Civic engagement and mental health system strengthening in Indonesia: a qualitative examination of the views of health professionals and national key stakeholders
Abstract Background Mental health services in Indonesia are developing rapidly in response to national and global health policy to support people living with psychosis. This presents a unique opportunity for civic engagement, the active involvement of patients, carers and communities in mental healt...
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doaj-ff623e6e25c54b45a965d4ed15bcfba92020-11-25T03:01:02ZengBMCBMC Psychiatry1471-244X2020-04-0120111510.1186/s12888-020-02575-3Civic engagement and mental health system strengthening in Indonesia: a qualitative examination of the views of health professionals and national key stakeholdersIrman Irmansyah0Herni Susanti1Karen James2Karina Lovell3Sri Idaiani4Soimah Imah5Giur Hargiana6Budi-Anna Keliat7Bagus Utomo8Erminia Colucci9Helen Brooks10National Institute of Health Research and DevelopmentFaculty of Nursing, Universitas IndonesiaCentre for Health and Social Care Research, Faculty of Health, Social Care and Education, Kingston and St GeorgesDivision of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science CentreNational Institute of Health Research and DevelopmentNational Institute of Health Research and DevelopmentFaculty of Nursing, Universitas IndonesiaFaculty of Nursing, Universitas IndonesiaKPSIDepartment of Psychology, Middlesex UniversityDepartment of Health Services Research, Institute of Population Health Sciences, University of LiverpoolAbstract Background Mental health services in Indonesia are developing rapidly in response to national and global health policy to support people living with psychosis. This presents a unique opportunity for civic engagement, the active involvement of patients, carers and communities in mental health care, to shape emergent services. In-depth explorations of the views of professionals and other key stakeholders in mental health care on the use of civic engagement in Indonesia are lacking which contributes to a limited understanding of its potential in this regard. The study aimed to explore contemporary professionals’ and other key stakeholders’ perspectives on the current use of and potential for civic engagement to strengthen mental health systems in Indonesia. Methods Qualitative interviews were undertaken and analysed using thematic analysis underpinned by a critical realist approach. Eighteen multi-disciplinary professionals and lay health workers involved in mental health care in Jakarta and Bogor and 10 national key stakeholders were recruited. Results Despite high levels of awareness of and support for civic engagement amongst mental health professionals and policy makers combined with a nascent grass roots movement, analysis revealed unstructured and insufficient mechanisms for civic engagement which resulted in ad-hoc and mostly superficial levels of involvement activity. Civic engagement was thought to require a marked shift in existing practices as well as organisational and societal cultures. Challenging stigma is a key feature of civic engagement and our analysis highlights the relevance of social contact methods which are locally and culturally contextualised in this regard. Our findings point to a need to expand current definitions of civic engagement which focus on indivdiual enablement to ones that also encompass environmental and organisational enablement to optimise the future use of civic engagement in mental health settings. Conclusions Key mental health stakeholders have identified that central aspects of Indonesian culture are well aligned to the ethos of civic engagement which has the potential to facilitate the enactment of recent global health policy. However, full realisation is likely to be impeded by prevailing paternalistic cultures in mental health services and high levels of stigma and discrimination towards those with mental illness in Indonesia without intervention.http://link.springer.com/article/10.1186/s12888-020-02575-3Civic engagementImplementationIndonesiaLow- and middle-income countriesMental healthPatient and public involvement |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Irman Irmansyah Herni Susanti Karen James Karina Lovell Sri Idaiani Soimah Imah Giur Hargiana Budi-Anna Keliat Bagus Utomo Erminia Colucci Helen Brooks |
spellingShingle |
Irman Irmansyah Herni Susanti Karen James Karina Lovell Sri Idaiani Soimah Imah Giur Hargiana Budi-Anna Keliat Bagus Utomo Erminia Colucci Helen Brooks Civic engagement and mental health system strengthening in Indonesia: a qualitative examination of the views of health professionals and national key stakeholders BMC Psychiatry Civic engagement Implementation Indonesia Low- and middle-income countries Mental health Patient and public involvement |
author_facet |
Irman Irmansyah Herni Susanti Karen James Karina Lovell Sri Idaiani Soimah Imah Giur Hargiana Budi-Anna Keliat Bagus Utomo Erminia Colucci Helen Brooks |
author_sort |
Irman Irmansyah |
title |
Civic engagement and mental health system strengthening in Indonesia: a qualitative examination of the views of health professionals and national key stakeholders |
title_short |
Civic engagement and mental health system strengthening in Indonesia: a qualitative examination of the views of health professionals and national key stakeholders |
title_full |
Civic engagement and mental health system strengthening in Indonesia: a qualitative examination of the views of health professionals and national key stakeholders |
title_fullStr |
Civic engagement and mental health system strengthening in Indonesia: a qualitative examination of the views of health professionals and national key stakeholders |
title_full_unstemmed |
Civic engagement and mental health system strengthening in Indonesia: a qualitative examination of the views of health professionals and national key stakeholders |
title_sort |
civic engagement and mental health system strengthening in indonesia: a qualitative examination of the views of health professionals and national key stakeholders |
publisher |
BMC |
series |
BMC Psychiatry |
issn |
1471-244X |
publishDate |
2020-04-01 |
description |
Abstract Background Mental health services in Indonesia are developing rapidly in response to national and global health policy to support people living with psychosis. This presents a unique opportunity for civic engagement, the active involvement of patients, carers and communities in mental health care, to shape emergent services. In-depth explorations of the views of professionals and other key stakeholders in mental health care on the use of civic engagement in Indonesia are lacking which contributes to a limited understanding of its potential in this regard. The study aimed to explore contemporary professionals’ and other key stakeholders’ perspectives on the current use of and potential for civic engagement to strengthen mental health systems in Indonesia. Methods Qualitative interviews were undertaken and analysed using thematic analysis underpinned by a critical realist approach. Eighteen multi-disciplinary professionals and lay health workers involved in mental health care in Jakarta and Bogor and 10 national key stakeholders were recruited. Results Despite high levels of awareness of and support for civic engagement amongst mental health professionals and policy makers combined with a nascent grass roots movement, analysis revealed unstructured and insufficient mechanisms for civic engagement which resulted in ad-hoc and mostly superficial levels of involvement activity. Civic engagement was thought to require a marked shift in existing practices as well as organisational and societal cultures. Challenging stigma is a key feature of civic engagement and our analysis highlights the relevance of social contact methods which are locally and culturally contextualised in this regard. Our findings point to a need to expand current definitions of civic engagement which focus on indivdiual enablement to ones that also encompass environmental and organisational enablement to optimise the future use of civic engagement in mental health settings. Conclusions Key mental health stakeholders have identified that central aspects of Indonesian culture are well aligned to the ethos of civic engagement which has the potential to facilitate the enactment of recent global health policy. However, full realisation is likely to be impeded by prevailing paternalistic cultures in mental health services and high levels of stigma and discrimination towards those with mental illness in Indonesia without intervention. |
topic |
Civic engagement Implementation Indonesia Low- and middle-income countries Mental health Patient and public involvement |
url |
http://link.springer.com/article/10.1186/s12888-020-02575-3 |
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