2007 there were only 0.46 per mile. The highest
prevalence of severe mental health problems occurred
in Jakarta (20.3 per mile) (Riskesdas, 2013). This
figure tends to keep increasing considering the rising
complexity of social problems faced by Indonesian
citizens such as poverty, unemployment, crimes,
disasters, and political instability as well.
Based on the result of interviews with PwMD and
the family of PwMD, it was found out that the decline
of productivity and quality of life is worsened by
stigma and discrimination experienced by the PwMD
and the family. PwMD are very liable to encounter
varied stigmatizations and discriminations from
society members. These may include being dropped
out of school, fired from the office, divorced by the
spouse, ignored by the family, locked the legs with
woods or chain and also defrauded (Depkes, 2014)
A research finding carried out in Australia
discloses that the major factor to improve the life of
mentally retarded people is to reduce stigma. It was
exposed in a national interview by SANE Australia
during the Mental Health Week in October 2000. The
survey reveals that the misunderstanding of mental
health problems and discrimination greatly influences
all aspects of human life including the treatment
provided by mental health service agency (Carr and
Halpin, 2002).
The Low Prevalence Disorders Study (LPDS)
pointed out that 15.3% people with psychotic disorder
(17.2% male and 12.4% female) did not feel secured
in their own place. Besides, 17.6% reported that they
had gotten physical violence, been tortured and
bullied within the last twelve months, and 13.2%
indicated that they were expecting to have assistance
from police or others, yet to no avail (Carr and Halpin,
2002).
Social isolation widely spread among the
sufferers of psychotic disorder. LPDS also indicated
that 63.5% of the single participants, 31.3% lived
alone and did not actively participate in the family
programs. Almost 40% reported that they did not
have any one to whom they could share their burden,
and 44.9% thought that they needed a close friend.
Then, there were only few participants of LPDS
reporting satisfactory sexual intercourse (Carr and
Halpin, 2002).
2 REVIEW OF LITERATURE
Mental disorder is a maladaptive response upon
internal and external stressors indicated by improper
thought, feeling and behavior against the norms and
disturbing social relations, job as well as physical
functions (Stuart, 2009). In addition, Videbeck (2006)
affirms that mental disorder is a sort of syndrome or
someone’s psychological pattern or behavior
clinically related to the presence of distress and
disability or the death risk. In conclusion, mental
disorder is the presence of maladaptive responses
indicated by cognitive, affective, physiological,
behavioral and social individual judgment.
The causes of mental disorder are very complex,
multi-causalities, not only related to social problem
as previously suggested. It can also be caused by
biological, psychological, socio-cultural and spiritual
factors.
The greatest hindrance in handling this problem is
stigma or the response of society upon the mental
disorder itself. The term ‘stigma’ here means sign,
sign of disgrace or to discredit; and ‘to stigmatize’
means to label someone socially unacceptable or
shameful. The consequences of being stigmatized
include shame, humiliation, isolation and desperate.
The burden is even worsened by the unfairness of
treatment. This case is not only about the attitude of
society and the efforts to change it but also related to
human rights. Likewise, discrimination, prejudiced-
based treatments, is also related to human rights and
is not tolerable to occur within the society upholding
the commitment of justice for all (Carr and Halpin,
2002).
The main focus of treating the symptoms of
PwMD is aimed at improving the quality of life.
Unfortunately, personal experience of being
stigmatized which surely affects the quality of life is
not becoming the priority of treatment given by either
the society or the mental health professionals. As a
matter of fact, Reports of National Investigation on
the Human Rights of People with Mental Disorder
recorded that PwMD experienced the awful stigma
and discrimination almost in every aspect of their
lives (Carr and Halpin, 2002).
Furthermore, stigma tends to intensify and
strengthen the practice of social isolation, limit the
equal chance for job and recreation (Markowitz,
1998), hamper the search for assistance activity
(Sartorius 1998), create, affirm and nurture the
mythology of pseudo-mental, often internalized by
people with mental disorders which may cause a lot
of pains (Markowitz, 1998). Even though PwMD are
able to describe their personal experiences of being
stigmatized, health mental nurses and professionals
are often hard to prove that the experience took place
as the direct impact of negative attitude or
discriminative actions (Carr and Halpin, 2002).
Sartorius (1998) further asserts: “... stigma and
discrimination are the most significant obstacles in
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