Mental Health Care

in Indonesia
and
Bali province
By.
Ns. I Gusti Ayu Rai Rahayuni, S.Kep.,MNS

Mental Health Nursing Lecturer

in Institute of Health Sciences Bali
( STIKES Bali )
LOGO
 outline
Overview the condition of Mental Health in
Indonesia

Mental Health Law of Indonesia Republic

August, 2014

Mental Health care in Indonesia

Mental Health care in Bali Province

Overview the condition of Mental
Health in Indonesia
Overview the condition of Mental Health in Indonesia ……cont
The distribution of mental health hospitals in Indonesia

Total population(2008) 228.523.300

Number of province : 33
Number of mental health hospital : 35

8 province without MHH

The burden condition of mental health problem
compare with other disease

Mental
disorders
Road MAP of Mental health nursing
development in Indonesia

Profesional
practice
Community
standardd
Hospital
standard

Without
standard
DEVELOPMENT OF MENTAL
NURSING EDUCATION

Master
Bachelor and
of nursing specialist

Diploma 3
 Mental Health Condition in Indonesia ……...cont

Basic Health Research (Roskesdas) in 2007,

there were an estimated 19 million people
mental disorder in Indonesia.

One million of them suffered severe mental

disorder or psychosis.

Lack of facilities and lack of public

awareness more than 19 million
Indonesian people have mental disorders
and do not have access to maximum
health services
 Mental Health Condition in Indonesia ……...cont

 Indonesia 48 mental health hospital with

bed capacity around 7.700

 However, WHO encourage Indonesia have

minimum 80.000 bed capacity for mental
disorders’ patients

 Primary health center as a basic mental health

services in community can not solve all of
mental health problems in their area.

 Stressor stress depression, anxiety especially

in post disaster areas
 Mental Health Condition in Indonesia ……...cont

 Low of economic income stimulate mental

disorders with some reasons lack of facilities,
attention and fee to access the health services

 Some of the family caregivers not have positive

attitude toward care for the mental disorders
patient at home neglected, restrained

 Community negative stigma, discrimination

, isolation etc for mental disorders people
 The ways to solve the problems
 Indonesia goverment by the IX commision
encourage to give legal guarantee for the
people with mental disorders

 The ministry of health try to discuss the concept

or draft the law to protect patient’s human
right

 After long time waiting for the decision from

goverment about the accepted the law draft,
finally the mental health law can accepted
Indonesia president

 Implemented start Agust 2014

 Mental Health low of Indonesia, 2014
Backround
 Government guarantees every person living in
physical and spiritual welfare and get health
services
 Mental health services for everyone and
guarantees the rights of people with mental
disorders can not be realized optimally;
 Not optimal mental health services for everyone
and not ensuring the rights of people with
mental disorders lead to low productivity of
human resources;
 implementation of mental services in the
legislation currently not regulated
comprehensively so that needs to be regulated
specifically in the mental health low
Mental Health care in Indonesia Based
on The mantal health
low of Indonesia,
2014
Mental Health care Services based on the
principle

Justice
Humanity
Benefits
Transparency
Accountability
Comprehensive
Protection
nondiscrimination.
 Mental Health care …cont

 Mental health care implemented by :

a. promotif;
b. preventif;
c. kuratif;
d. rehabilitatif.

 Include : government and community

 principle : integrated, komprehensif, continue,
koordinated
The aims of mental health promotion efforts

a. maintain and increase the optimum level of

mental health in community
b. eliminate stigma, discrimination, human
rights violations MHP(mental health patient )
as part of the community
c. improve understanding and community
participation towards Mental Health
d. increase acceptance and participation of
the community to Mental Health.
 Health care
facilities family

Mass media Promotive strategy : Educational

place institution

Religious
institutions workplace
 The aims of Mental Health preventive

a. prevent the occurrence of psychiatric

problems

a. prevent the recurrence of mental disorders

a. reduce risk factors due to mental disorder

in the general community or individual

b. prevent the impact of psychosocial

problems.
The implementation of Preventive efforts
in society

a. creating an environment conducive in

society

a. provide communications, information, and

education about the prevention of mental
disorders

a. provide social counseling

The aims of Mental Health Curative

a. healing or recovery

b. reduction of suffer

c. control of disability

d. control the symptoms of the disease.

