforts. Parenting is a process that includes maintaining/caring for, protecting, and directing a new life along with the child\'s growth and development process; and providing resources to meet basic needs, love, attention, and values. Even, parenting and family communication patterns have been regulated in Law No. 18 of 2014 concerning Mental Health long before President Jokowi talked about superior HR. Unfortunately, the follow-up in the form of derivative regulations has been ignored by the relevant ministries for the past five years.
Nova Riyanti Yusuf, Secretary-general of the Asian Federation of Psychiatric Associations; general chairman of the Jakarta Mental Medicine Specialists Association