mental health aid program to tsunami affected countries mental health aid program to tsunami...
TRANSCRIPT
Mental Health Mental Health Aid Aid Program to Program to
Tsunami Affected Tsunami Affected CountriesCountries
Japanese Society of Japanese Society of Psychiatry and NeurologyPsychiatry and Neurology
Tsuyoshi AkiyamaTsuyoshi Akiyama
Inter-Inter-governmental governmental
ConferenceConference April 4, 5 April 4, 5 JakartaJakarta India, MalaysiaIndia, Malaysia ThailandThailand Sri Lanaka, Indonesia Sri Lanaka, Indonesia
Inter-Inter-governmental governmental
ConferenceConference America, Australia,America, Australia, Iran, Japan, TurkeyIran, Japan, Turkey
WHO, UNICEF WHO, UNICEF UNESCO, IOM UNESCO, IOM
India India
Death: Death: 10,697 10,697 Missing: 5,811Missing: 5,811 Affected: 2,880,468Affected: 2,880,468
Malaysia Malaysia
Death: Death: 68 68 Affected: 7,827Affected: 7,827
Thailand Thailand
Death: Death: 5,309 5,309 Missing: 3,810Missing: 3,810 Injured: 10,000Injured: 10,000
Sri Lanka Sri Lanka
Death: Death: 2,846 2,846 Missing: 1,027Missing: 1,027 Injured: 2,375Injured: 2,375 Affected: 250,000Affected: 250,000 Displaced: 70,000Displaced: 70,000
IndonesiIndonesia a
Death: Death: 126,915 126,915 Missing: Missing: 93,063 93,063 Injured: 2,375Injured: 2,375 Displaced: Displaced: 795,385795,385
India India
Psychiatric Symptom 60-80% Psychiatric Symptom 60-80% Grave Psychiatric DisorderGrave Psychiatric Disorder
2,250 2,250 Training Training 110110 TraineeTrainee 4,387 4,387 SessionSession 35,00035,000
ThailanThailand d
Psychiatric SymptomPsychiatric Symptom 100100% % Grave Psychiatric DisorderGrave Psychiatric Disorder
2,3252,325 ClientClient 9,0159,015
IndoneIndonesia sia
Psychiatric SymptomPsychiatric Symptom 9090% %
Indonesia, Sri Indonesia, Sri Lanka Lanka
Lack of PsychiatristLack of Psychiatrist Lack of Primary Lack of Primary Mental Health SystemMental Health System Huge DisasterHuge Disaster Lack of AidLack of Aid
Number of Number of Psychiatrist Psychiatrist
20012001 Population 100,000Population 100,000 United States: 10United States: 10 Japan: 8Japan: 8 Indonesia: 0.21Indonesia: 0.21 Sri Lanka: 0.2Sri Lanka: 0.2
Lack of Primary Lack of Primary Mental Health Mental Health
System System District: No Psychiatrist District: No Psychiatrist Coordination with GeneralCoordination with General Primary Health Care (-)Primary Health Care (-) Local Policy (-)Local Policy (-) Lack of Psychiatric Care Lack of Psychiatric Care
Lack of Aid in Lack of Aid in Aceh Aceh
Conflict Conflict SafetySafety Language DifferenceLanguage Difference Malaysian-Indonesian Malaysian-Indonesian
Aid Aid ProgramProgram
Trauma: OnceTrauma: OnceStress: Stress: ContinuesContinues
Few Years Few Years SystematicSystematic
RecommendationRecommendation
Inter-ministry Inter-ministry CooperationCooperation
Inter-sectoral Inter-sectoral CoordinationCoordination
Public AwarenessPublic Awareness
Psychosocial Psychosocial SupportSupport
Mental Health Mental Health CareCare
Psychosocial Psychosocial AreasAreas
Formal Education Formal Education Non-formal Education Non-formal Education Social and Economic Social and Economic Cultural and Religious Cultural and Religious EnvironmentalEnvironmental
Formal Formal EducationEducation
Group Activities Group Activities Children & ParentsChildren & Parents Teacher Support / Training Teacher Support / Training Curriculum on the Issues Curriculum on the Issues Student Guidance Center Student Guidance Center
Non-formal Non-formal EducationEducation
Community CenterCommunity Center Youth CenterYouth Center Drop-out – Reintegration Drop-out – Reintegration Life SkillLife Skill Vocational Training Vocational Training Peer to Peer Support Peer to Peer Support
Social and Social and Economic Economic
Media Campaign Media Campaign Community Participation Community Participation Income GeneratingIncome Generating Program Program Culturally Appropriate Culturally Appropriate Support Services Support Services
Social and Social and Economic Economic
ContinuedContinued CommemorativeCommemorative ActivitiesActivities Training of Support Training of Support Service Providers Service Providers Lost Documents Lost Documents Legal Support Legal Support
Cultural and Cultural and ReligiousReligious
Training Training Religious Leaders Religious Leaders Community LeadersCommunity Leaders Traditional, Religious Traditional, Religious Healing Healing Community Activities Community Activities
