PERAN PEMERINTAH DAERAH DALAM MEMPERKUAT

PERAN PEMERINTAH DAERAH DALAM MEMPERKUAT KESEHATAN MENTAL dr. Hasto Wardoyo, Sp.OG (K) Bupati Kulonprogo

DEFINISI KESEHATAN UU.KES. No 36 Tahun 2009 Adalah keadaan sehat baik secara fisik, mental, spiritual maupun sosial yang memungkinkan setiap orang untuk hidup produktif secara sosial dan ekonomis.

UNSUR KESEHATAN PARIPURNA

UU KESWA NO 18 / 2014 • Terwujudnya derajat kesehatan yang setinggi-tingginya. • Perlu berbagai upaya kesehatan termasuk upaya kesehatan jiwa dengan pendekatan promotif, preventif, kuratif, dan rehabilitatif. • Upaya kesehatan jiwa harus diselenggarakan secara

terintegrasi, komprehensif, dan berkesinambungan oleh Pemerintah, Pemda, dan/atau masyarakat.

Tugas Pemda UU KESWA NO 18 / 2014 1

Memberikan kesempatan bagi ODMK dan ODGJ melaksanakan kewajibannya sbg warga negara RI

3

2

Menjamin ketersediaan dan keterjangkauan sumber daya dalam upaya kesehatan jiwa.

Meningkatkan mutu upaya layanan kesehatan jiwa sesuai dengan perkembangan IPTEK

BURDEN OF DISEASE IN INDONESIA 1990 –2010 AND 2015 Year 1990

Year 2010

Year 2015

Increasing/decreasing Burden of Disease

10. Depresi

8. Depresi

8. Depresi

Global Burden Of Disease- WHO NO

1990

2020

1

Infeksi pernafasan bawah

Penyakit jantung iskemik

2

Diare

DEPRESI MAYOR UNIPOLAR

3

Keadaan yang timbul pada periode perinatal

Kecelakaan lalu lintas

4

DEPRESI MAYOR UNIPOLAR

Penyakit Serebrovskuler

5

Penyakit jantung iskemik

PPOK

6

Penyakit Serebro vaskuler

Infeksi pernafasan bawah

2

MASALAH KESEHATAN JIWA DI INDONESIA, DIY & KULON PROGO

Gangguan Mental Emosional (termasuk Depresi & Ansietas)

Gangguan Jiwa Berat (Psikosis) : ODGJ

Riskesdas 2013

Indonesia

DIY

6%

8,1 %

1,7 permil

2,7 permil

Prevalensi Gangguan Jiwa Berat/Psikotik di Daerah Istimewa Yogyakarta No

Kabupaten/ Kota

Jumlah penduduk

PrevaLensi (Permil)

Gangguan jiwa psikotik

1

Kulon Progo

455.222

4,67

1.892

2

Bantul

968.632

4

3.875

3

Gunung Kidul

698.825

2,05

1.433

4

Sleman

1.163.970

1,52

1.769

5

Kota

400.467

2,14

857

DIY

3.637.116

2,7

9.820

Riskesdas 2013

Prevalensi Gangguan Mental Emosional (Termasuk Cemas dan Depresi) di DIY No

1

Kab./kota

Jumlah Penduduk > penduduk 15 tahun (70% )

Kulon Progo 455.222

Preva Lensi

Jml gang. mental emosional

12,1

3.432

8,3

5.628

8,3

4.060

283.665 2

Bantul

968.632

3

Gunung Kidul 698.825

678.042 489.117

4

Sleman

1.163.970

814.779

5,4

4.400

5

Kota

400.467

280.326

11,4

3.196

DIY

3.637.116

2.545.981

8,1

20.622

Kasus ODGJ di Daerah Istimewa Yogyakarta (Jumlah yang membutuhkan rawat inap & yang di Komunitas )

NO

Kabupaten/ Kota

1 Kulon Progo 2

Bantul

3

Gunung Kidul

4

Sleman

5

Kota DIY (total)

Jumlah psikotik

Akut : Perlu rawat inap Di komunitas (10%)

1892

189

1703

3875

388

3487

1433

143

1290

1769

177

1592

857

86

771

9.820

982

8.838

Lima Besar Kasus Gangguan Jiwa Di Kabupaten Kulon Progo Tahun 2016

Skizofrenia berdasarkan golongan Umur di Kulon Progo Tahun 2016

Kasus Skizofrenia Berdasarkan Jenis Kelamin Di Kulon Progo Tahun 2016

Kasus Psikotik Akut Di Kabupaten Kulon Progo Tahun 2016

Kasus Yang perlu pengawasan langsung (Risiko terjadi Pemasungan) NO

TAHUN

JUMLAH

1

2014

22

2

2015

8

3

2016

16

4

2017

19

Peran Pemerintah Daerah • Sesuai dengan UU.Keswa

• Pasal 75 Pemerintah dan Pemerintah Daerah memiliki tugas, dan tanggung jawab terhadap penyelenggaraan Upaya Kesehatan Jiwa.

