Sistem Kesehatan Jiwa di Indonesia: Tantangan untuk Memenuhi Kebutuhan
Abstract
Abstrak
Sistem kesehatan jiwa yang baik akan menghasilkan masyarakat Indonesia yang sehat jiwa dengan ketersediaan pelayanan kesehatan jiwa yang bermutu, merata, tanggap, efisien dan terjangkau. Tulisan ini bertujuan untuk memberikan tinjauan sistem kesehatan jiwa di Indonesia beserta tantangannya. Studi ini merupakan kajian di bidang kesehatan jiwa. Informasi diperoleh melalui telaah kepustakaan, dokumen, curah pendapat, kunjungan ke lapangan dan wawancara terhadap pelaksana program jiwa. Hasil kajian memperlihatkan masih minimnya sumber daya kesehatan, pengeluaran biaya kesehatan yang masih rendah di Indonesia dibandingkan negara-negara tetangga. Sistem informasi kesehatan juga belum memadai. Kelebihan yang dimiliki Indonesia adalah adanya obat psikotropika yang cukup variatif dalam daftar obat esensial, memiliki Undang-Undang Kesehatan Jiwa, dan beberapa Peraturan Menteri Kesehatan yang menyangkut kesehatan jiwa. Meskipun memiliki Undang-Undang Kesehatan Jiwa, namun belum tersedia perangkat hukum dibawahnya untuk melaksanakan Undang-Undang. Peran serta sektor lain serta upaya promotif dan preventif belum dirasakan.
Kata kunci: sistem kesehatan jiwa, undang-undang kesehatan jiwa, sumber daya, sistem informasi, Indonesia
Abstract
A good mental health system will produce a healthy mental Indonesian community with the availability of good quality, equitable, responsive, efficient and affordable mental health services. This paper aims to provide a review of the mental health system in Indonesia and it challenges. This study is a review of mental health. Information is obtained through literatures and documents review, brainstorming, field visits and interviews with the implementers of the mental health program. The result shows that human resources, health expenditure are still minimal than neighbour countries. Health information system has not yet been adequate. The advantages of Indonesia are this country have adequate list of essential medicines, have a Mental Health Law and some Ministerial decree related to mental health. Although Indonesia has a Mental Health Law, but there has no legal devices available under the law to implement it. Other sector role’s and promotive, prevention program have not been felt.
Keywords: mental health system, mental health law, resources, information system, Indonesia
References
WHO Pacific Region. The health services development 2018 [cited 2018 Januari 20]. Available from: http://www.wpro.who.int/health_services/health_systems_framework/en/
WHO. Introduction and objectives of the handbook. Monitoring the building blocks of health systems: a handbook of indicators and their measurement strategies. Geneve2010. p. v-vi.
Idaiani S. Kesehatan Jiwa Yang Terabaikan dari Target Milenium. Jurnal Kesehatan Masyarakat Nasional. 2009;4 Nomor 3:137-44.
Tujuan Pembangunan Berkelanjutan Jakarta 2018 [Available from: http://sdgs.bappenas.go.id/kehidupan-sehat-dan-sejahtera/
WHO mental health atlas-2011 country profile 2011. Available from: http://www.who.int/mental_health/evidence/atlas/profiles/en/.
WHO. Mental health atlas-2014 country profie. Available from: http://www.who.int/mental_health/evidence/atlas/profiles-2014/en/.
Rencana Aksi Kerja 2014-2019 Direktorat Bina Upaya Kesehatan Jiwa. Jakarta: Direktorat Bina Upaya Kesehatan Kementeran Kesehatan RI, 2014.
Laporan Riset Fasilitas Kesehatan 2011. Jakarta: Badan Penelitian dan Pengembangan Kesehatan, 2011.
Secretariat ASEAN. ASEAN Mental Health Systems. Jakarta 2017.
Idaiani S. Laporan kajian integrasi kesehatan jiwa di pelayanan primer di Indonesia. Jakarta: Pusat Teknologi Terapan Kesehatan dan Epidemiologi Klinik Kementerian Kesehatan, 2014.
Kementerian Kesehatan. Pedoman umum program Indonesia sehat dengan pendekatan keluarga. edisi II. Jakarta 2017.
Idaiani S, Raflizar. Faktor yang paling dominan terhadap pemasungan orang dengan gangguan jiwa di Indonesia. Buletin Penelitian Sistem Kesehatan. 2015;18 No.1:11-7.
