Expert Opinion: Family Mental Health – Healing The Unseen
Kenapa penting tapi peduli masih kurang? Karena kita menganggap sakit harus berdarah. Data Riset Kesehatan Dasar menunjukkan prevalensi gangguan mental emosional naik dari 6% pada 2013 menjadi 9,8% pada 2018, dengan kelompok perempuan paling tinggi. Lebih dari 19 juta penduduk alami gangguan mental emosional dan 12 juta alami depresi. Tapi dari hampir 12 juta penderita depresi, hanya 9% yang memperoleh pengobatan. Stigma masih kuat: dianggap kurang iman, manja, atau aib keluarga. Padahal satu orang depresi dalam keluarga, seluruh sistem keluarga terganggu.
Why family mental health is so important? Why do we remain care less of it? The first reason may be because we had this notion that sickness means bleeding. The Indonesia Basic Health Research showed that prevalence of mental health disorders increased from 6% in 2013 to 9.8% in 2018, where women were the most affected population. More than 19 millions of Indonesians experienced mental health disorders, whereby 12 millions of it went through depression. Sadly, only 9% of those who had depression received medical care. One of the reasons might be stigma in the community is still high. They might stigmatized people with mental health disorders as: had less faith to God, been spoiled persons, or considered as a family disgrace. However, when there is one family member experienced depression, the whole family system would be disrupted.
Kedua, akses layanan. Puskesmas adalah garda depan, tapi cakupan layanan jiwa di puskesmas DIY tahun 2011 hanya 1,76% dari total kunjungan. Dokter umum sering tidak terlatih deteksi depresi. Kabar baiknya program Cek Kesehatan Gratis 2025 kini mewajibkan skrining: hasil awal menemukan 1% depresi dan 0,9% kecemasan, DKI Jakarta tertinggi 9,3% depresi dan 7,6% cemas. Skrining harus rutin untuk kelompok rentan, remaja dengan SDQ, pekerja dengan WHO-5, siswa dengan PHQ-9A di UKS, bahkan artis dan atlet yang rentan burnout karena tekanan publik. Contoh nyata: Puskesmas Klasaman Sorong sudah integrasikan layanan jiwa, tapi pencatatan masih manual, butuh sistem digital.
Secondly, access to care. Primary health centers (Puskesmas) serve as the front line in the health care system of Indonesia. Nevertheless, coverage for mental health care remains low. For example, the coverage of mental health unit at these centers in the Special Region of Yogyakarta (DIY) was only 1.76% of total visits in 2011. General practitioners are often lack of training for detecting depression. On the good side, the 2025 Free Health Check program now mandated health screening. The early results showed that there were 1% depression cases, 0.9% anxiety, whereby people of DKI Jakarta showed higher percentage of mental health disorders: 9.3% have had depression and 7.6% have had anxiety. Screening must be conducted routinely for vulnerable populations, including adolescents (using the SDQ), workers (using the WHO-5), and students (using the PHQ-9A in school health units)—as well as for artists and athletes as they are susceptible to burnout due to public censure. A concrete example is the Klasaman Community Health Center in Sorong, which has integrated mental health services but still relies on manual record-keeping and requires a digital system.
Ketiga, dukungan keluarga adalah obat pertama. Keluarga bukan hanya pengantar ke puskesmas, tapi co-terapis. Mendengarkan tanpa menghakimi, menjaga rutinitas tidur dan makan, dan tidak mengucilkan ODGJ. Keluarga yang edukatif menurunkan risiko kekambuhan psikosis hingga 40%.
Thirdly, family support is a critical medicine. Family is not just for accompanying patients to the centers, but they could act as co-therapist. Listening without being judgmental, keeping the routines such as sleeping and meal times, and include people with mental health disorders (orang dengan gangguan jiwa; ODGJ) in daily activities. Families who are well-informed could lower the risk of psychosis relapse by up to 40%
Keempat, perempuan butuh perhatian istimewa. Perempuan memikul beban ganda: pekerja, ibu, istri, plus kekerasan. Komnas Perempuan mencatat 457.895 kasus kekerasan terhadap perempuan pada 2022, 79,5% korban adalah perempuan, dan KDRT paling banyak dilaporkan. Jenis pelaku 83,3% laki-laki. Bentuknya 50% fisik, sisanya psikis, seksual, dan penelantaran ekonomi. Perempuan korban KDRT 84,4% alami kekerasan emosional yang berujung depresi kronis.
Fourthly, women require special attention. They shouldered double burdens of balancing roles: workers, mothers, wives, and also facing violence. The National Commission on Violence Against Women (Komnas Perempuan) recorded 457,895 cases of violence against women in 2022; whereby women constituted 79.5% of the victims, with domestic violence being the most reported cases and perpetrators were 83.3% male. In regards to the types of violence: 50% was physical, while the remainder involved psychological abuse, sexual violence, and financial neglect. Among female victims of domestic violence, 84.4% experienced emotional abuse that led to chronic depression.
Jika keluarga sehat mental, Indonesia tidak hanya produktif, tapi juga manusiawi.
When families are mentally healthy, Indonesia will not only be productive, but also humane.
Samsuridjal Djauzi
