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Abstract

Deinstitusionalisasi adalah kebijakan di bidang kesehatan jiwa yang dimulai di negara-negara maju sekitar tahun 1950. Kebijakan tersebut telah dilakukan di Indonesia, meskipun informasi tentang keberhasilan dan kegagalan masih terbatas pada pendapat profesional di kalangan psikiatri. Disaat program ini belum sepenuhnya berhasil, Indonesia mengalami perubahan politik yang mengantarkan pada kebijakan desentralisasi. Pada saat yang bersamaan, muncul masalah kekurangan tenaga dokter spesialis psikiater. Tujuan analisis ini adalah untuk melakukan kajian terhadap berbagai masalah yang berkaitan dengan psikiater dan deinstitusionalisasi pada era desentralisasi. Dalam artikel ini disajikan beberapa kondisi yang terjadi di negara lain serta kajian terhadap kebijakan yang ada di Indonesia. Berdasarkan informasi yang dikumpulkan dapat disimpulkan bahwa di Indonesia terjadi kekurangan tenaga psikiater, masalah deinstitusionalisasi terkait erat dengan pembiayaan bidang kesehatan. Perlu kajian lebih mendalam tentang dampak dan model yang sesuai untuk Indonesia melalui penelitian terapan, riset operasional khususnya di bidang kesehatan jiwa masyarakat. Desentralisasi akan berhasil meningkatkan pembangunan kesehatan jiwa apabila ada perkuatan dukungan lintas sektor khususnya legislatif.

Deinstitutionalization is an international mental health policy started in 1950 by developed countries. This policy has implemented in Indonesia, even though there were no evaluation related to the policy. The opinion is still limited by professional judgment. While the program has not finished, Indonesia had political reformation. Decentralization was a part of reformation program. Besides, there was lack of psychiatrist in Indonesia. The aim of this study is to assess problems related to psychiatrist, deinstitutionalization and decentralization. Several policies and conditions in other country were informed. The conclusion of this study mentioned that there was lack of psychiatrist in Indonesia at present; the deinstitutionalization was influenced by national health financial. It needs further studies of effectiveness of community mental health programs through applied or operational research. Decentralization will succeed to improve mental health development if there is support from all sectors including the legislative.

References

  1. Novella EJ. Theoretical accounts on deinstitutionalization and the reform of mental health services: a critical review. Med Health Care & Philos. 2008; 11: 304-14.
  2. Stiles PG, Culhane DP, Hudley TR. Before and after deinstitusionalization: comparing state hospitalization utilization, staffing, and costs in 1949 and 1988. Administration and Policy in Mental Health. 1996; 23 (6): 513
  3. Stiles PG, Culhane DP, Hudley TR. Old and New: a comparison of state psychiatric hospitals. Psychiatric Services. 1996; 47 (8): 862-68.
  4. Murphy MJ, Dorwart R. Mental health in Calkins D, Fernandopulle RJ, Marino BS. Health care policy. Massachusetts: Blackwell Science; 1995.
  5. Departemen Kesehatan Republik Indonesia. Profil kesehatan 2007. Jakarta: Depkes RI; 2007.
  6. Nasution AH. Analisis kebijakan. Majalah Kesehatan Masyarakat Indonesia. 2000; XXVIII (9): 498-503.
  7. Direktorat Kesehatan Jiwa Masyarakat Ditjen Binkesmas Depkes RI. Kebijakan Nasional Pembangunan Kesehatan Jiwa 2001-2005. Jakarta: Depkes RI; 2001.
  8. Departemen Kesehatan Republik Indonesia. Kebijakan nasional kesehatan jiwa. Jakarta: Depkes RI; 2008.
  9. Eka V. Situasi RSJ di Indonesia [edisi Desember 2008]. Psikiatri Indonesia
  10. Rossi IM. Psikiater di Indonesia masih minim. Tempo Interaktif. 29 Juni, 2006.
  11. Goodwin R, Lyons JS. An emergency housing program as an alternative to inpatients treatment for person with severe mental illness. Psychiatric Services. 2001; 52: 92-5.
  12. Anderson RL, Lewis DA. Clinical characteristics and service use of person with mental illness living in an intermediate care facility. Psychiatric Services. 1999; 50: 1341-45.
  13. Anderson RL,Lyons JS, West C. The prediction of mental health service use in residential care. 2001; 37 (4): 313-23.
  14. Mechanic D, Mc Alpine DD. Use of nursing homes in the care of persons with severe mental illness: 1985 to 1995. Psychiatric Services. 2000; 51: 354-8.
  15. Thornicroft G, Bebbington P, Leff J. Outcome for longterm patients one year after discharge from a psychiatric hospital. Psychiatric Services. 2005; 56: 1416-22.
  16. Azrul Azwar. JPKM dan pemberdayaan dokter Indonesia. Majalah Kesehatan Masyrarakat Indonesia. 2000; XXVIII (4): 191-259.
  17. World Health Organization. Mental health policy, plans, programmes 2005.
  18. Barker C. The health care policy process. London; SAGE Publications Ltd; 1996.
  19. Lynch F. The effects of state intergovernmental transfers on local public mental health services. Administration and Policy in Mental Health. 1997; 24 (4): 279-99.
  20. Rosenheck R. The delivery of mental health services in the 21 st century : bringing the community back in. Community Mental Health Journal. 2000; 36 (1): 107-24.

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