Saiful Anwar
Public Health Nursing Inpatient Sidomulyo

A. Problem Analysis

 1. What was the problem before the implementation of the initiative?
Any problems encountered prior to the implementation of this initiative? The situation before the carried out activities of community mental health: Many people do not know about mental health so that if there are mental patients thought they possessed continue to be brought into the paranormal, many patients ganggun soul in people who are not netted or not recorded so that they do not get treatment, psychiatric patients who never went to the Hospital of the psyche of many who drop out of medicine because of the range to the mental Hospital very much and memebutuhkan a huge cost to get there, while most of the families of mental patients are people with low income, so that the recurrence rate is high, the patient's family does not understand how to care mental patients they pay less attention in taking the medication. The main issues that need to be resolved to provide education on mental health in the community, Networking mental patients, nursing care of patients and families of patients with mental disorders and the treatment of mental patients. "Describe the situation that existed before the initiative began, at most 500 words. What are the main issues that need to be resolved? Which social groups, as the poor, the illiterate, the disabled, the elderly, immigrants, women, youth, ethnic minorities, were affected and in what way "

B. Strategic Approach

 2. What was the solution?
Who has proposed solving mental health problems that Ka.UPT Sidomulyo Inpatient Health Center, Cross-sectoral especially community leaders who feel disturbed by the presence of mental patients, especially patients with severe mental disorders that destroy society. The initiatives that we have implemented is to advocate with South Lampung District Health Office and Head Sidomulyo regarding our proposals in the implementation of community mental health. To disseminate to the village heads, community leaders about mental health, providing training to health care workers in health centers Inpatient Unit Sidomulyo regarding mental health, especially how to find out the early signs and symptoms of mental patients. Collaborated / MOU with the Mental Hospital (RSJ) Lampung province in order to attempt the implementation of community-based mental health program on April 27, 2011.

 3. How did the initiative solve the problem and improve people’s lives?
"At most 600 words, a summary of what the initiative is about and how this initiative has solved the problems encountered. Also describe strategies that have been carried out, including the main objectives and the target group. " UPT Inpatient Health Center Sidomulyo District of Sidomulyo South Lampung regency as a responsible health care, want to ensure that health workers in UPT Inpatient Health Center Sidomulyo can serve all the needs of public health, but the limitations of the Human Resources and Dana have difficulty in meeting community needs for health physical and spiritual. Starting from the village of Cultivation Simulyo District of South Lampung regency, with the support of the Village Head direct, supervise and care for community members who experience mental illness. With these activities social problems to do with individual behavior disorders who experience mental illness can be reduced. Strategy success of the Programme Implementation and Application of Nursing Families initiated on stakeholders, to hold discussions on Standards of Mental Health Services. In the discussion of cooperation between the family and health centers are introduced as solutions to problems of mental health by the relevant authorities and supported by the parties. Adequate support to this initiative facilitates the perpetrators to immediately be able to take part in order to meet the challenge. The approach to tradition and local culture rangkamerubah become very important in people's behavior contributed significant successes this Community Mental Health Program at the quality of mental health care provided by the Government.

C. Execution and Implementation

 4. In which ways is the initiative creative and innovative?
Inisiarif implementation of Community Mental Health Program at the community health center is based on the idea of how to creatively tackle the situation difficult and controversial because it involves local culture, tradition is entrenched, the role of family, community and health workers. The involvement of the parties there to participate in Community Mental Health Program proved to be very successful. Families and communities are the guidance given by officials from both health centers and from Lampung Province Mental Hospital. The situation escalated into a liquid and all parties merasamenjadi part of the process changes. For this to continue to happen, then the members of the family, community and health workers make menjelaskantentang kesepakatn the duties and functions of each party. Similarly, people can continue to monitor the course of this initiative and berpartisipai actively in its implementation. "At most 200 words, illustrate what makes this initiative unique and how this initiative has been solving problems in ways new and different. Mention creative approaches and innovative to make this initiative succeed. "

