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Suicides highlight poor mental health care in Indonesia 

Rate of people killing themselves is sure to go up if nothing is done to improve help for the mentally ill across the country

Suicides highlight poor mental health care in Indonesia 

A man with a mental health condition shackled in a hut in Majene in West Sulawesi by his family. (Photo: AFP)

Suicide is quite low among the primary causes of death in Indonesia such as cancer and heart disease, but it illustrates a hefty problem with the country’s mental health system.

New cases continue to make headlines, including that of Bernardus Nabu, a farmer in Christian-majority East Nusa Tenggara province who hanged himself on Oct. 25 due to financial problems. His death was one of many such cases coming from the province.

A 38-year-old mother in Central Java also hanged herself because she could not repay loans. Her suicide note said she was being terrorized by debt collectors hired by her creditors. 

Her death became a high-profile case as it prompted thousands of people who had fallen victim to exorbitant interest rates levied by illegal lenders, especially during the pandemic, to speak out.

The government responded by cracking down on the lenders, forcing many out of business. 

The World Health Organization says suicide remains a major cause of death around the world, with around 800,000 cases annually.

Such figures highlight the urgency of reform in mental health care and the need for more people to work in the field

Although the suicide rate has been relatively stable in the past 20 years at about 2.4 deaths per 100,000, the organization had warned of a possible increase during the pandemic. 

Indonesia’s statistics agency recorded 5,787 actual and attempted suicides in 2020, sharply up from the roughly 1,800 cases in previous years. 

However, psychologist Indria Laksmi Gamayanti, who heads the Association of Indonesian Clinical Psychologists, recently said the pandemic has exacerbated a much bigger underlying problem — mental health, which often leads to suicide.

The association alone has handled more than 14,600 individuals who have experienced various mental health problems during the pandemic. 

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Meanwhile, the Indonesian Psychiatric Association said 57 percent of people who come to them for consultation had depression symptoms, mostly due to difficulties with things like studies or finances. More than half of them had admitted to having suicidal thoughts, it said.

Such figures highlight the urgency of reform in mental health care and the need for more people to work in the field.

Mental health reform, however, will be a tough task considering at least 30 million Indonesians aged over 15 experience mental health problems, while nearly half of them suffer from depression.

If they are not provided sufficient psychological assistance, the suicide rate could rise sharply.

Everyone knows that this should be anticipated before it happens. But the underlying concern here is that there has been a lack of health facilities, qualified psychiatrists and unequal distribution of funding. 

Despite the large number of people suffering from mental health problems, psychiatric hospitals remain a scarcity. Indonesia only has 48 mental hospitals and 269 psychiatric wards in general hospitals throughout the country and most of the mental hospitals are located in only four out of its 34 provinces, meaning demand far outweighs available facilities.

It also means many people with mental problems cannot get proper treatment. This shows that treating mentally ill people has not been a priority for decision-makers.

Indonesia has only 1,053 psychiatrists and 11,500 psychologists, which is a considerably lower ratio than in other Asian nations. 

If the Indonesian government is serious about curbing suicides, attention must be given to improving the mental health care sector. Since financial constraints are an issue regarding building new hospitals, focus should be given on increasing the number of mental health professionals and assigning them to the country’s 2,344 hospitals and 10,134 Puskesmas or state-run health centers.

The pandemic's impacts will last a long time and among them will be psychological ones affecting people who have lost their family members

Ideally, public health centers should have a full-time doctor, nurses and a mental health professional, considering such centers are present in almost every community throughout the country. 

If these units are managed professionally, they can save the lives of many people with mental issues such as depression, bipolar disorder, schizophrenia and others that lead to suicide. 

In some regions such as East Nusa Tenggara, shackling people is a problem illustrating a general lack of awareness about mental health issues. They are shackled by family members who fear they may harm others and because they and the community do not know how to deal with people with mental disorders.

More mental health professionals in community health centers would go a long way to stopping this practice.

More professionals will be extremely important in the post-pandemic era.

The pandemic's impacts will last a long time and among them will be psychological ones affecting people who have lost their family members, especially children who have lost their parents.

Kevin Caruso, the founder of a group called Suicide Prevention, Awareness and Support, says the main cause of suicide is untreated depression resulting from an inability to deal with failure, feeling helpless, unemployment and money problems, among other things.

These problems are clear and should be easy for decision-makers and society as a whole to see, he said.

The mental health situation in Indonesia points to wholesale neglect. Greater investment and education about such problems are urgently needed so that help can come from various levels from the state to the family to help cure people who would otherwise suffer and needlessly take their own lives. 

The views expressed in this article are those of the author and do not necessarily reflect the official editorial position of UCA News.

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