Unequal Access to Mental Health Services

The people of Indonesia still do not have adequate access to mental health services, despite the rising risk of mental illnesses during the pandemic.

KOMPAS/RIZA FATHONI

A number of patients with mental disorders gathered after undergoing a PCR swab test at the Bina Insan Bangun Daya 2 Social Institution, Cipayung, East Jakarta, Monday (23/8/2021).

JAKARTA, KOMPAS – The increased risk of mental disorders during the COVID-19 pandemic has also increased the demand for mental health services. Thus, public access to mental health services is expected to be easy, affordable and within reach.

A psychiatrist from Marzoeki Mahdi Hospital in Bogor, who is also a member of the Indonesian Psychiatrists Association (PDSKJI), Lahargo Kembaren, said that there had been an increase in various mental health issues during the pandemic, ranging from sleep disorders and anxiety to depression and even schizophrenia.

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“Mental health issues have been observed in both people who have experienced mental disorders before as well as those who haven’t but are vulnerable to them,” he said when contacted in Jakarta, Monday (11/10/2021).

Amid these conditions, unequal access to mental health services will only exacerbate the situation. Mental illnesses that are not treated immediately can reduce the effectivity of treatment efforts. Not only will treatment be prolonged, but its cost and the drugs administered may also increase.

KOMPAS/RONY ARIYANTO NUGROHO

The expression of a patient with mental disorders when receiving an injection of the Covid-19 vaccine at the Basudewa Pavilion, Dr. Marzoeki Mahdi Hospital, Bogor City, West Java, Tuesday (1/6/2021).

Telemedicine and teleconsultation services can act as a short-term solution to reach a wider audience. However, it must be supported by a sturdy technology system.

Telemedicine services are also needed to address the shortage of human resources in the country’s mental health sector. Currently, Indonesia only has about 1,000 psychiatrists with 70 percent of them located in Java. This means that each psychiatrist has to treat approximately 250,000 residents. The World Health Organization has stated, however, that it would be ideal to have one psychiatrist for every 10,000 residents.

Consultations

Shinta, 25, a resident of Sumedang, West Java, wanted to consult a psychologist about her anxiety as she is often restless and has trouble sleeping.

“Up until now I want to consult a psychologist because I don’t want to give myself a diagnosis. But it costs money and that’s that,” Shinta, who is now unemployed, said on Friday (8/10).

Shinta did not even know where the nearest consultation service was. Consultations through telemedicine applications were not an option for her as they required payment but she also did not know that the government provides mental health services through the 119 call center.

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The chairwoman of the Indonesian Clinical Psychologists Association (IPK) in Jakarta, Anna Surti Ariani, said that teleconsultations should not only be provided via chat or telephone. Remote consultations can also be done by video call. In a number of cases, it is not enough to rely solely on consultations via text message or phone.

“Of course, to support this, strengthening internet networks is crucial. Currently, online consulting services are only effective in big cities. But mental health issues are not just experienced by people living in the city; it can affect everyone,” said Anna.

KOMPAS/RONY ARIYANTO NUGROHO

Patients with a mental disorder queues to receive an injection of the Covid-19 vaccine at the Basudewa Pavilion, Dr Marzoeki Mahdi Hospital, Bogor City, West Java, Tuesday (1/6/2021).

Global issue

At the commemoration of World Mental Health Day this year, themed “Mental Health in an Equal World” at the Surakarta Mental Hospital in Surakarta municipality, Central Java on Sunday (10/10), Health Minister Budi Gunadi Sadikin acknowledged the limited access to mental health treatment. Thus, he called for wider access to mental health services.

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The ministry’s acting director general for disease prevention and control, Maxi Rein Rondonuwu, said access to mental health services was not evenly distributed in various parts of the world, especially in developing countries. In fact, only 20-25 percent of residents with mental illnesses can easily access such services.

Maxi hopes that the COVID-19 pandemic can make way for innovations for mental health services that are within the people’s reach. For one, the Health Ministry developed the application Sehat Jiwa (Mental Health), with which psychiatrists and clinical psychologists can help and detect mental illnesses early on for people that access it.

Stigma

According to Federation of Asian Oceanian Neuroscience Societies (FAONS) president Adhi Wibowo Nurhidayat, public awareness and understanding of mental health was still minimal, which reduced the quality of mental health services. Although the government, professional organizations and NGOs have done their best to provide various mental health services, the people have not fully optimized them.

“There is still a huge stigma surrounding mental health. People who come to mental hospitals or access mental health services are considered ‘insane’. What makes it even worse is the sociocultural backgrounds of Indonesians who expect to solve problems they are facing on their own,” he added. (TAN/SKA/NCA/DIT/ADH)

This article was translated by Kesya Adhalia.