Following the tsunami in 2004, more than 100 Indonesian and international organizations came together to offer a wide range of mental health and psychosocial support services e.g. support to tsunami survivors, and awareness and demand for services. After most of these agencies left Aceh, Indonesia’s Ministry of Health and the World Health Organization provided leadership to develop sustainable community based mental health services, based on WHO’s Recommendations for Mental Health in Aceh (2005). The main objective was to integrate mental health into the province’s PHC system. The following activities, alongside additional parallel efforts by international organizations, occurred to ensure this objective was achieved:
- Mental health programme planning workshop was organised to build consensus on developing mental health services in PHC and commitment from major stakeholders.
- A training module was developed with the University of Indonesia’s Faculty of Nursing for community mental health nurses on mental health care delivery as the programme would rely on community mental health nurses to deliver the care. Three training levels – basic, intermediate, and advanced – were developed to teach nurses to provide care of people with severe mental health problems and to prevent mental disorders and promote mental health.
- Medical Officers, the Ministry of Health and the Department of Psychiatry’s Faculty of Medicine developed a short refresher course on primary care psychiatry.
- Training and supervision were implemented in 11 of the most affected districts of Aceh. In each district, 10 primary care centres were selected. A total of 110 PHC centres and 220 nurses participated. The nurses were responsible for providing mental health services in their communities.
- Reform executed at the Banda Aceh Mental Hospital by international organisations advocating for open wards instead of locked wards, developing training programmes for doctors and nurses, and establishing a fully equipped epilepsy clinic.
- First psychiatric intensive care unit established in Jantho General Hospital in Aceh Besar, now serving as the model for providing acute inpatient mental health care in a general hospital.
- Two inpatient units established within general hospitals covering patients along the west coast and the central region of Aceh.