Maria Wigati-Indonesia

  • September 26, 2020 at 3:11 am #2875
    Daniel Ochieng

    2. Please write a short paragraph of fewer than 300 words on your definition of mental health from a youth’s perspective. How has it made you feel about the concept of mental health? Have you experienced mental health challenges in your past or do you know of someone who has or is ongoing mental health management challenges? Tell us their story (you may be anonymous or use fictional characters, we respect our privacy and of those around you). How was this managed, if at all?
    I know the concept of mental health from my study. Since I learned about health science, there was a time when I had a lecture about mental health and I agree with the statements. Mental health is the ability to cope with all challenges our life brings. Life is not always good. Sometimes we feel desperate, sad, worry, and other bad things as something in our life cannot go smoothly. The ability to face all those negative feelings are different from each person. Maybe, “A” and “B” face the same thing of failing to get their dream job. However, “A” can perceive his/her situation as a part of life but “B” cannot accept the results and feel desperate. It is funny that sometimes you feel most depressed because of someone you caring the most. Does that mean we cannot believe in others? I do not think like that. I know the story of my friend who experienced a mental health problem in the past. It happened in 2017 when someone whom she thought was her friend betrayed her, she failed to apply for several jobs, and her role model in the family failed her expectancy. She said the sadness is just around her that year. All things she did were the worst and it continued in the next year. She was stopping to care about her life when sudden light came to her. Neither a family nor best friend, but someone she knew in the past. What saves her is just a simple question “so what if you have nobody? Will you stop doing anything you love? You can tell me about your feeling. We are friend after all!”

    3. In your opinion, is mental health management necessary in society? What are the signs and symptoms that someone is experiencing mental health challenges? Do you believe that these signs and symptoms are more common in their communities or are they seen as the typical signs and symptoms of mental health worldwide? Why?
    In my opinion, mental health management is necessary for society. As far as I know, the sign and symptoms of mental disorders are 1) feeling down/depressed/sad that persists for 14 days or more, 2) sleeping disorders (sleep too much or too little), 3) changing in eating behavior, 4) low interest in daily activities or hobbies, 5) easily irritated and thinking too much 6) intention to hurt their physical body, and others. I think these signs and symptoms are typical of mental health worldwide. Actually, I do not get involved in groups or communities of mental disorders so I cannot give an exact opinion about this. However, from several stories I have heard, these symptoms also common in their communities.

    4. The common statement is that mental health management especially among youth is a developed world problem and not an issue that affects developing countries. Is this true or false? Please provide an explanation and possible examples.
    Mental health issues are a problem for either developed or developing countries. Mental health disorders can happen regardless of origin, sex, ethnic, religion and others. Just like in previous assignment, about the study of Dr Primack, the increase of social media usage is associated with a higher occurrence of mental health disorders, including depression and anxiety among youth. One of the biggest social media users are from developing countries. If I can give an example of my own countries, data from Indonesian basic health research 2018 showed the prevalence of people with depression and anxiety were 6%. If we assume the Indonesian population were 250 million, this percentage equals to 1.5 million youth and adults. Youth in developing countries may be seen as more resilience since they have to face “more problems” if they want to live a better life. On the other hand, “more problems” do not guarantee if the problem is harder or if they have better supports than others. As mentioned by Hildebrand (2019), violence is one determinant of mental disorders while social support is the one to develop resilience. There is a huge gap in developing countries, between the side who have good literacy of mental health and the other who do not. For example, during this Covid-19 pandemic, I saw much more articles about people (mostly students) who commit suicide. The reasons are varied. One because the parents did not buy him/her something he/she wants and the other because he/she felt the parents did not love him/her anymore. In an extreme case, a father threatened to burn (with a real fire and petrol) his son if he keeps on playing outside but accidentally threw the fire to his only son. It is so saddening to see many bad things happen when it should not. I believe that more cases are preventable – if mental health literacy has taken into account in this Republic.
    Link for Hildebrand (2019):

