Membangun Kesehatan Mental & Wellbeing

melalui Sistem-sistem yang Lebih Besar:

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Tujuan Pendidikan Psikolog
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 Membantu meningkatkan kesejahteraan (wellbeing) pada:

 Individu Penanganan kasus individu (Klinis-Pendidikan-PIO)
Mencapai masyarakat sehat
 Organisasi Penanganan kasus Sistem (Pendidikan – PIO) mental/wellbeing
 Masyarakat/ Komunitas Penanganan kasus komunitas (Klinis)
3 Manusia merupakan sistem yang kompleks -
Biopsikososialpolitik
Sistem supranasional

Sistem Kemasyarakatan

Sistem Organisasional

Sistem Kelompok

Sistem Organismik/individu

Sistem Organ

Sistem Sel

Sistem : seperangkat unit yang saling berhubungan untuk mencapai tujuan. Perubahan dalam salah satu unit
akan mengubah pola hubungan dalam system tersebut.
 Paradigm Shift
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Patogenesis
 Paradigma “negative”, patologis, tradisional,
diskrit, medis-psikiatris
 Sehat mental :
 absennya simptom-simptom patologi
 sehat mental dan sakit mental dipandang
sebagai suatu kutub yang yang berlawanan, di
mana bila tingkat sakit mentalnya rendah
sama dengan tingkat sehat mentalnya tinggi,
demikian juga sebaliknya
 dinamis
indikator dalam menilai sehat-sakit mental
adalah standar-standar DSM. Seseorang
dianggap sehat mental bila tidak ditemukan
indikasi-indikasi sakit mental menurut kriteria
diagnostic
 Fokus : meredakan simptom-simptom
patologis
Kuratif
Salutogenesis
 Paradigma “positif”, kontemporer,
continuum, public mental health
 Sehat mental:
 tidak sekedar absennya simptom-
simptom patologis namun tercapainya
keadaan wellbeing
 Sehat mental – sakit mental merupakan
sebuah continuum, dan bergerak secara
 Indikator dalam menilai :
kesejahteraan/wellbeing/ complete
mental health
 Fokus: mencapai keadaan sehat mental
secara komplit / wellbeing
Komprehensif: kuratif-preventif-promotif
Public Mental Health Perpective: Why?
Mental disorder has a range of
significant impacts
Mental disorder results in economic
costs (and is costly to treat)
Levels of mental disorder are
projected to increase
Mental wellbeing has a broad range
of impacts
• 10% of 5 to 16 year-olds have a mental disorder (anxiety, depression, conduct)
• 18% of adults have a common mental disorder, 6% alcohol dependence and 3% drug dependence
• 25% of older adults have depression requiring intervention
• dementia affects 20% of people aged over 80
• 50% of lifetime mental illness (except dementia) arises by age 14
• 40% of young people experience at least one mental disorder by age 16
Mental disorder is responsible for the largest burden of disease – 23% of
the total burden ( compared to 16% for cancer and 16% for heart
disease)
By 2026: The number of people who experience a mental disorder is
projected to increase by 14%
• Better general health
• Improved educational outcomes
• Healthier lifestyle and reduced health risk behavior, including reduced smoking and harmful levels of
drinking
• Increased productivity at work, reduced absenteeism, and reduced burnout
• higher income
• Stronger social relationships
• Increased social/community participation
• Reduced antisocial behavior, crime and violence
Contemporary Perspective/ Public Mental
Health Perspective Involves:
1. An assessment of the risk factors for mental disorder, the protective factors
for wellbeing, and the levels of mental disorder and wellbeing in the local
population
2. The delivery of appropriate interventions to promote wellbeing, prevent
mental disorder, and treat mental disorder early
3. Ensuring that people at ‘higher risk’ of mental disorder and poor wellbeing are
proportionately prioritized in assessment and intervention delivery
Risk and Protective Factors

• a characteristic at the biological, psychological, family,

Risk factors community, or cultural level that precedes and is associated

with a higher likelihood of problem outcomes.
• A condition that increase the probability of a disorder