Environmental Environmental ResettlementResettlement On Higher GroundOn Higher Ground ProtectionProtection Re-planting of Mangrove Re-planting of Mangrove Natural or Artificial Natural or Artificial Reefs Reefs
How to How to Strengthen Strengthen
Mental Health Mental Health Care Care
Access to Basic CareAccess to Basic Care All PeopleAll People All Kinds of ProblemsAll Kinds of Problems General Mild Severe General Mild Severe
Important Important IssuesIssues
Anti Stigma Anti Stigma Inter-ministry Cooperation Inter-ministry Cooperation Integration with General Integration with General Health Care SystemHealth Care System Protection to Workers Protection to Workers Information System Information System
4Self and family care
3Community care
2
Primary health care
Specialty mental health services
1
low
low
high
high
Need
CostFrequency of need
MIX OF SERVICES
Adapted from WHO (2003) WHO Dr. Van Ommeren, modified by Akiyama, 2005
Specialty Specialty Sector Sector
MEMBER MEMBER
PsychiatristPsychiatrist PsychologistPsychologist Psychiatric NursePsychiatric Nurse Clinical Social WorkerClinical Social Worker
Specialty Specialty Sector Sector
ROLEROLE
Inpatient/Outpatient Inpatient/Outpatient TreatmentTreatment OutreachOutreach Community TreatmentCommunity Treatment
Specialty Specialty Sector Sector
RECOMMENDATIONRECOMMENDATION
Acute Treatment WardAcute Treatment Ward Community Mental Community Mental Health TeamHealth Team Training to PHC Training to PHC
Primary Health Primary Health Sector Sector
MEMBER MEMBER
General Physician General Physician Nurse Nurse Midwife Midwife Assistants Assistants
Primary Health Primary Health Sector Sector
ESSENTIEL ROLE ESSENTIEL ROLE
Early Detection Early Detection Referral Referral Basic Mental Health Care Basic Mental Health Care Case Follow-up Case Follow-up
Primary Health Primary Health Sector Sector
ADDITIONAL ROLE ADDITIONAL ROLE
Counseling Counseling Psychosocial Education Psychosocial Education Prevention Prevention Inter-sectoral Linkage Inter-sectoral Linkage
Primary Health Primary Health Sector Sector
RECOMMENDATION RECOMMENDATION
Referral System Referral System Family Folder Method Family Folder Method Training Training Supervision Supervision
Community Community Sector Sector
MEMBER MEMBER
CounselorsCounselors TeachersTeachers Self-help GroupSelf-help Group NGO WorkersNGO Workers Community Leaders Community Leaders
Community Community Sector Sector
ROLE ROLE
Early Detection Early Detection Referral Referral Basic Support Basic Support Prevention Prevention Health Promotion Health Promotion
Community Community Sector Sector
RECOMMENDATION RECOMMENDATION
Guideline Development Guideline Development Training Training Supervision Supervision Prevention Prevention Linkage Linkage
Self and Family Self and Family Sector Sector
MEMBER MEMBER
Self Self Family Family RelativeRelative FriendFriend
Self and Family Self and Family Sector Sector
ROLE ROLE
Basic KnowledgeBasic Knowledge DisasterDisaster Mental Health Mental Health Networking Networking
Self and Family Self and Family Sector Sector
RECOMMENDATION RECOMMENDATION
InformationInformation Education / Basic TrainingEducation / Basic Training Peer Support ActivityPeer Support Activity Self-help Group Self-help Group
Japanese Japanese Society Society
Aid ProgramAid Program Fund: Initial PhaseFund: Initial Phase TrainingTraining Primary SystemPrimary System Trauma Care CenterTrauma Care Center
FFund in Initial und in Initial PhasePhase
Malaysian PsychiatricMalaysian Psychiatric AssociationAssociation Japanese BusinessJapanese Business FederationFederation
Training Training
Key PersonsKey Persons
Disaster Preparation Disaster Preparation WHO Model WHO Model SSpecific Programpecific Program
Specific Specific Program Program
According to the InterestsAccording to the Interests
Cognitive Therapy Cognitive Therapy Industrial Mental Health Industrial Mental Health Psychiatric NursingPsychiatric Nursing
Primary Mental Primary Mental Health System Health System
8 Districts in Aceh 8 Districts in Aceh Coordination by WHO Coordination by WHO 1, 2 Districts by Japan?1, 2 Districts by Japan?
Trauma Care Trauma Care Center Center
Center of Excellence Center of Excellence Coordination CenterCoordination Center Selected SitesSelected Sites
Collaboration Collaboration with World Bank with World Bank
Training: Community Sector Training: Community Sector Primary Mental Health System? Primary Mental Health System? Trauma Care Center?Trauma Care Center?