Mental Health Research Role in Global World

Sri Idaiani

National Institute of Health Research and Development, Ministry of Health, Indonesia

Keywords: Mental Health Research, Health Policy, Quality, Priority.

Abstract: The role of mental health research is very important to support health programs. Health programs should be

developed and evaluated based on scientific evidence. Not all research results could be used for health

planning and policy. Many studies stop until the report finished or only in the form of articles published.

There is one more step that is translating the results of the research into a policy brief therefore it could be

used as a reference for developing the program. To formulate the policy, the research should have a good

quality, in line with priority topics and using good research principles.

1 INTRODUCTION

Research is a systematic, rigorous investigation of a

situation or problem in order to generate new

knowledge or validate existing knowledge. Health

program is any activities to improve, maintain, and

restore health. Mental health research is any research

within the field of mental health. The role of

research is very important in the current

development both at global and national level.

The health programs should be based on

scientific evidence, as well as the evaluation of a

program should be implemented through a research.

Not only that, the evaluation of the economic aspect

has also become an integral part of research.

Programs should have a good clinical effectiveness

and economically affordable. Currently the research

results are developed to be cost effectiveness, cost

utility, cost benefit and budget impact analysis

studies.

In developed countries which have a sufficient

research budget, research has become a necessity.

Contrary in developing countries, research is often

not a priority therefore there is no adequate budget

for research. Even in developed countries though,

mental health research budget is much smaller than

the research budget for other diseases (Ahmed and

Mari, 2014).

In mental health field, the approach is different

from other diseases such infectious diseases. Mental

disorder and mental health problems have not direct

impact on mortality, but have impact on the burden

of disease and decrease productivity including

disability. Based on burden of disease analysis,

neuropsychiatric disease and substance abuse

provided a considerable burden. The depression

disorder occupied the sixth rank of contributor to the

disease burden caused by the disease calculated by

the years live with disability (YLDs) (IHME, 2016).

Another problem is the quality of researches is not

sufficient therefore it can’t be translated into the

health policy. The following will be discussed about

the research points in the global (international) and

national situation.

2 CURRENT SITUATION

Determinants of mental health are not only

individual attributes but also social, culture,

political, economic, environmental factors such as

national policies, social protection, working

standards, living condition etc. Besides the

determinants there are vulnerable groups such as

people living in poverty, people with chronic health

condition, infants and children exposed to neglect,

adolescent exposed to substance use, indigenous

group, minority group, older people, people

experiencing discrimination and human right

violation, prisoners, people exposed to conflict or

natural disaster, gay, bisexual, etc (WHO, 2013).

People with mental disorder have 40-60% greater

chance of premature death. They also have more risk

to get Human Immunodeficiency Virus (HIV)

infection, non-communicable disease such as

cardiovascular disease, diabetes, cancer etc. Mental

Idaiani, S.

Mental Health Research Role in Global World.

DOI: 10.5220/0008585300630065

In Proceedings of the 3rd International Conference on Psychology in Health, Educational, Social, and Organizational Settings (ICP-HESOS 2018) - Improving Mental Health and Harmony in

Global Community, pages 63-65

ISBN: 978-989-758-435-0

disorder leads people or their family into poverty

and their civil and political right is often ignored

(WHO,2013).

Treatment gap for severe mental disorder is

around 76-85 % in high income countries (HIC) and

around 35-50% in low middle-income countries

(LMIC) (Kohn et al., 2004). Annual spending for

mental health is less than 2 USD in HIC and less

than 0, 25 USD in LMIC. These spending are 67%

for mental hospital. Towards the spending will be

better directed to community, general health care

setting, maternal mental health, and promotion,

prevention, rehabilitation program.

Specialist health workers or general health

worker dealing with mental health are insufficient in

LMIC. The ratio population to mental health doctor

and facility is scarce and mental health legislation

has not reached most people with mental disorder.

Countries with mental health law or legislation are

only limited. Non-government institution,

community participatory including groups on

promotion, prevention movement have same

condition as well (WHO, 2017a).

In 2015 dementia affected almost 5% of the

world’s elderly population that is predicted to

increase to 75 million in 2030 and 132 million in

2050. Recent reviews estimated that globally 9.9

million people develop dementia each year. Almost

60% of people with dementia currently live in

LMICs and most new cases (71%) are predicted

happened in those countries (WHO, 2017b).

Essentials medicine for mental disorder is very

limited compared to medicines of communicable

diseases. In Indonesia there are various psychotropic

medicines in the essential medicine list, but the

availability of that medicine in health service is a

problem. In primary health care centres (PHCs)

those medicines are often not available

(WHO,2010).

3 GLOBAL STRATEGY

A good research should have a high quality. The

high quality characterised by existence of expert

review, efficient, effective, accessible, monitoring

and evaluation. Global issues including Sustainable

Development Goals (SDGs), ASEAN Economic

Community (AEC) could be included to show how

important it is to do. Inclusiveness i.e. partnership,

multisectoral approach, community and civil society

participation during the research process will

improve the quality of research.

