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"Penelitian ini dilaksanakan berdasarkan pentingnya layanan discharge planning sebagai upaya preventif relapse pasien yang telah dipulangkan dari rumah sakit. Tujuan penelitian ini adalah menjelaskan mengenai layanan Discharge Planning mulai dari perencanaan hingga pada gambaran proses pelayanan Discharge Planning bagi pasien dengan gangguan jiwa di Rumah Sakit Jiwa Atma Husada Mahakam Samarinda Kalimantan Timur. Teori Kesehatan Mental, Pelayanan Institusional, Rumah Sakit Jiwa, Discharge Planning, Kerja Tim dalam Psikiatri digunakan dalam penelitian ini sebagai bahan kajian. Penelitian ini dilakukan pada tahun 2021, memiliki tujuh (7) informan dengan latar belakang dari profesi multidisiplin. Penelitian ini merupakan penelitian kualitatif dengan metode deskriptif. Teknik pemilihan informan adalah dengan metode non-probabilitysampling. Teknik sampling yang digunakan adalah purposive sampling. Pengumpulan data penelitian dilakukan dengan studi literatur, observasi, dan wawancara secara mendalam untuk pengambilan data secara mendalam dengan masing-masing informan. Wawancara yang dilakukan sebagain secara daring dan sebagian wawancara secara langsung dengan penyesuaian dan protokol kesehatan. Selain itu, saat melakukan wawancara secara langsung penelitian memiliki kesempatan untuk melakukan observasi secara langsung di Rumah Sakit Jiwa Atma Husada terutama saat tahapan edukasi dan administrasi saat keluarga menjemput paisen. Hasil dari penelitian ini adalah discharge planning merupakan layanan yang diterima pasien sejak pasien masuk rumah sakit berfokus dalam membantu pasien dan keluarga dalam memiliki rujukan ke perawatan selanjutnya, pengetahuan, keterampilan dan sikap dalam memperbaiki serta mempertahankan kondisi kesehatan pasien agar dapat kembali ke masyarakat serta mampu mengembalikan keberfungsian sosial dan kesejahteraan pasien. Tahapan layanandischarge planning terbagi menjadi 2 tahapan: Pertama, proses perencanaan yang dilakukan oleh tim kesehatan multidisiplin dimulai sejak pasien masuk rumah sakit dan melalui clinical pathway dan mendapatkan assessment mengenai gejala klinis dan penegakkan diagnosis pasien, selain itu informasi yang dibutuhkan dari keluarga mengenai tempat tinggal pasca rumah sakit, siapa yang akan bertanggung jawab atas pasien. Kedua, informasi yang didapatkan dalam proses perencanaan akan diterapkan dalam proses pelayanan mulai dari edukasi dan konseling keluarga sampai pada kediatandropping dan home visit. erdasarkan hasil penelitian menunjukkan Discharge Planningdirasa kurang optimal dalam penerapannya di Rumah Sakit Jiwa Daerah Atma Husada Mahakam, hal ini disebabkan rumah sakit belum memiliki profesi pekerja sosial yang berdampak pada kurang optimalnya dalam proses pelayanan discharge planningkhususnya dalam assessment masalah pasien serta dalam pelaksanaan kegiatan home visit.