The implementation of curative efforts
in society
The Management of psychiatric conditions in
MHP ( mental health patient )implemented in
service facilities in the field of Mental Health.
The management of psychiatric conditions in
MHP implemented by referral system.
 The management of psychiatric conditions
in MHP can be implemented by:
a. outpatient
b. inpatient.
The management include : using product,
modality therapy
 The aims of Mental Health Rehabilitative

a. prevent or control the disability

b. recovery of social functions

c. recovery of occupational functioning

d. prepare and give MHP ability to be

independent in the community.
 The implementation of rehabilitation efforts
in society
a. motivation and psychosocial diagnosis;
b. treatment and care
c. vocational training and entrepreneurship
development
d. mental and spiritual guidance
e. physical guidance
f. social counseling and psychosocial counseling
g. improve accessibility
h. social assistance
i. resocialization guidance
j. Further guidance
k. referral.
 Mental Health care in Bali Province

Implemeted by Bali’s Mental Health Hospital

and Primary Health Centers

Bali’s Mental Health Hospital

 MEDICAL DIAGNOSIS Year 2014

DIMENSIA 138

EPILEPSI 461

RM 273

Depresi 443

GGN Kepribadian 74

GMO 613

Psikosis akut 845

Skizofrenia 3903
 Nursing Diagnose 2014
800

736
700

600
583

500 PK
Halusinasi
waham
400
isos
372 HDR
361
Resiko BD
300
DPD

238 242
200

100

0 22
PK Halusinasi waham isos HDR Resiko BD DPD

halucination Believe Social Low self Suicise Depresion

violence
disorders isolation esteem risk Persinlity
disorders
 THE AVERAGE OF DAILYPATIENTS TREATED IN 2014

350
330
315 319
310
297 294
290 292 291
300 283
271
266

250

200

150

100

50

0
Mental Health Services in Bali’s
Mental Health Hospital
OUTPATIENT SERVICES :

Psychiatric Polyclinic
Nerves Polyclinic
Psychology Polyclinic
Dental Polyclinic
Medical Rehabilitation
Mental rehabilitation
laboratorium Rongent elektromedik

Fisioterafi

FASILITAS PENUNJANG
 Laboratorium ECT
 Elektromedik
 Fisioterapi
 Rongent
 EEG
 ECT
 Inpatient activities
PERSONAL HYGIeNE maintenance therapy
 Group activity Therapy

Thepeutic communication
 Emergency situation

restrain
 REHABILITATION ACTIVITIES
MEMBUAT BATAKO

MEMBUAT CANANG (SARANA UPACARA)

 farm POSTURAL ThERAPy

REcreation Art activities

 Outdoor activities
Packing up the patient mental disorders

Droping pasien
Home visit
Nasional competition of
mental disorders ‘patients
 Outdoor activities …cont
Mental health propotion in Social activities
the school

Home visit Apel pagi

Droping pasien
Example Implementation of mental health
care in family and community
Family Psychoeducation program
 References

 Presiden republik Indonesia. Undang-undang

Republik Indonesia Nomor 18 Tahun 2014 tentang
Kesehatan Jiwa
 Bali Mental Health Hospital profile, 2014
 Jacob KS, Sharan P, Mirza I et al. Mental health
systems in countries: where are we now? Lancet
2007;370:1061-77.
 World Health Organization. Mental health atlas
2005. Geneva: World Health Organization, 2005.
 Tebayashi Y. Cambodia. In: Shinfuku N, Asai K
(eds). Mental health in the world. Tokyo: Health
Press, 2009:112-9.
 Office of the Council of State, Thailand. Mental
health act. www.thaimentalhealthlaw.com.