 5. Who implemented the initiative and what is the size of the population affected by this initiative?
Describe the organization through the which the program is administered and how many people it benefitted. Community Mental Health Program Initiative with families and communities strategy and implemented according to the following action plan: 1. Identify the mental health issues that exist in every individual, family and society one of the first steps in implementing the action plan is to conduct focus group discussions with stakeholders from government and non-government mengidentikasi masala mental health problem and its solution. One of the problems related to mental health is the lack of knowledge of the family and the community in providing mental health services in the community. Various stakeholders present in the discussion, including the head of the health center, the Village Head, Community Leaders, Religious Leaders and Officers of Lampung Province Mental Hospital. 2. Coordination of information to follow up the discussion, the main issues discussed was delivered to officials is important in South Lampung Health Office. As a result the relevant Department decided to support the Community Mental Health Program and seek advice yng built daripemangku related interests about how to verify the processes of participation in the implementation of the program. 3. Signing of Cooperation Agreements. After discussing the terms of the agreement, families, communities, health centers and personnel officers Mental Hospital was inaugurated with the signing of the cooperation agreement which was witnessed by officials of the Department of Health, Community Health Centers, Psychiatric Hospital, Community, Community leaders and village heads. Inpatient Health Center Sidomulyo District of Sidomulyo South Lampung Regency which provides capacity building support and advocacy in the field of mental health services community, in partnership with the Mental Hospital Lampung Province, the village chief and Health Officer and Acting Mental Hospital facilitate discussions on a regular basis during the implementation of the initiative , This was done to support relevant stakeholders in the implementation of monitoring and evaluation in order to measure the impact of community mental health programs and opportunities for further development. On the implementation of monitoring and evaluasiProgram Community Mental Health of all elements of both the Department, Community leaders and families are actively involved, as did visits to the home (Home Care) together with the Officers of the Health Center and the Mental Hospital. To implement the Community Mental Health Program, families and communities and the various stakeholders to provide facilities to support this initiative: 1. Families provide a place for therapy patient and willing to release stocks. 2. The Department of Health and Mental Hospital to provide medical personnel and medicines. In addition to the resources above, parties that support the implementation of the Community Mental Health Program also involves other resources, including: 1. Health Agency of South Lampung. 2. Home Life Sakir Lampung Province. 3. Inpatient Health Center Sidomulyo 4. Responsibility Program of Mental Health Inpatient Health Center Sidomulyo. 5. Family. 6. Community. 7. Community Leaders, Religious Leaders and Print and Electronic Media. All sunber power mentioned above play an active role in supporting and encouraging the implementation of the Community Mental Health Program at UPT Puskesmas Sidomulyo. This commitment is enhanced through a series of activities coordination meetings and workshops. These activities are conducted openly and continuously and general nature. It is expected to build a common understanding among families and communities. One of the outputs is important that the basis for the establishment of Community Mental Health Program is the Cooperation Agreement between the UPT Puskesmas Inpatient Psychiatric Hospital Sidomulyo with Lampung Province. Exodus has contributed to the success of the Community Mental Health Program are: 1. With the collection of mental patients in each village can be netted and recorded. 2. With home visits and psychiatric patients drug delivery to the patient's home lots patients who did not drop out of medicine, as well as offset the cost of the patient's family since it no longer taking medication to RSJP Bandar Lampung, 3.With the dissemination of the mental health community to know about mental health so that if there are people who qualify as mental disorders they immediately took him to the health center, 4. With the extension of nursing care or family with mental patients reduce recurrence of patients since the family began to care about the mental patients and always bring medication to the clinic if the drug out. 5. Facilitate ambulance to refer severe patients and new patients to the Mental Hospital Lampung Province 6. adanaya visit from Tim Lampung Province Mental Hospital every Wednesday every fortnight to the health center as a consular team. To better understand the implementation of the Community Mental Health Programme and to monitor, mengevalausi progress achieved on a regular basis, then UPT Inpatient Health Center Sidomulyo conduct regular evaluation and consultation to the Mental Hospital on a regular basis in accordance with the letter of agreement. To better understand the implementation of the Community Mental Health Programme and to monitor, mengevalausi progress achieved on a regular basis, then UPT Inpatient Health Center Sidomulyo conduct regular evaluation and consultation to the Mental Hospital on a regular basis in accordance with the letter of agreement. In addition to these, monitoring is also done using the following approach: 1. The Health Department and Community Health Center make inforkasi monitoring system to people who experience mental illness. 2. Contact with family, community and society. 3. Home Visits. In addition it has also received complaints from the public, with respect to community mental health services, this is done to facilitate access and improve health center responsiveness to the needs of Community Mental Health services
 6. How was the strategy implemented and what resources were mobilized?
With the mental health problems that exist in the health center, the health center seeks Sidomulyo seeks a mental health program. The strategies that we have implemented in this activity Advocacy with our first Chief Medical Officer of South Lampung then formed a partnership / MOU with the RSJP Bandar Lampung in order to attempt exercising community mental health programs. Both do training of health personnel in health centers Inpatient Unit Sidomulyo, on community-based mental health and the resource person of the team RSJP Bandar Lampung, the third of the socialization of community mental health with intersectoral (TOMA, Kadesh), to four pendatan or netting of mental patients in the community each village, to the formation of a corner five souls in UPT. Inpatient Health Center Sidomulyo to bring in doctors from RSJP Bandar Lampung Every Wednesday the second Sunday of each month that works for consultation and treatment, the five we provide nursing care in patients with psychiatric patients were post treated from RSJP Bandar Lampung and provide follow-up treatment prescription of RSJP Bnadar Lampung, and home visits each month for patients post of stocks or those patients who do not want to take medication and did not want to care with injections skizonoate injection or hallopuridol decanoate injection every 28 days, fetching medication collectively to RSJP Bandar Lampung for patients medicine not available at the health center for patients JAMKESDA and JAMKESMAS (but for 2013 s / d in 2014 we were no longer allowed to bring drugs collectively as the Health Insurance prohibits collective distribution, so that for those patients who the medicine is not available, at the health center patients we refer again to RSJP Bandar Lampung). Recently we tried to set up alert village healthy life in the village cultivation by establishing a cadre of mental health involve the local community, for use in health centers there are grooves treatment of psychiatric patients first patient came ushered keluaraga kind of area health centers Sidomulyo or outside the region to sign up to the window, enter the counseling room or corner the soul (the patient or family anamnesis, physical inspection, counseling, patients are given a simple remedy for patients with mild disorders eg insomnia, restless enough given relaxation therapy, for patients with anxiety, insomnia, withdrawal, no hallucinations treated with medication and amuck more severe patients we refer to RSJP Bandar Lampung.