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This study is based on the importance of discharge planning services as an effort to prevent relapse of patients who have been discharged from the hospital. The purpose of this study is to explain about Discharge Planning services starting from planning to the proses of discharge planning services for patients with mental illness at Atma Husada Mahakam Samarinda Mental Hospital, East Borneo. The study utilized the mental health theory, institutionalized services at mental hospital, and perspectives on discharge planning and interdisciplinary teamwork in Psychiatry. This research was conducted in 2021 and involved seven(7) informants with backgrounds from multidisciplinary professions. The study benefits from the use of qualitative approach and the descriptive method, purposive sampling in selecting the informants. This qualitative research was conducted with data collection methods using literature study, observation and in-depth interviews with each informant. Interviews were conducted partly online and partly in- person interviews with health adjustments and protocols. In addition, when conducting direct interviews, the study had the opportunity to make direct observations at the Atma Husada Mental Hospital, especially during the education and administration stages when the family picked up the patient.The results of this study shows the discharge planning at Atma Husada Hospital consist of a service received by patients from the time the patient enters the hospital focusing on helping patients and their families to have referrals for further treatment, gain knowledge, skills and attitudes in improving and maintaining the patient's health condition so that they can return to their community and be able to restore social functioning and patient well-being. The discharge planning service are divided into 2 stages: First, planning process carried out by a multidisciplinary health team starts from the time patient enters the hospital and goes through the clinical pathway and gets an assessment of clinical symptoms and patient diagnosis, in addition to the information needed from the family regarding the place of residence post-hospital, also who will be in charge of the patient through the treatment. Second, information obtained in the planning process will be applied in the service process starting from family education and counseling until dropping the patient and home visits. However, the findings indicate that discharge planning is considered less than optimal in its implementation at the Atma Husada Mahakam Regional Mental Hospital dute to lack of social worker’s engagementin the process that contributes to implementation of discharge planning services, especially in assessing patient problems and in carrying out home visit activities that felt not optimal."

"Penelitian ini berlokasi di Panti Sosial Bina Laras Harapan Sentosa II Cipayung, dan bertujuan untuk mendeskripsikan bentuk-bentuk dukungan sosial dalam penerapan silabi yang membantu pemulihan personal ODGJ sebagai penerima manfaatnya. Penelitian ini merupakan penelitian deskriptif dan menggunakan metode kualitatif. Teknik pengumpulan data dilakukan melalui wawancara mendalam, observasi dan studi literatur.Hasil penelitian menunjukkan bahwa terdapat bentuk-bentuk dukungan sosial yang diberikan pada ODGJ melalui penerapan silabi yang mempermudah ODGJ dalam menghadapi pemulihan personal. Berbagai bentuk dukungan sosial membantu proses pemulihan yang dijalani penerima manfaat, terutama dalam meningkatkan kepercayaan diri, kemandirian, kemampuan berinteraksi dan bersosialisasi dengan lingkungan sekitar, serta pemahaman mengenai penyakitnya.

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This research is located at the Cipayung Harapan Sentosa II Social Institution, and aims to describe forms of social support in the application of syllabus that help the personal recovery of ODGJ as its beneficiaries. This research is a descriptive study and uses qualitative methods. Data collection techniques are done through in-depth interviews, observation and literature studies.

The results show that there are forms of social support provided to ODGJ through the application of syllabi that makes it easy for ODGJ in the face of personal recovery. Various forms of social support help the recovery process that is carried out by the beneficiaries, especially in increasing self-confidence, independence, ability to interact and socialize with the surrounding environment, and understanding of the disease."

"Skripsi ini merupakan sebuah telaah filsofis terhadap kondisi mental illness pada manusia. Dengan menggali kembali kondisi mind manusia yang terbentuk melalui pengalaman, maka muncullah dialog sebagai pola interaksi bagi ‘penderita’ mental illness. Berbeda dengan telaah psikologis yang bersifat empiris dan menekankan terapi pada tiap tahapnya, telaah filosofis menaruh perhatian pada kondisi abstrak mind yang bersentuhan dengan lingkungan. Penelitian dilakukan dengan membongkar kembali kondisi mind manusia dan hubungannya dengan pengalaman sebagai langkah awal mengenal mental illness dan pemulihannya.

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This undergraduate thesis is a philosophical analysis of mental illness in human being. By recollecting mind condition of human which is shaped by experience, dialogue appears as an interaction model for patient of mental illness. It is different with the psychological, which is more empirical and talk more about stages of therapy, the philosophical analysis talk about abstraction of human mind condition related to their society. This observation using phenomenological method by re-knowing human experience and find dialogue as the first step to cure mental illness."

