Unlocking Wellness: Navigating Provisions on Mental Health under GR 28/2024
On 26 July 2024, the Government of the Republic of Indonesia issued Government Regulation No. 28 of 2024 (“GR 28/2024”), an implementing regulation of Law No. 17 of 2023 on Health (the “Health Law”). GR 28/2024 encompasses a broad scope of provisions concerning the implementation of the stipulations outlined in the Health Law.
This Newsflash focuses on incentives for mental health provision, specifically addressing the rights, mental health efforts, and protection of individuals with mental disorders.
Previously, the regulation on mental health was governed under Law No. 18 of 2014 on Mental Health (the “Mental Health Law”). However, the Mental Health Law is revoked and replaced by the Health Law. The issuance of GR 28/2024 aims at strengthening the protection of rights and enhance mental health services in Indonesia since mental health issue remains a critical and growing concern in Indonesia.
♦ Background
The Health Law describes mental health as a condition in which an individual may develop physically, mentally, spiritually, and socially so that the individual is able to recognize his/her own abilities, manage stress, work productively, and contribute to the community.
Mental health efforts are provided proactively, in an integrated, comprehensive, and continuous manner to ensure that everyone may lead a high-quality life, maintain mental well-being without fear or disturbances, and have the opportunity to develop their various intellectual and psychological potentials. Mental health efforts shall be given to People at Risk, People with Mental Disorders, and the society.
♦ Rights of People at Risk and Individuals with Mental Disorders
Under GR 28/2024, People at Risk are defined as individuals having physical, mental, social, economic, developmental, and/or quality of life challenges, which place them at the risk of experiencing mental health issues. While People with Mental Disorders (in Indonesian, Orang dengan Gangguan Jiwa or “ODGJ”) are defined as individuals who experience disturbances in thoughts, behavior, and emotions that manifest as a set of symptoms and/or significant behavioral changes, which can cause suffering and impair their ability to function as a human being, and who are diagnosed with a mental disorder according to established diagnostic criteria.
People at Risk and ODGJs have the right to access mental health services that are easily reachable and meet established standards. They are also entitled to receive honest and complete information about their mental health data and medical actions from healthcare professionals. Additionally, they have the right to an encouraging environment for mental development, protection from all forms of discrimination and stigma, and equal rights as other Indonesian citizens.
Furthermore, ODGJs have the right to access psychotropic medications as indicated by their medical conditions, to give consent to medical actions (except under certain conditions), and to be protected from neglect, violence, exploitation, discrimination. They are also entitled to have their social needs met according to their mental disorder and to manage their own property.
♦ Mental Health Efforts
The mental health efforts provision is one of the new provisions introduced in GR 28/2024. Mental health efforts shall be carried out through promotive, preventive, curative, and/or rehabilitative efforts.
- Promotive Mental Health Efforts
Promotive mental health efforts, as outlined in Article 150, aim at (i) maintaining and enhancing the community’s mental health, (ii) eliminating stigma and discrimination against ODGJs, (iii) increasing public understanding and involvement in mental health, and (iv) improving communication, adaptation, and resilience.These efforts include positive parenting, mental health communication and education, creating supportive environments, and boosting community participation. They are implemented across various settings, including families, communities, workplaces, healthcare facilities, institutions, and media.
- Preventive Mental Health Efforts
Preventive mental health efforts aim to prevent mental disorders and suicide. These efforts include preventing mental health issues, early detection, counseling, initial psychological support, and suicide prevention.Pursuant to Article 153 of GR 28/2024, preventive efforts for mental disorders involve preventing mental health issues and relapses, reducing risk factors, and mitigating psychosocial impacts. These efforts are carried out through early detection, counseling, and initial psychological support in various settings such as families, communities, institutions, and healthcare facilities.Furthermore, Article 154 of GR 28/2024 stipulates that preventive efforts for suicide shall include the following:
- Managing risk factors by regulating accurate and responsible reporting about suicide in mass media and social media
- Preventing self-harm thoughts through the development of social-emotional life skills
- Preventing suicide attempts by restricting access to means of suicide, offering counseling via hotlines that provided by the healthcare service facilities, providing support through survivor groups, and addressing physical and mental disorders resulting from suicide attempts.
- Curative Mental Health Efforts
Article 157 of GR 28/2024 provides that curative mental health efforts aim at healing or recovery, reducing suffering, controlling disability, and/or managing symptoms of disease for individuals with mental disorders, including those with addiction, substance abuse, and victims of narcotics, psychotropics, and other addictive substances (the “Individuals with Mental Disorders“) who have been diagnosed by a qualified professional.Moreover, Article 158 of GR 28/2024 stipulates that medical actions for curative mental health efforts for the Individuals with Mental Disorders require written consent from such individuals themselves, except in cases where they are deemed incapable of making the decisions.
- Rehabilitative Mental Health Efforts
The rehabilitative mental health efforts include:- Psychiatric/Psychosocial Rehabilitation:
Psychiatric or psychosocial rehabilitation may involve pharmacotherapy, psychotherapy, psychoeducation, independent living skills training, and providing psychological support to both Individuals with Mental Disorders and their families. - Medical Rehabilitation:
Medical rehabilitation is carried out by providing physical therapy based on the needs of Individuals with Mental Disorders. - Social Rehabilitation:
Social rehabilitation focuses on enhancing social skills and establishing and maintaining social support systems for Individuals with Mental Disorders.
- Psychiatric/Psychosocial Rehabilitation:
The rehabilitative mental health efforts aim at preventing or controlling disability, restoring social and occupational functioning, and preparing the Individuals with Mental Disorders for independent living within the community.
♦ Protection of People at Risk and ODGJ
In GR 28/2024, the protection of People at Risk and ODGJs is explicitly addressed. Article 161 of GR 28/2024 stipulates that any forms of restraint, neglect, or violence against People at Risk and ODGJs is strictly prohibited.
Furthermore, GR 28/2024 provides the measures for addressing these actions, including initial management, release, referral, and prevention of repeated restraint cases.
AKSET
Please contact Johannes C. Sahetapy-Engel (jsahetapyengel@aksetlaw.com), Thomas Peter Wijaya (twijaya@aksetlaw.com), or Azzahra Saffanisa S. (asudiardiputri@aksetlaw.com) for further information.
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