Emergency Psychiatric Care in Primary Healthcare in Indonesia

DEAR EDITOR

The integration of emergency psychiatric care into basic healthcare services must be given top priority due to the continued prevalence of mental health disorders as a major public health concern. Improving the effectiveness and accessibility of mental health interventions is crucial, especially in primary care settings. Mental illnesses continue to rank among the top ten global causes of burden; they cause 16% of Disability-Adjusted Life Years (DALYs) worldwide, and their economic costs are projected to be around USD 5 trillion. ¹ The National health survey by the Indonesian government presented in 2018 in Indonesia revealed that the cases of Severe Mental Disorders (SMD) were 7 per 1000 population or a total of 1.6 million individuals. ² Among the individuals with SMD, 15.1% have not sought treatment, and 48.9% of those who are taking medication do not adhere to their medication regimen. The high number of SMD cases is not matched by easy access to healthcare services. ² This is evident from the high treatment gap in mental health issues, which exceeds 90%, indicating that fewer than 10% of mental disorder cases receive standard management. Primary healthcare providers play a key role in the early detection and crisis management of mental health issues, but the lack of resources and specialized training poses a significant challenge. ³

There is an urgent need to establish protocols and training programs that enable primary healthcare practitioners to identify and address mental health crises effectively. This involves the development of standardized assessment tools, enhancing collaboration with mental health specialists, and ensuring access to crisis intervention resources. By incorporating emergency psychiatric care into the primary healthcare setting, ⁴ we can reduce the stigma associated with mental health issues and facilitate a more holistic approach to healthcare.

Furthermore, addressing emergency psychiatric care in the primary healthcare setting can contribute to early intervention, preventing the escalation of mental health crises, and reducing the burden on emergency departments. ^{5 , 6} This shift towards a more comprehensive and integrated approach is in the same line with the overarching goal of achieving equality between mental and physical healthcare.

In conclusion, addressing the integration of emergency psychiatric care into basic healthcare services is necessary to tackle the growing burden of mental health disorders in Indonesia. To effectively address this issue, policymakers, healthcare organizations, and professionals should prioritize several key recommendations. Firstly, Indonesian policymakers need to prioritize mental health in national healthcare agendas by allocating adequate resources and developing policies that promote the integration of emergency psychiatric care into primary healthcare services. This proactive approach will ensure that mental health receives encompass the attention and resources it deserves within the healthcare system. Secondly, there is a crucial need to invest in training programs for primary healthcare practitioners. These programs should focus on enhancing their capacity to identify, assess, and manage mental health crises effectively. Specialized training in mental health assessment and crisis intervention techniques will better equip healthcare providers to respond to the needs of individuals experiencing mental health emergencies. Moreover, collaboration between primary healthcare providers and mental health specialists should be strengthened. This collaboration will ensure timely access to specialized care and resources for individuals in crisis. Adequate funding should be allocated to support the integration of emergency psychiatric care services into existing healthcare systems. By implementing these recommendations, Indonesia can take significant strides toward improving access to emergency psychiatric care and addressing the mental health needs of its population.

ACKNOWLEDGEMENT

To all who have been very helpful so that this article could be adequately prepared, to Lembaga Pengelola Dana Pendidikan (LPDP) and Pusat Layanan Pembiayaan Pendidikan (PUSLAPDIK), who have provided enthusiasm and support regarding funding.

Conflict of Interest:

None declared.

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