All Blog Let’s Talk (and Do Something!) about Mental Health
As World Mental Health Day rolls around again on 10 October, it is worth considering what actions have been and could be taken. Mental health in Indonesia remains a taboo topic due to social stigma, even though access for all citizens to health services is enshrined in Indonesia’s Constitution. This has resulted in a lack of information and support for people with mental illness. The consequences are real. According to WHO, an average of 82 people in Indonesia commit suicide each day, with the highest occurrence in the age range of 15 to 24 years. With little available data, it is difficult to verify suicide rates or estimate the relationship between mental health and suicide.
The government of Indonesia launched a suicidal prevention hotline on 24 October 2010, but there was little public promotion. The hotline was marked by declining callers and a lack of availability of trained psychologists and psychiatrists. As a result, it closed in 2014 during which only 39 registered callers used the service from January until September (down from 267 callers the previous year, according to a Ministry of Health official). Since then, the Indonesian government has provided no official hotline for suicide prevention and no clear and comprehensive public strategy to address this issue. The international suicide hotline, www.befrienders.org, has no current listings for Indonesia.
Elsewhere in Asia, governments have made efforts to address and de-stigmatize citizens’ mental health. Korea and India are in the top 20 of countries with the highest suicide rates. Their governments have tried to address mental health concerns by launching campaigns and providing a suicide hotline. For example, as the result of one Korean government advertising campaign, the number of crisis calls were approximately 1.6 times greater than the number outside of the campaign period. In India, a government-sponsored campaign to change the stigma related to help-seeking across 42 villages in rural Adhra Pradesh resulted in significant reductions in the stigma related to help-seeking.
Filling this gap in Indonesia, social enterprises and startups have been developing online platforms such as saveyourselves.id, intothelightid.org, and pijarpsikologi.org—aimed at helping people with information, education and assistance for mental health problems. These three platforms are, respectively, education, consultation, and suicidal prevention platforms. They help to administer mental health first aid to those with self-harm or suicidal tendencies. Narasi also recently implemented an innovative story-telling feature on mental health.
Online platforms have advantages—notably that they provide assistance and information anonymously. Research suggests that people seeking mental health assistance gain benefit even from interacting with chatbots and artificial intelligence. But there are drawbacks: needless to say, those not online cannot benefit from these services; some complex and longer-term conditions require interpersonal interaction and medication; and some online services still require the user to pay, such as for in-depth consultation. Along with the social stigma, fee-based services may dissuade marginalized Indonesians from seeking assistance for mental health whether online or offline.
So, what would an effective strategy look like? One key to reducing suicide rates is to reduce the cost and stigma associated with mental illness through large-scale campaigns, public information, and subsidized counselling which the government is best positioned to endorse and provide. And the government would be wise to enable innovative efforts from the private and social enterprise sectors to complement information efforts, facilitate essential assistance and explore practical applications of technology.
We are also frequently reminded in our work at Saraswati that mental health concerns are situation-driven (for example, for refugees) and profession-specific (for example, for journalists reporting in conflict areas and/or subject to harassment for their coverage). This suggests we could all start by looking close to home when considering how to support mental health.
Chairunnisa is Project Assistant at Saraswati, an Indonesian company focusing on development innovation.