Idaiani S: The effectiveness of community-based mental health program by community health centers on the recovery of patients with psychosis In Aceh. Asean Journal of Psychiatry 2015, 16 (2):212-221.
Sessions K, Wheeler L, Shah A, Farrell D, Agaba E, Kuule Y, Merry SP. Mental illness innBwindi, Uganda: Understanding stakeholder perceptions of benefits and barriers to developing a community-based mental health programme. Afr J Prm Health Care Fam Med. 2017;9(1), a1462. https://doi. org/10.4102/phcfm.v9i1.1462.
Vanderlip ER, Williams NA, Fiedorowicz JG, Katon W. Exploring primary care activities in ACT teams. Community Ment Health J. 2014;50:466=73.
Fleury M-Je, Grenier G, Bamvita J-M, Caron J. Mental Health Service Utilization Among Patients with Severe Mental Disorders. Community Ment Health J. 2011;47:365-77.
Keliat M, Virgianita A, Al Banna S, Aryanto AC. Laporan Pemetaan Pekerja Terampil Indonesia dan Liberalisasi Jasa Asean.2013.
Gururaj G, Varghese M, Benegal V, Rao G, Pathak K, Singh L, et al. National mental health survey of India : prevalence, pattern and outcomes. National Institute of Mental Health and Neuro Sciences; 2016.
The Prevalence of Major Depressive Disorders in Thailand: Results from the Epidemiology of Mental Disorders National Survey 2008 [Internet]. 2008. Available from: prasri.go.th/upic/ie.php/9a177a07fd2b9b9f.pdf.
Phanthunane P, Vos T, Whiteford H, Bertram M, Udemratn P. Schizophrenia in Thailand: prevalence and buden of disease. Population health metric. 2010;8 (24).
Steel Z, Marnanae C, Iranpour C, Chey T, Jackson JW, Patel V, et al. The global prevalence of common mental disorder; a systematic review and meta analysis 1980-2013. Int J Epidemiol. 2014;43(2):476-93.
Ahanhanzo YG, Ouedraogo LT, Kpozèhouen A, Coppieters Y, Makoutodé M, Wilmet-Dramaix M. Factors associated with data quality in the routine health information system of Benin. Archives of Public Health [Internet]. 2014; 72(25):[about 8 p.]. Available from: http://www.archpublichealth.com/content/72/1/25.
Idaiani S. Penyakit-penyakit di bidang psikiatri yang harus dituntaskan di puskesmas. Kebijakan Kesehatan Indonesia. 2016;5 No.4:168-77.
Ayano G. Significance of mental health legislation for successful primary care for mental health and community mental. Afr J Prm Health Care [Internet]. 2018:[about 4 p.]. Available from: https://doi.org/10.4102/phcfm.v10i1.1429.
Barry MM, Clarke AM, Jenkins R, Patel V. A systematic review of the effectiveness of mental health promotion interventions for young people in low and middle income countries. BMC Public Health [Internet]. 2013; 13:[about 19 p.]. Available from: http://www.biomedcentral.com/1471-2458/13/835.
Lauriks S, Buster MC, Wit MAd, Arah OA, Klazinga NS. Performance indicators for public mental healthcare: a systematic international inventory. BMC Public Health [Internet]. 2012; 12:[about 26 p.]. Available from: http://www.biomedcentral.com/1471-2458/12/214.
Drapeau A, Boyer R, Diallo FB. Discrepancies between survey and administrative data on the use of mental health services in the general population: findings from a study conducted in Québec. BMC Public Health [Internet]. 2011; 11 [about 10 p.]. Available from: http://www.biomedcentral.com/1471-2458/11/837.
Augustinavicius JL, Greene MC, Lakin DP, Tol WA. Monitoring and evaluation of mental health and psychosocial support programs in humanitarian settings: a scoping review of terminology and focus. Conflict and Health. 2018;12:9. doi:10.1186/s13031-018-0146-0
Perić N, Hofmarcher MM, Simon J. Headline indicators for monitoring the performance of health systems: findings from the european Health Systems_Indicator (euHS_I) survey. Archives of Public Health [Internet]. 2018; 76(32):[about 17 p.]. Available from: https://archpublichealth.biomedcentral.com/track/pdf/10.1186/s13690-018-0278-0.
Acharya B, Ekstrand M, Rimal P, et al. Collaborative Care for Mental Health in Low- and Middle-Income Countries: A WHO Health Systems Framework Assessment of Three Programs. Psychiatric services (Washington, DC). 2017;68(9):870-872. doi:10.1176/appi.ps.201700232.
