Implementation of Community Mental Health Service in Malang, East Java

Abstract

Background: The culture of mental-health care in Indonesia relies heavily on backward pseudo-science rooted in dated spiritual traditions. In Indonesia, some people with mental disorder was shackled in sheds or backyards for years on end, which is known as pasung. Based on report, 1 in 7 mental disorder patients were at risk of pasung. The success of mental health service program need a collaboration from community as preventive and promotive besides curative component. This study aimed to analyze the legal system working based on legal, substance, and law's culture in Wonorejo, Malang District, East Java. Subjects and Method: This was a qualitative study (descriptive non-doctrinal legal research) conducted in Wonorejo, Malang, East Java. Nine informants consisting of psychiatrist, general doctor, nurse, caregiver, social worker, public health officer, and village leader was selected for this study by purposive sampling. Data collected by interview, observation and documentary review. Data were analyzed by data reduction, presentation, and verification. Results: Integration of human resources is needed as a driver of the legal structure and there was urgency to add more resources (human, technology, fund). The constraint of this program is the limited number of workers (doctor, nurse, social worker) and limited distribution and kind of psychiatric drugs. Communication as a modality of legal substance has done well between social worker, caregiver, public health services, mental health hospital dan village. Community acceptance be legal culture was completely done by various educational programs, advocacy, and socialization. There was good coordination and acceptance between internal and external legal culture. The legal system has done well and leads to optimal community mental services. Conclusion: Analyzing of legal system working in community mental health services from structure, substance and legal culture in Wonorejo, Malang District, East Java has shown integration, effectiveness and acceptance from their community. Implication of this study that are needed policies to increase resources and fulfill of psychiatric drug distribution that was need by the patient.