"Sebagian besar pasien dengan gangguan mental emosional pertama-tama belum berobat ke fasilitas pelayanan kesehatan jiwa. Pasien gangguan mental emosional yang berobat ke Puskesmas wilayah Jakarta Timur hanya 1,88 % dari kasus yang ada di masyarakat dengan rata-rata kunjungan 1,31 kali pada tahun 1994. Agar gangguan tersebut tidak menjadi berat atau menjadi penyakit lain, maka diperlukan pengobatan sedini mungkin. Untuk mencapai maksud tersebut, yang menjadi masalah penelitian ini adalah bagaimana pola perilaku pencarian pengobatan dari pasien gangguan mental emosional dan faktor-faktor apa yang berhubungan dengan perilaku tersebut. Jenis disain penelitian ini adalah crossectional, namun menggunakan analisis yang lazim digunakan pada studi case control pada penduduk dewasa (17 tahun ke atas) yang mengalami gangguan mental emosional. Gangguan mental emosional ditetapkan berdasarkan pengisian instrumen Self Reporting Questionnaire (SRQ) dengan cut-off points 6. Pengambilan sampel dilakukan secara systematic random sampling dengan sampling fraction 9. Unit sampel adalah rumah tangga dengan jumlah 650 KK yang meliputi 1950 penduduk dewasa sehat. Sampel pasien gangguan mental emosional yang diteliti berjumlah 446 kasus. Untuk mengetahui hubungan faktor dengan perilaku pengobatan dilakukan perhitungan Odds ratio melalui analisis regresi logistik multivariat. Hasil penelitian menunjukan bahwa pola perilaku pengobatan pertama pasien gangguan mental emmosional di Kelurahan Pulogadung adalah melakukan pengobatan sandhi 27,8 %, ke dokter umum 18,4 %, tidak mencari pengobatan 17,4 %, ke Puskesmas 13,2 %, ke pengobat tradisional 8,7 %, ke rumah sakit umum 6,1 %, ke spesialis penyakit dalarn 5,8 % dan ke psikiater 2,5 %. Pasien yang melakukan kegiatan rujukan adalah 23,6 %. Sebagian besar pasien yang melakukan rujukan dan pasien yang melakukan pengobatan selanjutnya tidak berobat ke fasilitas pelayanan kesehatan jiwa. Pasien gangguan mental emosional lebih mungkin tidak mencari pengobatan apabila pasien tidak merasa terganggu akibat gangguan mental emosional yang dialaminya (OR 0,01 ; 95% Cl 1,5E-03 - 0,02), kurang mendapatkan informasi pelayanan kesehatan jiwa (OR 0,49 ; 95% CI 0,25 - 0,95) dan apabila pasien malu berobat ke psikiater (OR 2,24 ; 95% 1,02 - 4,85). Pelayanan kesehatan jiwa di masyarakat diharapkan tidak hanya menunggu pasien datang berobat ke fasilitas kesehatan jiwa. Kegiatan pelayanan kesehatan jiwa di Puskesmas perlu dikembangkan dalam kegiatan Puskesmas lainnya (Taruna Husada, Sala Shakti Husada dan sebagainya). Pelayanan prevensi sekunder (mendorong pasien berobat) melalui peningkatan pengetahuan gangguan mental emosional dan fasilitas pengobatannya perlu lebih diprioritaskan. Penyegaran pengetahuan gangguan mental emosional terhadap dokter umum perlu dilakukan secara periodik. Peningkatan mutu pelayanan jiwa di Puskesmas dan pembinaan pengobat tradisional perlu lebih diperhatikan. Disamping itu perlu juga dipertimbangkan tentang perubahan konsep figur psikiater di masyarakat.

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Most patients with mental emotional disorder didn't visit health facility with mental health service at the first treatment. There is only 1,8 % of people with mental emotional disorder who visited Puskesmas at East Jakarta with average 1.31 visit in 1994. To prevent the disturbance become more severe or to become another illness, early treatment is needed. To reach the purpose, the problem of this study is to identify health seeking treatment pattern of patient with mental emotional disturbance and to find factors which was associated with the behavior treatment.

