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Panel on Psycho-social and Mental Health

Panel on Psycho-social and Mental Health


    
Carla R. Marchira

1.  




Training on Mental Health ForPrimaryHealth Care Workers to Provide Psychoeducation to Family Care Providers of Persons with A Psychotic Disorder. Lesson Learnt from Jogja’s Earthquake
Carla R. Marchira
Department of Psychiatry, Faculty of Medicine, Gadjah Mada University
Abstract
Indonesia is a country that often experiences natural disasters. The tsunami in Aceh in 2004 and the earthquake in Jogyakarta in 2006 are critical examples. WHO has estimated that disasters increase the occurrence of mental disorders by 20%. However, in Indonesia, mental health facilities and resources are extremely limited, and the burden of care for persons suffering from severe mental disorder thus falls primarily on families. Indonesia has a national policy of integrating the management of mental health problems into the primary health care system.  However, in practice, such care is often not implemented effectively.
AfterJogja’s earthquake, several mental health programs were  implemented in primary care. Nevertheless, preliminary studies in primary health care centers in two subdisticts of the districtsBantul and GunungKidul, in Jogjakarta province, showed that there is very little or no training for health care providers on the diagnosis and treatment of severe mental disorder such as psychotic illnesses.
For that reason, a team from Jogyakarta is developing a program to provide training to prepare primary health care workers in three primary health care centers in Jogyakarta, Indonesia, to provide psychoeducation to family caregivers for persons with psychotic illnesses. We will evaluate the quality of the training program and provide empirical evidence of the effectiveness of the training program, which will support advocating with policy makers to support bringing such a training program to scale.
This paper will provide data about the mental health consequences of disaster and the need for long-term interventions that can be brought to scale to promote mental health services which can promote recovery for those with severe mental illnesses in the communities affected.

Tri Hayuning Tyas


2.  




Focus on social recovery in the aftermath of disaster: Responding the need for the provision of continuous care for people with mental health problems
Tri Hayuning Tyas
Faculty of Psychology, Gadjah Mada Unviversity
Abstract
A number of disaster occurred in Indonesia in the recent years, e.g Aceh tsunami in 2004, Jogjakarta earthquake in 2007, and eruption of Merapi in 2010. The have given chances for the humantarian responders to make improvement in sectoral service provision during and after emergency such as shelter, food, clean water and sanitation, rehabilitation of houses, economic recovery and health services. The interactions during response time often help reveal the presence of persons with severe mental health problems amongst the affected communities. In Aceh Tsunami and Jogjakarta  Merapi eruption cases, the persons found are ‘kept under control’ by being tied or confined, or known as pasung.
From the observation of humanitarian response in different affected communities, it is concerning that there is still very limited efforts thought out and provided tangibly to the persons with severe mental health problem. Reasons of the lacking response for the mental health are many include limited capability of relief workers or volunteers on the ground to identify the persons’ presence and to bring the findings into an integrated planned and sustainable response.  When the needs of the mentally health persons are not addressed accordingly by capable responders, the problems faced by the relatives in difficult time of disaster increase.
This paper will share some findings from a research related to this issue, carried out in Aceh in 2007, and the activities has been conducted by the local communities as an effort to continue the improvement of mental health service. Recent preliminary study on similar issue shows a significant number of people with mental health problems amongst the people affected by volcano eruption in Central Java. Interestingly both places show that pasung are still being practiced, and more-humane ways of taking care of the people still needs to be sought for. The improvement of mental health service is deeply influenced by willingness of local government to facilitate the process.  A continuity of care in broader terms will also be discussed.

Subandi


3.  




Developing Psychological Services in Primary Health Care in Aceh Post tsunami to Promote Social Recovery
Subandi
Faculty of Psychology, Gadjah Mada University
Abstract
Following tsunami in Aceh, there have been a large number of Government institutions and NGO’s from around the world set up many kinds of disaster response programs. One of them was UniversitasGadjahMada program. Funded by World Vision Australia, this program aimed at strengthening health care system in Meulaboh district and Banda Aceh. In the area of mental health UGM program implemented by providing clinical and psychological services in primary health care.Including in the psychological services were counseling, psychotherapy, home visit and psycho-education to improve mental health condition and awareness of Acehnese people.
While providing psychological services program was intended as a short term response to disaster, the long-term UGM program was setting up a psychological study program under the Faculty of Medicine, Syiah Kuala University. This study program recruited 36 students in 2007 and their first graduates were inaugurated in 2011. During that time a continuous and closed supervision in academic issues was conducted by staffs from Faculty of Psychology, GadjahMada University. Meanwhile some of academic staffs of the psychology study program continued providing psychological services in four primary health care centres in Banda Aceh. The development of research capacity among academic staffs began in 2011 by involving them in a project entitled: Inter-University Partnership for Strengthening Health care system in Indonesia: Building New Capacityfor Mental Health care.
This paper discusses many factors need to be considered in order to have a short term disaster response to have a long term effect to help Acehnese go through social recovery in the area of mental health.

Byron J Good, Mary-Jo DelVecchio Good


4.  




The Importance of Mental Health Services in the Development of Sustainable Programs of Social Recovery
Byron J Good, Mary-Jo DelVecchio Good
Harvard Medical School
Abstract
Humanitarian organizations responding to disaster and conflict settings often recognize the importance of “trauma” in inhibiting recovery of populations, and have undertaken psychosocial and mental health programs aimed at improving both mental health and social functioning of individuals and communities.  These programs are often focused on acute needs.  As the acute situation subsides, programs develop “exit strategies” aimed turning over programs to local government agencies and NGO’s which can “sustain” these activities.  In Indonesia, “sustainability” has often been more of a slogan than reality.  The extraordinary limitations of mental health resources available have meant that even with the best of intentions, humanitarian organizations have largely failed to make mental health programs sustainable in ways that will support longer term recovery of individuals and communities and provide services for those most in need.  This paper will discuss a strategy involving interuniversity partnerships, supported by USAID, and collaborations between university staff and provincial and district level health offices to support the development of capacity for longer term, sustainable programs that will support social recovery in communities.


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