4 NATIONAL STRATEGY

The important points to consider in developing

proposal or research such as national strategic plan

2015-2019 (Rencana Pembangunan Jangka

Menengah Nasional = RPJMN) and some

Ministerial decree (Peraturan Menteri Kesehatan or

Permenkes). In RPJMN was stated that government

should reach the 50% target of Health Service

Facility Recipient Institution (IPWL= Institusi

Penerima Wajib Lapor) of active narcotics addicted

people in 2019, number of districts or cities

developing mental health strategy in PHCs should be

280 in 2019 and referral regional general hospital

implementing mental health service or psychiatric

service should be 60% in 2019.

Ministerial decree number 5 in 2014 explains

four psychiatric disorders should be treated

thoroughly in PHC level by medical doctor; the

disorders are insomnia, mixed anxiety depression

disorder, psychosis and dementia. Ministerial decree

number 43 in 2016 regulates health minimum

standard or standar pelayanan minimum (SPM)

therefore local government should allocate budget

for mental health in their region. In 2016, the

Ministry of Health launched Indonesian Healthy

Indonesian Program with family approach or

Program Indonesia Sehat dengan Pendekatan

Keluarga (PIS-PK). There are 12 indicators in PIS-

PK and the eighth indicator is about mental health.

PIS-PK was regulated in Ministerial decree number

36 in 2016. Other Ministerial decree such as number

75 in 2015 about PHC and number 57 in 2017 about

physical restraint in people with mental disorder.

Besides those above, there are several situations

influencing health research such as implementation

of universal health coverage in 2014, Law No 18 in

2014 about mental health etc.

5 MENTAL HEALTH RESEARCH

Mental health research is developed with general

principles for research i.e. quality, impact and

inclusiveness. For that purpose, research culture in

research institution should be strengthened. The

capacity of research institution and human resources

should be strengthened as well (WHO, 2012). The

research itself should have a focusing topic and in

priority setting (Sharan et al., 2014). The research

procedure uses standards, guideline or norms i.e.

good clinical practices, (GCP) good clinical

laboratory practices (GCLP), applying ethical

principles etc. The results of research then are

ICP-HESOS 2018 - International Conference on Psychology in Health, Educational, Social, and Organizational Settings

published in high index journal, and another

important thing it should be translated into health

policies (WHO, 2013).

Mental health research or research in general can

be classified by disease approach i.e. epidemiology,

risk factor, aetiology, pathogenesis, therapy, and

prognosis. By system approach is classified as health

policy, health management, health financing, health

service, health empowerment, human resources,

medical devices and drug, health economic, and

social determinant of health. Implementation and

evaluation research are as a part of one of those

approaches.

Another thing is that when conducting research,

researchers must obey the applicable regulations in

the country where the research is conducted. For

research collaborative with foreign parties,

researchers are asked to carry out the procedures set

by the government through the Ministry of Research

and Technology and Higher Education.

6 CONCLUSIONS

Mental health researches and health researches are

an essential in global world. The research priorities

should be directed to support mental health

programs and policies. A major effort is needed to

ensure all countries and institutions use their

resources on a priority setting. The research program

should involve scientific participatory and conduct

transparently.

REFERENCES

Ahmed H.U. and Mari J.D.J, 2014. The role of research in

prevention of mental disorder. Trend psychiatry

pstchoter, 36(1), pp.1-2.

Institute of Health Metric and Evaluation (IHME), n.d.

Country profile: Indonesia [Online]. Available at:

<http://www.healthdata.org/indonesia> [Accessed 29

January 2019].

Kohn, R., Saxena, S., Levav, I., and Saraceno, B., 2004.

The treatment gap in mental health care. Bull World

Health Organ, 82, pp.858-866.

Sharan, P., Gallo, C., Gureje, O., Lamberte, E., Mari, J.,

Mazzotti, Patel, V., Swartz, L., Olifson, S., Levav, I.,

Francisco, A. D., Saxena, S, and WHO-Global Forum

for Health Research Mental Health Research Mapping

Project Group, 2009. A Survey of Mental Health

Research Priorities in Low- and Middle-Income

Countries of Africa, Asia, and Latin America and the

Caribbean. Br J Psychiatry., 195(4), pp.354-363.

The Ministry of Research, Technology and Higher

Education, 2017. Research permit procedures for

foreign universities, research and development

institutions, companies and individuals, regarding

research and development activities in Indonesia

World Health Organization (WHO), 2010. Introduction

and objectives of the handbook. Monitoring the

building blocks of health systems: a handbook of

indicators and their measurement strategies. Geneva.

World Health Organization (WHO), 2012. WHO strategy

on research for health. Geneva: WHO Press.

World Health Organization (WHO), 2013. WHO Mental

health action plan 2013-2020. Available at:

<www.who.int/mental_health/action_plan_2013/en/>

[Accessed 18 November 2018].

World Health Organization (WHO), 2017a. Mental health

atlas [Online]. Available at:

<http://www.who.int/mental_health/evidence/atlas/pro

files/en/> [Accessed 18 November 2018].

World Health Organization (WHO), 2017b. Global action

plan on the public health response to dementia 2017–

2025, Geneva.

Mental Health Research Role in Global World