The study design is cross sectional study but method of analysis is case control. Sample of the study are adult (17 years or more) who experience mental emotional disorder. The criteria of mental emotional disorder is based on answers of Self Reporting Questionnaire (SRQ) with cut-off 6. Sampling method is systematic random sampling with sampling fraction of 9. Sampling unit is household with totally 650 household which include 1950 adult with good health. Sample of patient with mental emotional disorder are 446 cases. To identify relationship between factors with health seeking treatment, logistic regression with odds ratio is applied.

The result showed that for the first treatment there is 27,8% of the mental emotional disorder patients performing self medication, 18,4% visit medical doctor, 17,4 % didn't seek any treatment, 13,2 % visit Puskesmas, 8,7 % going to traditional healer, 6,1% to general hospital, 5,8% visit internist and 2,5% visit psychiatrist. There where 23,6 patient who were given referral. Most of the patients who were referred or patient who continue the treatment didn't visit health facility with mental health service.

Patients with mental emotional disorder probably not seek any treatment if they didn't feel uncomfortable with the disturbance they experienced (OR 0,01 ; 95% CI 1,5E-03 - 0,02), did not obtained enough information about mental health service (OR 0,49 ; 95% CI 0,25 - 0,95), or if the patient was ashamed to visit psichiatrist (OR 2,24 ; 95% CI 1,02 - 4,85).

Patients with mental emotional disorder probably would performed self medication if their social economic status is low (OR moderat 0,52 ; 95% CI 0,06-0,83; OR high 0,45 ; 95% CI 0,04-0,62), if they were not bothered by the disturbance they experienced (OR 0,47; 95% CI 0,03-0,91), didn't consider the disturbance as severe (OR 0,54 ; 95% CI 0,07-0,91), didn't obtained enough information on the mental health service (OR 0,52 ; 95% CI 0,06-0,79), were not suggested to have treatment (OR 0,45 ; 95 % CI 0,04-0,57), they have no work (OR 0,35 ; 95 %CI 0,17-0,67) and if they are Askes member (OR 2,48 ; 95% CI 2,40-17,54).

Patients with mental emotional disorder will probably visit traditional healer if they have expectation that the treatment not only give drug (OR 8,76 ; 95% CI 1,86 - 42,26), have supernatural believe (OR 7,53; 95% CI 3,15-40,22), and have enough knowledge on the traditional healer service (OR. 6,67; 95% CI 1.86-23,57), did not feel comfortable with the disturbance they experienced (OR 8,84; 95% CI 3,00 - 26,05), their knowledge on the mental emotional disorder was not good (OR 0,12;95% CI 0,03-0,56), and have no information on the mental emotional service (OR. 0,25; 95% CI 0,06-0,98).

Patients with mental emotional disorder will probably visit mental health service if they felt disturbed (OR 4,43 ; 95% CI 1,76 - 11,13), did not have senior high school or more education (OR 0,36 ; 95% CI 0,16 - 0,81), expected to be given more than just drug (OR 5,93 ; 95% CI 1,93 - 18,17), feeling that the high cost of the treatment influence the effort to seek treatment (OR 7,17 ; 95 % CI 2,83 - 17,81), obtained enough information on the mental health service (OR 5,22 ; 95% CI 2,34 - 11,59), and did not feel ashamed to visit psychiatrist (OR 0,43; 95% CI 0,18 - 0,99).

Patients with mental emotional disorder will probably visit Puskesmas if they feel bothered (OR 14,41 ; 95% CI 4,14 - 50,40), feeling the cost of the treatment influence the effort of seeking treatment (OR. 4,28 ; 95% CI 1,39 - 13,06), their social economic status is low (OR high 0,11 ; 95 % CI 0,03 - 0,37), lived near to Puskesmas (OR 0,21 ; 95% CI 0,06 - 0,77), realize that there is mental health service in the Puskesmas (OR 14,31 ; 95 % CI 4,09 - 49,89), did not know about traditional service (OR 0,05 ; 95 % CI 0,01 - 0,25), did not have knowledge about the general health service (OR 0,23; 95% CI 0,07 - 077), and the healer attitude did not influence the choice of treatment (OR 0,35 ; 95 % CI 0,14 - 0,88).

