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The Indonesian Mental Health Act: psychiatrists' views on the act and its implementation.

Authors
  • Bikker, Annemieke P1
  • Lesmana, Cokorda Bagus Jaya2
  • Tiliopoulos, Niko3
  • 1 The Usher Institute, Population Health Sciences, The University of Edinburgh, Old Medical School, Teviot Place, Edinburgh, EH8 9AG, UK.
  • 2 Department of Psychiatry, Faculty of Medicine, Udayana University, Jalan Diponegoro, 80114, Denpasar, Bali, Indonesia. , (Indonesia)
  • 3 School of Psychology, The University of Sydney, Rm 448, Brennan MacCallum (A18), NSW 2006, Sydney, Australia. , (Australia)
Type
Published Article
Journal
Health Policy and Planning
Publisher
Oxford University Press
Publication Date
Nov 23, 2020
Identifiers
DOI: 10.1093/heapol/czaa139
PMID: 33227140
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

In 2014, the Indonesian government passed the Mental Health Act (MHA) to address the country's complex mental health situation. The implementation of the MHA has been slow, and little is known about how the MHA is perceived by mental healthcare providers within local settings. This study aimed to obtain insight into psychiatrists' views on the MHA, including on how it affected their clinical practice and on challenges of translating the MHA into practice. The study was conducted in Bali, and 27 psychiatrists (15 men and 12 women) participated in a semi-structured interview. Thematic analysis indicated four overarching themes: raising the profile of mental health, developing a shared understanding of mental illness, integrating psychiatric practice with other services and views on implementation of the MHA into practice. Overall, the psychiatrists viewed the MHA as a step in the right direction to improve mental health services and to create awareness at local and national levels. However, there was consensus that the meaning of the MHA's concepts of mental problems and disorders were not compatible with psychiatric everyday practice or their patients' understandings. As a result, many assumed that the MHA was targeted at government and policy officials. Furthermore, there was a perceived lack of clarity on issues relating to collaborating with other services and unequal access to resources among regencies that impacted on their clinical practice in a negative way. Moreover, a few psychiatrists raised concerns that local beliefs and practices were not acknowledged in the MHA. According to the participants, mental health remained a highly political issue and without national support, mental health would remain a low priority. In conclusion, insights into providers' perspectives contribute to developing an evidence-base that can inform the implementation process of the MHA in Indonesia, and possibly elsewhere, into local level guidelines and regulations. © The Author(s) 2020. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: [email protected]

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