Sunday, February 28, 2010

Volume 16, April 2010
St. Louis, Missouri, USA

Editor: Mohamed Ziauddin

In the Name of Allah, the Most Beneficent and the Most Merciful


Mental patients take their lunch in front of their shelter at the Galuh foundation compound in East Bekasi, outskirt of Jakarta November 5, 2009. The Galuh foundation house has housed more than 288 underprivileged mental patients since it was founded in 1982 by Gendu Mulatip. The foundation give patients a shelter to stay, treat them with prayers and traditional medicine, and feed them vegetarian food. Most of them became mentally ill due to the poor economy, head nurse Suharyono said on Thursday. REUTERS/Beawiharta (INDONESIA HEALTH SOCIETY)


ISLAM is a universal religion that stands for peace, love, care and concern for one another. There is still a lot of room for improvement in terms of caring for one another.

Head nurse Suharyono (L) brings in a man suffering from mental illness shortly after finding him at a street in East Bekasi, outskirt of Jakarta November 5, 2009. REUTERS/Beawiharta (INDONESIA SOCIETY HEALTH)

The chronic and severely mentally ill are a very vulnerable group of people who are unable to function normally like others in the general population to lead a productive and satisfactory quality of life. We believe that the Government, Public and Private Organizations and Muslims in general should strive to do more than what they are currently doing to assist the mentally ill. For those who are unable to help the mentally ill, the least they can do is at least to avoid the unfortunate stigmatization of the mentally ill.

A mental patient named Totok reacts during a relax therapy session at the Galuh foundation compound in East Bekasi, outskirt of Jakarta November 5, 2009. REUTERS/Beawiharta (INDONESIA HEALTH SOCIETY)

We realize the economical, technological limitations and other realities "on the ground" of Muslim Governments that may impair their ability to help the mentally ill. One way to reduce such impairment is to give higher priority to such a vulnerable group and increased co-operation and co-ordination with other entities that are specialized in helping the mentally ill.

Mental patients stand in front of their shelter at the Galuh foundation compound in East Bekasi, outskirt of Jakarta November 5, 2009. REUTERS/Beawiharta (INDONESIA SOCIETY HEALTH)

In Indonesia, there is a need for additional structural changes in the mental health system. Once above is implemented, then the focus could be to expand the number of various treatment interventions provided by a multi-disciplinary team. Part of such intervention would include psychotherapy.

Below is a condensed version of an article that briefly enlightens about Mental Health Care for the severely mentally ill in Indonesia.

Dr. Irmansyah:
Improving Mental Health Care in Indonesia

Director of Mental Health, Indonesia
Global Health Matters Newsletter
(Condensed version)

A proponent of human rights for the mentally ill, former Fogarty trainee Dr. Irmansyah was recently appointed Indonesia’s director of mental health. Irmansyah is not afraid to say that - as in many developing countries :

"Psychiatry is a neglected branch of medicine in Indonesia".

He shared his views publicly in a recent article he authored for The International Journal of Mental Health Systems.

Photo courtesy of Dr. Irmansyah

Former Fogarty trainee Dr. Irmansyah (on left) confers with the director of the Jakarta state mental hospital and her staff. Dr. Irmansyah studied genetics, disaster relief and advanced mental health services and systems during a year-long fellowship at Harvard University.

His particular interest in community mental health services developed during a research project early in his career. “I went to a rural area looking for patients with schizophrenia. Some had been restrained for years. That was not every schizophrenic’s fate, but it wasn’t unusual,” says Irmansyah. “I also interviewed people who had struggled to take care of a family member with schizophrenia. hat encouraged me were families that wanted to let the patient get services, and learn how to take care of them better.”

In his new role as mental health director in the fourth most populated nation in the world, where mental illness is highly stigmatized, Irmansyah faces daunting challenges. Indonesia has less than 500 psychiatrists to serve 230 million people, and there are minimal community services.

The health ministry plans to create a new department, the Center for Mental Health. This office will have increased authority, elevating the status of mental health in Indonesia, as well as Irmansyah’s position and ability to affect policy.

Photo by Saichu Anwar, courtesy of Photoshare

As Indonesia’s new director of mental health, Dr. Irmansyah advocates for the mentally ill in
a country with minimal community services and less than 500 psychiatrists for a population of 230 million.

Irmansyah led a team that studied the genetics of siblings with schizophrenia. The researchers developed family-based interventions and supported a nascent Indonesian Mental Health Association for people with mental illness and their families.
When Irmansyah returned to the University of Indonesia in Jakarta after his fellowship, he was elected chair of the psychiatry department. That position, as well as his work in disaster relief in Aceh after the 2004 tsunami, brought him to the attention of the Ministry of Health.

His Harvard mentor, Dr. Byron Good, says Irmansyah has a deep commitment to building a community-based mental health system able to provide evidence-based psychiatric care. “His appreciation for both basic science and implementation research, his strategic vision and his desire to give a voice to Indonesians suffering from mental illness and their families, makes him a wonderful selection to serve as director of mental health. The Fogarty International Center can be proud of the role it played in his evolution as a leader in Indonesian psychiatry.”

Human rights of persons with mental illness in Indonesia: more than legislation is needed. Irmansyah I, Prasetyo YA, Minas H. International Journal of Mental Health Systems 19 June 2009, 3:14.


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