• a characteristic at the biological, psychological, family, or

community (including peers and culture) level that is
Protective associated with a lower likelihood of problem outcomes or
that reduces the negative impact of a risk factor on problem
Factors outcomes
• A condition that inhibits, reduce, or buffers the probability as
disorder
 Example Risk & Protective Factors:
(Individual-Social-Environmental)
Level Risk factors
Individual • Low self esteem
• Cognitive/emotional immaturity
• Medical illness, substance use
Social • Loneliness
• Neglect, family conflict
• Low income & poverty
• Work stress, unemployment
Environmental • Injustice and discrimination
• Exposure to disaster
Protective factors
• Self esteem, confidence
• Ability to solve the problems and
manage stress
• Physical health, fitness
• Social support of family & friends
• Good parenting/family interaction
• Economic security
• Satisfaction, success at work
• Social justice, tolerance, integration
• Physical security & safety
Implications of Public Mental Health
Perspective

a. Comprehensive service provision (continuum of services:

promotion - prevention - treatment)
b. An ecological model (takes into account of social, cultural, and
physical environmental factors)
c. Provision to service that easily to accessed by general population
(ex: through public facilities: schools; public health care center,
etc)
Ecological Perspective
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 Paradigma Penanganan Kasus Sistem
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Design

Design Implementation
Evaluation
Partnership

Implementati
Evaluation
on
 Tahapan Penanganan Kasus
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• System Entry
Formative
(Research) Phase
• Model Development

• Program Development
Program
(Intervention) • Program Continuation or Extension
Phase
13 Formative (Research) Phase
System Entry
• Phase-1: Existing theory; research;
practice (personal theory)
• Phase-2: Learning the culture
critical phase; key stakeholders (
brokers who facilitate acceptance
into the culture)
• Phase-3: Forming Partnership
Model Development
• Phase-4: Goal-problem
identification
• Phase – 5: Formative research
• Phase-6: culture-specific theory or
model
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Program (Intervention) Phase

Program Continuation or
Program Development
Extension
• Phase-7: Program design • Phase-10: Capacity
• Phase-8: Program building (sustainability &
implementation institutionalization)
• Phase-9: Program • Phase-11: Translation
evaluation (Dissemination and
deployment)
Pertanyaan Kunci pada Setiap Fase
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F Pertanyaan Kunci Metode Informan /
a Partisipan
s
e
1 Bagaimana gambaran kesehatan mental & wellbeing warga sekolah?
Bagaimana pandangan pemangku kepentingan tentang hal tersebut?
Bagaimana budaya-kebiasaan, pola perilaku-interaksi pemangku kepentingan
di sekolah? Apakah sekolah tertarik/berminat untuk melakukan perubahan
agar kondisi lebih baik?
2 Apa saja yang menjadi keprihatinan bersama semua pemangku kepentingan
sekolah?
3 Siapa saja pemangku kepentingan kunci di sekolah? Siapa yang potensial
menjadi tokoh perubahan? Bagaimana cara melibatkan semua pemangku
kepentingan?Bagaiman agar semua pihak berkontribusi secara efektif?
Pertanyaan Kunci pada Setiap Fase
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F Pertanyaan Kunci Metode Informan /
a Partisipan
s
e
4 Apa saja problem utama yang dihadapi oleh sekolah dalam mengembangkan
kesehatan mental dan wellbeing warga sekolah?
5 Apa saja factor risiko & factor protektif (psikologis/individu, social,
lingkungan ) dari perspektif teoretis dan perspektif pemangku kepentingan
sekolah? Apa gap yang ditemukan untuk mengatasi problem?

6 Bagaiman dinamika keterkaitan antara masalah, factor protektif & factor

risiko dalam konteks sekolah? Apa alternative pemecahan masalahnya
(kuratif-preventif-promotif??
Pertanyaan Kunci pada Setiap Fase
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F Pertanyaan Kunci Metode Informan /
a Partisipan
s
e
7 Bagaiman rancangan program/kegiatan strategis untuk mengatasi masalah?
Kuratif-preventif-promotif? Apa tujuan – sasaran-setiap program? Instrumen
apa yang akan digunakan untuk mengukur perubahannya? Bagaimana
melakukannya? Siapa pihak-pihak yang terlibat? dll
8 Apa saja hal-hal yang berjalan dengan baik, kurang berjalan dengan baik?
Bagaimana hal tersebut terjadi?

9 Apa rekomendasi elemen-elemen esensial yang penting untuk diperbaiki

agar program/kegiatan dapat mencapai tujuan?
Pertanyaan Kunci pada Setiap Fase
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Fa Pertanyaan Kunci Metode Informan /
se Partisipan
10 Siapa saja potensi-potensi local yang dapat diberdayakan untuk penguatan
kapasitas guna mencapai sustainability program/kegiatan?

11 Apa saja yang penting dilakukan agar good practices tetap terjadi dan
direplikasi oleh sekolah lain?; dukungan dana? MoU?; Perjanjian
Kerjasama?, penyusunan regulasi di tingkat kecamatan?, kabupaten?,
provinsi?, dll
Terimakasih

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