    5. What do you think are the main reasons for Mental Health issues among youth in developing and least developed countries? Do you think the issues are less or more severe than in developing countries?
    Almost all parts of life can be the reason for mental health issues in developing and less developed countries. It can be economic factors, parents are depressed for not being able to fulfil the family needs. It can be social factors, someone has traumatic events they cannot cope with. How to raise a child can also be a determinant shaping a child’s mental condition. In most developing countries, mental health literacy is low while stigma for people with mental disorders is high. Those make fewer people not aware of how and when they should seek help for their mental health. The severity of the problems is relative. I do not think that it can be measured since developed and developing countries have different problems. Even if the problem is relatively the same, the response can be different. This is what makes strengthening resilience is more important than avoiding life’s challenges.
    6. Please refer to assignment 2: Social Media and Personal Banding. We posted a study by Dr. Primack and colleagues in 2014-2016 at the University of Pittsburgh, the study found that there is a significant, linear relationship between social media use and depression, measured either as total time or frequency of visits. Do you think social media has an impact on Youth Mental Health? How are your community leaders dealing with it?
    I agree with that statement since I witnessed some of my friends have mental health issues due to excessive social media usage. A review by Hermansyah (2020) also stated that youth with a higher social media habit tended to have negative behaviors such as sleep disturbance, depression, anxiety, body image, cyberbullying, and the extreme one was suicide. Sadly, all I can say is that my community leaders do not take into account mental health issues seriously. The concept of health is still understood as being free from physical diseases and disabilities. Investments in mental health management are still underestimated because the direct impact on productivity was low. However, although it is not the best action we have, I think there is an improvement to increase mental health literacy in Indonesia. As the example, the establishment of a suicide prevention call center and non-governmental organization focusing on mental health campaign. I believe that it will be better in the future and we are just on our way there.

    Link for Hermansyah (2020):

    7. Is there decent access to mental care for youth in your country? Do you think youth seek the help of mental care officers first when they have mental health issues? Are the officers being active in helping the youth?
    I think decent mental care is more accessible in big cities but not in the village or hinterland. In my hometown, to have a mental disorder is seen as taboo. They will perceive not thankful enough or lack of faith. In extreme cases when the symptoms affect their behavior, we prefer to bring the patients to a healer or religion leader. Even though, the existence of mental care in an area is proportional to the health-seeking behavior among youth. On the other hand, as I also live in Yogyakarta (it is a city) for my study, we have better mental care access. I heard from my supervisor that the number of students who perceived themselves of having mental illnesses are increasing. My fellow students often came to seek help from this care, either it is psychiatry treatment or counselling. Since 2018, my university held campaigns about the health-promoting university to promote a healthy lifestyle both physically and mentally. In this earlier September 2020, our Faculty of Psychology launched a call center to prevent suicide. I just hope that similar mental care access can be adopted in other regions and more suicide cases can be prevented.

    8. Please write a paragraph of 400 words or less on whether your government is taking into account mental health management. Give suggestions on what changes you as a youth would advocate for. List a few steps you are willing to undertake as a youth to fight for change in terms of mental health.
    Indonesian government do have a regulation to prevent mental health issues. As an example is Decree of the Minister of Health of the Republic of Indonesia No 220 / MENKES / SK / III / 2002 concerning General Guidelines for the Guidance Team, the Steering Team, the Implementation Team of the Community Mental Health. The decree is about the establishment of mental health prevention teams in all sectors of health facilities (including community primary health care), not just hospital. However, the enforcement of the law is weak, not a priority of our health policy, and give more focus on the extreme cases such as shackling of people with mental disorders (which is very common in some regions). Our government already have a program called “mental immunization”, how we should nurture our mental resilience to be ready to face the challenges of this world. The program seems fine, however, it just stops in the central policymaker. Indonesia is really a big country which has one of the highest numbers of the population and the largest archipelago state in the world. It can be one of the challenges to bring effective programs, including the prevention of mental disorders. Effective programs need multi-sector collaboration. As a youth who is interested in education, recently I get involved in the preparation of a lecture named “Feeding program for the risk group”. One of the agendas is to conduct a mini-webinar about the role of nutrition in mental health management. This webinar is freely available from the public in October. I hope I can start a small step to contribute to mental health literacy in Indonesia.