Mental health service in the public is expected not only waited patients to visit the mental health service. Mental health service at the Puskesmas needs to be integrated and to be developed with the other Puskesmas activity (Taruna Husada, Bhakti Husada, Karang Werdha). Secondary prevention thru knowledge development on the mental emotional disorder, treatment facility and early detection should be give more priority. Knowledge refreshment on the mental emotional disorder to medical doctor needed to be in force periodically. Quality improvement of health service in Puskesmas' and education of traditional healer need to be given more attention. The figure of psychiatrist in the society need to changed as well."

"ABSTRAKGangguan jiwa pada warga binaan di dalam Lapas merupakan suatu hal yang mungkin terjadi. Pelayanan kesehatan yang kurang baik dan kondisi di dalam Lapas yang penuh dengan tekanan serta adanya pembatasan bergerak dapat memunculkan terjadinya stress dan depresi pada narapidana/tahanan, bahkan pada beberapa kasus muncul gejala psikotik yang perlu penanganan lebih serius. Meskipun masalah kesehatan jiwa merupakan hal yang penting di dalam Lapas/Rutan, namun sampai saat ini belum tertangani dengan baik. Kesehatan jiwa seolah-olah terabaikan, karena yang selama ini menjadi fokus penanganan adalah kesehatan fisik saja. Sebagai sebuah lembaga yang memiliki fungsi melakukan pelayanan terhadap masyarakat, dalam hal ini narapidana/tahanan, tentu saja lapas memiliki tanggung jawab memberikan pelayanan yang optimal kepada warga binaannya. Manajemen yang baik tentu sangat diperlukan, termasuk dalam manajemen pelayanan kesehatan jiwa. Dalam penelitian ini ada dua pertanyaan yang hendak dijawab, Bagaimana manajemen pelayanan kesehatan jiwa di Lapas Narkotika Klas IIA Jakarta saat ini; serta Apa saja kendala-kendala yang dihadapi dalam pelaksanaan Manajemen Pelayanan Kesehatan Jiwa di Lapas Narkotika Klas IIA Jakarta saat ini. Metode yang digunakan adalah metode kualitatif dengan wawancara menggunakan pedoman wawancara. Informan penelitian terdiri dari: informan penting, terdiri dari 4 orang petugas lapas dan 6 orang warga binaan; informan kunci, adalah Kalapas Narkotika Klas IIA Jakarta; serta informan tambahan, terdiri dari mantan warga binaan, mantan Direktur Jenderal Pemasyarakatan, dan keluarga warga binaan. Berdasarkan hasil penelitian ditemukan bahwa manajemen pelayanan kesehatan jiwa di Lapas Narkotika Klas IIA Jakarta belum mendapat perhatian yang serius baik dalam perencanaan, pengorganisasian, kepemimpinan dan pengendalian. Masih ada kendala dalam pelayanan kesehatan jiwa yaitu peran dan komitmen penentu kebijakan, keterbatasan SDM, keterbatasan sarana prasarana, serta belum adanya MoU dengan Rumah Sakit Jiwa.

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ABSTRACTMental illness of inmates inside the correction is something that possibly can happen. Low health treatment and overcrowd with lots of pressure and limited access could possibly give stress and depression to the inmates/prisoners. Even there are psychotic symptom which need serious treatment occurred in few cases. Although mental health is one of the important things inside the correction/detention house, but it is still not yet treated very well. It is seems to be ignored because, so far, the treatment only focusing on physical health. As an institution which has a function to serve the society, in this case is the inmates/prisoners, correction has an obligation, of course, to give an optimum care to the inmates. Good management is needed, including mental health care. There are two questions to answer in this study, how is the treatment of mental health in Jakarta Class IIA Narcotic Correction at present; and what are the obstacles encountered in the implementation of mental health care management in Jakarta Class IIA Narcotic Correction at present. This is a qualitative study by conducting interview with interview guidelines. The interviewees are important informants consist of 4 correction officers and 6 inmates; key informant is The Head of Jakarta Class IIA Narcotic Correction; also additional informant consist of ex-prisoners, former Director General of Correction and the inmates’ family. Based on the result of study, it is revealed that the mental health care management in Jakarta Class IIA Narcotic Correction is not seriously taken care in terms of planning, organizing, leading and controlling. There is, still, an obstacle in mental health care which is commitment and role of the policy makers, lack of human resources and infrastructures, also there is no Memorandum of Understanding (MoU) with the mental hospital."

