Friday, 29 October 2010

Indonesian Mental Health Care Unshackled

A great account from New Matilda of Indonesian Health Workers working to improve the lives of mentally ill people, on one hand freeing people from shackles and on the other working to prevent more people being shackled.

"The new model reserves hospitalisation for cases of demonstrated need. Nurses trained to deal with serious disorders are made responsible for as many as twenty families in a given area. According to Dr Viora, the goal is to "empower the primary health care worker" to treat people in their own communities. Judged a success in Aceh province, the model is now being rolled in other parts of Indonesia.

Professor Achir Yani, Head of the Provincial Health Office in Aceh, is managing a provincial government programme that aims to eradicate forced restraint and confinement by the start of 2011. Yani told New Matilda that as well as being less costly, community care reduces relapse problems.

Deinstitutionalisation has been a global trend in mental healthcare. Australian health services have been going through the process for more than thirty years. Decades ago, Indonesia was the acknowledged leader in healthcare among the nations of South East Asia. Over the past decade this vast nation has been working hard to catch up. As a question of human rights as well as of quality and accessibility of care, the campaign to end confinement is a fitting yardstick of progress.

Hundreds of people have been released. The issue has been placed on the national agenda, with the Indonesian government’s recent commitment to ending forced restraint nationwide by 2014. Dr Pandu Setiawan is a leading architect of mental health reform and heads the Indonesian Mental Health Network. He describes this commitment as the culmination of a decades-long campaign to improve mental health policy. And Dr Setiawan is confident that the committed group of young mental health professionals at the heart of the anti-pasung push will be successful.

Earlier this month, a sign proclaiming "Toward an Indonesia free of pasung" was posted at the entrance of the Ministry of Health (see image above). The words are superimposed over a shattered chain. If the efforts of the professionals and activists leading the charge are matched by sustained political will, Indonesia will meet its commitment to those still in shackles."

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