    9. Highlight a role model in your life who was battling with mental health and is a survivor. Explain in depth what makes this individual unique to you as a youth. Tell us their story on how they overcame mental health and the lessons you derived from their history.
    My role model is IU or Lee Ji Eun, a solo singer, songwriter, and actress from South Korea. Many celebrities experience mental illnesses because of the burden to maintain their “star” status. However, idols from Asian countries are less spoke up about their mental condition compared to Western actresses/actors. I like the story of IU about her struggle and how she chose to be healthy. Before she debuted, her relatives always belittling her dreams of becoming a singer. However, she always believes in her dream and keeps practicing. After she debuted in 2007 when she was only 15 years old, her career did not go smoothly as of today. She experienced cyberbullying which makes her believed that she was not good enough as a singer. In 2014, she openly spoke how she was struggling with bulimia (a type of eating disorders) due to the burden of becoming successful. Despite her anxiety, sadness, and emptiness during that time, she was lucky enough to have a good support system and chose to be healthy. She may be famous today, however, her good and down-to-earth personality never change. Since 2012, she has been the ambassador for the anti-bullying campaign in school. She also actively donated a certain amount of fund to help youth who have difficulties to continue the study.
    Her story inspired me for not giving up my dreams. Even if I am alone, the one that can help me is myself. As a human, it is okay to feel different emotion, cry when we are sad, laugh when we are happy, low mood when we are not in our best, etc. That is just how life goes on. I want to wrap this story into in the lyrics of the Disney Cinderella song:
    Have faith in your dreams and someday
    Your rainbow will come smiling through
    No matter how your heart is grieving
    If you keep on believing
    The dream that you wish will come true

    In our society, more people are having trouble to manage their mental health. It was a good opportunity to discuss mental health with some of my colleagues. Recently, I help my supervisor to prepare a lecture about the feeding program for the risk group. People with mental health issues are considered as one of that group. It is interesting that food and our eating behavior actually has effects on our mood. In the future, I hope I can have the chance to study more about that.
    Our views about mental health
    From our discussion, we agreed that some mental disorders related to emotion and behavior, including depression, anxiety, and eating disorders. When I carried out an anonymous survey for them (because I respect their privacy), two of them confessed to be sad that persisted for the last 7 days. I am just surprised with the results since I expect them all to say no. Of course, it does not mean that they have mental disorders. But it can be if their situation does not get better. What I can learn from this discussion is that we mostly do not know the real feeling of our closest friend. Indonesian (or maybe typical Asian behavior) tends to hide the emotion.
    Our views about mental health are similar to what I explained before. It is a mental state that the sign and symptoms are not always obvious. Unfortunately, most of my colleagues do not know someone who currently has mental issues but we believe that it is a condition which can be prevented and recovered with proper management.
    Health seeking behavior regarding mental health
    About mental care access, we agreed that not youth have the same situation. It is multi-factors and cannot be generated for the Indonesian population. First, the mental health literacy of the youth might be low. They do not know if they have a mental problem and if they need help. Second, not all areas in Indonesia have proper health facilities. There are even residents in rural villages who have to travel very long distances to get to the hospital, which has limited facilities. If the facilities for their physical health is limited, how can they expect for mental health care? Last but not least, the professionalism of the psychologist and psychiatrist also affect the trust the patients gave to them.
    We think that youth should find their way to build resilience and when the symptoms are getting worse, they should know-how and who to help. Many services can be used. For example, is joining mental health communities. In Jakarta and other big cities of Indonesia, there is a community called “Into the Light”. People with or without mental issues can freely join the club and sharing stories. It can be a good way for youth with mental disorders to have their community, where they are not judged for who they are. The other options were virtual counselling or face-to-face, call center, live chatting, and other warming communication to ease the burden.
    Suggestion to Kectil
    We want to suggest Kectil increase mental health literacy among youth. It is defined as to increase the understanding of mental health disorders, the signs and symptoms, the preventions, treatments, and decreasing the stigma of people with mental health issues. We think the better mental health literacy, the better resilience we have. In October, I have a mini-webinar discussing the role of nutrition on mental health management. Although it is just a small agenda, I hope many people attract to join this webinar and sharing. For myself, after knowing about this mental health and reflect. I will be more sensitive to friends. Words can sometimes hurt feelings more deeply than we think. Values that we believe to be true may differ from others. But that doesn’t mean it’s wrong. Therefore, as a Kectil colleague, I will try to communicate better, whether through words, actions, or paintings. Communication can bring warmth and love.
    Mental health action plan 2013-2020
    We think this plan is feasible and fundamental to mental health management. In Indonesia, our government have fulfilled most points of this plan – at a minimum level. What I mean is that we have established universal health coverage, human right commission, and research on mental health treatment. There is also a multisectoral approach to the implementation of health programs. Laws regarding the empowerment of persons with mental disorders also exist. Although the basic needs are there, disparities and inequalities are big. There are still many improvements that need to be made in these sectors. The most important thing is to maintain the implementation of mental health programs. Many program implementers just do it because it is a routine not to solve problems. This is what, in my opinion, is the biggest obstacle in implementing an effective and efficient program.

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