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Gambaran Perilaku Mencari Bantuan Kesehatan Jiwa pada Siswa SMA di Depok

 

Remaja adalah kelompok usia yang mengalami berbagai proses perkembangan dalam kehidupannya. Berbagai faktor dapat berperan sebagai faktor risiko dan faktor proteksi dalam kesehatan jiwa remaja. Layanan bantuan profesional dapat menjadi intervensi dini dalam mencegah gangguan jiwa pada remaja. Perilaku mencari bantuan kesehatan jiwa dapat diidentifikasi dengan melihat sikap dan intensi remaja dalam mencari kesehatan jiwa, serta determinan lain seperti dukungan sosial, tingkat literasi kesehatan jiwa, dan status kesehatan jiwa. Penelitian ini bertujuan untuk mengetahui perilaku mencari bantuan profesional kesehatan jiwa pada siswa SMA di Depok. Metode penelitian menggunakan desain penelitian kuantitatif dengan metode deskriptif sederhana pada 147 siswa SMA Negeri 13 Depok. Instrumen pada penelitian ini adalah kuesioner Multidimensional Scale of Perceived Social Support, Mental Health Knowledge Schedule, Depression, Anxiety, and Stress Scale (DASS – 21), Attitudes toward Seeking Professional Help – Short Form, dan Mental Help Seeking Intention Scale. Analisis data yang digunakan adalah analisis univariat untuk mengetahui frekuensi dan presentase. Hasil penelitian menunjukkan dukungan sosial tinggi (51,7%), tingkat literasi kesehatan jiwa sedang (74,1%), status depresi normal (83%), status kecemasan normal (69,4%), status stres normal (90,05%), sikap terhadap perilaku mencari bantuan profesional kesehatan jiwa positif (53,1%), dan intensi untuk mencari bantuan kesehatan jiwa sedang (92,5%). Pihak sekolah dan layanan kesehatan jiwa perlu menyediakan dukungan, baik instrumental, informasional, atau emosional kepada siswa tentang kesehatan jiwa maupun gangguan jiwa.

 

Kata kunci: Remaja, dukungan sosial, literasi, sikap, intensi, pencarian bantuan, kesehatan jiwa

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An overview of Mental Health Help-Seeking Behavior in High School Students in Depok

 

Adolescence is an age group that experiences various developmental processes in their lives. Various factors can act as risk and protective factors in adolescent mental health. Professional assistance services can be early intervention in preventing mental disorders in adolescents. The behavior of seeking mental health assistance can be identified by looking at the attitudes and intentions of adolescents in seeking mental health, as well as other determinants such as social support, mental health literacy levels, and mental health status. This study aims to determine the behavior of seeking mental health professional assistance for high school students in Depok. The research method uses a quantitative research design with a simple descriptive method on 147 students of SMAN 13 Depok. The instruments in this study were the Multidimensional Scale of Perceived Social Support, Mental Health Knowledge Schedule, Depression, Anxiety, and Stress Scale (DASS-21), Attitudes toward Seeking Professional Help - Short Form, and Mental Help Seeking Intention Scale. Analysis of the data used in this study is univariate analysis to determine the frequency and percentage. The results showed high social support (51.7%), moderate mental health literacy level (74.1%), normal depressive status (83%), normal anxiety status (69.4%), normal stress status (90.05 %), positive attitudes toward mental health professional seeking help (53.1%), and moderate intention to seek mental health assistance (92.5%). Schools and mental health services need to provide students, both instrumental, informational, or emotional support about mental health and mental disorders.

 

Keywords: Adolescence, social support, literacy, attitudes, intention, help-seeking, mental health

 

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