 7. Who were the stakeholders involved in the design of the initiative and in its implementation?
That has to contribute in the implementation of this activity is Chief Medical Officer of South Lampung who have supported our activities, Ka.UPT Inpatient Health Center Sidomulyo in charge of this program, teams of RSJP Bandar Lampung to cooperate in the provision of training of health personnel and inpatient health centers Sidomulyo become our consular, Cross-sectoral (village heads, community leaders) who are willing to work and to support our programs, mental health programs and its shareholders health center doctor who has been conducting Sidomulyo mental health programs with limited abilities, health officials Sidomulyo inpatient health centers. "At most 300 words, mention anyone who has contributed to the design and / or implementation of this initiative, including relevant civil servants, government agencies, organizations, citizens, NGOs, private sector and others."

 8. What were the most successful outputs and why was the initiative effective?
The activities of our activities that have been successful are: 1. the presence of mental disorder patient data in each village can be netted and mostly we have given the treatment, 2. with their home visits and psychiatric patients drug delivery to the patient's home many patients who do not drop out of medicine, as well as offset the cost of the patient's family since it no longer taking medication to RSJP city float, 3.With the socialization of mental health community know about mental health so that if there is residents who qualify as mental disorders they immediately took him to the health center, 4. with their nursing care or counseling of families with mental patients reduce recurrence of patients since the family began to care about the mental patients and always bring medication to the clinic if the drug out. 5. Facilitate ambulance to refer severe patients and new patients to RSJP Bandar Lampung 6. adanaya visit from Tim RSJP bandar lampung every Wednesday every fortnight to the health center as a consular team. "At most 400 words. Mention at most five concrete outputs that supports the success of this initiative? And how it was answered SDGs " In no more than 400 words list no more than five concrete outputs that illustrate the success of the initiative and its role in advancing the SDGs

 9. What were the main obstacles encountered and how were they overcome?
The main problem we faced in the implementation of the program kesehtana our first mental deficiency as for oral drugs and injection drugs available in the health center we are Hallopuridol 1.5 mg, 5 mg hallopuridol, trihexipenidyl 2 mg, 25 mg Amitriptyline, Resperidon 2 mg, Chlorpromazepine 25 mg, Chlorpromazepine 100 mg, 2 mg diazepam. Meanwhile, we also need Hallopuridol decanoate injection, injection Lodomer (hallopuridol), trifluoperazine 5 mg, Fluoxetine 20 mg, 25 mg Maprotiline, Alprazolam, Clozaril 25 mg. Skizonoate injection for our own procurement using funds Capitation JKN. Secondly there are patients Gannguan souls who do not have families and do not have their identity became homeless we never refer to it twice but relapsed again because no family to care for patients after discharge from RSJP. Inadequate health workforce overall because they can not visit the patient's home to provide family nursing care to patients with mental disorders. Most patients with mental disorders are a family can not afford, do not have a vehicle to come to the health center for that we have to deliver medication to the patient's home so that the patient does not drop out of medicine. Treatment of people with mental disorders in conditions of acute need of care and health facilities but after treated in RSJP most communities and families not ready to accept because of the stigma of mental disorders is still strong. Therefore we need to coordinate with social services to empower them, especially for patients with patients who did not have families. "At most 300 words, mentioned description of the main problems faced during implementation as well as countermeasures and solutions"

D. Impact and Sustainability

 10. What were the key benefits resulting from this initiative?
In no more than 500 words, describe the impact of the initiative. Provide concrete example for how the initiative made a difference in the delivery and impact of public services. Describe how the improved delivery of services had a positive impact on the public and Whether and how the initiative, for example, Responded to the needs of people, Notably the poorest and more vulnerable, or promoted social inclusiveness or gender equality, or improved access to public services, or facilitated participation, etc. please provide information on how this impact was measured The results and impact on the community with the community mental health program is the existence of networking and data collection, the mental patients of mental patients in the village will be created and will get treatment, so residents will not be troubled by the mental patients. A reduction in the recurrence rate of patients with mental disorders so that they can take medication regularly and routinely because it can take drugs to health centers Sidomulyo and get a simple service at the health center, the health center is able to provide mental health services through clinics psychiatric consultation and treatment of family health in people with mental disorders so that the family does not feel burdened by the high cost of taking the drug to RSJP Bandar Lampung because drug dispensing can be carried out in health centers Sidomulyo. PHC facilitates ambulance to refer patients with mental disorders city RSJP to float, so that people are not hard difficult to rent a car outside.

 11. Did the initiative improve integrity and/or accountability in public service? (If applicable)
(If applicable) In no more than 400 words, explain Whether and how the initiative improved integrity and / or diminished corruption in public service. Also explain Whether and how the initiative made it Easier for people to hold the government accountable on the delivery of public services. Please provide information on how this impact was measured Invites the public to participate in the detection of diseases and guard against the emergence of community mental health problems, alert to the emergence of mental health problems in the community, Empowers people to be willing and able to live a healthy life is therefore in the development of the necessary steps educative approach is an attempt to assist the communities to undergo a learning process being a process of solving problems in a natural.

 12. Were special measures put in place to ensure that the initiative benefits women and girls and improves the situation of the poorest and most vulnerable? (If applicable)
Has the initiative had a formal evaluation (The system is implemented for monitoring progress and evaluating the activities?) / In no more than 300 words explain Whether the initiative had a formal evaluation and highlights key findings. Also provide information on how the initiative Actively sought and incorporated citizens' feedback.

Contact Information

Institution Name:   Public Health Nursing Inpatient Sidomulyo
Institution Type:   Local Government  
Contact Person:   Saiful Anwar
Title:   COMMUNITY MENTAL HEALTH PROGRAM  
Telephone/ Fax:   081279425114
Institution's / Project's Website:  
E-mail:   sidomulyopuskesmas@gmail.com  
Address:   Sidomulyo
Postal Code:   Sidomulyo
City:   Lampung Selatan
State/Province:   Lampung
Country:  

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