BAB VII TUGAS, TANGGUNG JAWAB, DAN WEWENANG Pasal 76 1. Pemerintah dan Pemerintah Daerah bertugas dan bertanggung jawab mengadakan komunikasi, 1nformasi, dan edukasi tentang Kesehatan Jiwa kepada masyarakat secara menyeluruh dan berkesinambungan.

2.

Pemerintah dan Pemerintah Daerah dalam mengadakan komunikasi, informasi, dan edukasi tentang Kesehatan Jiwa sebagaimana dimaksud pada ayat (1) wajib berkoordinasi dengan pemangku kepentingan.

3.

Komunikasi, informasi, dan edukasi tentang Kesehatan Jiwa sebagaimana dimaksud pada ayat (1) dapat diselenggarakan dengan melibatkan peran serta masyarakat.

TUGAS, TANGGUNG JAWAB, DAN WEWENANG.....

Pasal 77 Pemerintah dan Pemerintah Daerah bertugas dan bertanggung jawab menyediakan sarana dan prasarana dalam penyelenggaraan Upaya Kesehatan Jiwa.

Pasal 78 Pemerintah dan Pemerintah Daerah bertugas dan bertanggung jawab terhadap ketersediaan dan kesejahteraan sumber daya manusia di bidang Kesehatan Jiwa.


Pasal 79 (1) Pemerintah dan Pemerintah Daerah mengatur ketersediaan obat psikofarmaka yang dibutuhkan oleh ODGJ sesuai standar.

(2) Obat psikofarmaka yang dibutuhkan oleh ODGJ sesuai standar sebagaimana dimaksud pada ayat (1) harus tersedia secara merata di seluruh Indonesia dengan harga terjangkau oleh masyarakat. (3) Ketersediaan, pemerataan, dan keterjangkauan obat psikofarmaka sebagaimana dimaksud pada ayat (2) dapat dilakukan dengan melibatkan peran swasta.


Pasal 80 Pemerintah dan Pemerintah Daerah bertanggung jawab melakukan penatalaksanaan terhadap ODGJ yang terlantar, menggelandang, mengancam keselamatan dirinya dan/atau orang lain, dan/atau mengganggu ketertiban dan/atau keamanan umum.


Pasal 81 1.

Pemerintah dan Pemerintah Daerah wajib melakukan upaya rehabilitasi terhadap ODGJ terlantar, menggelandang, mengancam keselamatan dirinya dan/atau orang lain, dan / atau mengganggu ketertiban dan/atau keamanan umum.

2.

ODGJ terlantar, menggelandang, mengancam keselamatan dirinya dan/atau orang lain, dan/atau mengganggu ketertiban dan/atau keamanan umum sebagaimana dimaksud pada ayat (1) meliputi ODGJ: a. tidak mampu; b. tidak mempunyai keluarga, wali atau pengampu; dan/atau tidak diketahui keluarganya.


Pasal 82 Pemerintah dan Pemerintah Daerah wajib melakukan penampungan di fasilitas pelayanan di luar sektor kesehatan bagi ODGJ yang telah sembuh atau terkendali gejalanya yang tidak memiliki keluarga dan/atau terlantar.

Peraturan Gurbenur Pedoman Penanggulangan Pemasungan 81/2014 Daerah Istimewa Yogyakarta

Pemerintah Daerah bertugas : a.

Membentuk Tim Pengarah Kesehatan Jiwa Masyarakat

b.

Memberikan layanan serta akses komunikasi, informsi dan edukasi yang benar kepada masyarakat tentang kesehatan jiwa

c.

Mengkoordinasikan lintas program dan lintas sektoral upaya penanggulangan pemasungan pada pihak pemangku kepentingan

d.

Menyusun perencanaan, pengadaan dan peningkatan mutu,

penempatan dan pendayagunaan serta pembinaan sumber daya manusia d bidang kesehatan


e.

Menyediakan akses pelayanan yang berkesinambungan meliputi pengobatan, pemulihan, psikososial, rehabilitasi, pendampingan, dan atau dukungan lain yang memadai untuk ODMK atau ODGJ

f.

Melakukan

pembinaan

dan

pengawasan

pelaksanaan

program

penanggulangan pasung kepada Pemerintah Kabupatan / Kota;

g.

Menyediakan pengobatan dan perawatan ODGJ di Rumah Sakit Jiwa, Rumah Sakit, dan Puskesmas ODMK : orang dengan masalah kejiwaan ODGJ. : Orang dengan gangguan Jiwa

Peraturan Gurbenur Pedoman Penanggulangan Pemasungan 81/2014 Daerah Istimewa Yogyakarta h.

Menyediakan panti sosial untuk penempatan sementara bagi

ODGJ paska perawatan.

i.

Menjamin cadangan ketersediaan obat untuk ODGJ;

j.

Mencegah timbulnya stigmatisasi dan diskriminasi bagi ODGJ; dan

k.

Menyusun dan meyebarluaskan panduan praktis tentang penanggulangan pemasungan


Pemerintah Kabupaten/ kota bertugas: a.

Membentuk Tim Pelaksana Kesehatan Jiwa Masyarakat;

b.

Memfasilitasi

pembentukan

kelompok

bantu

diri,

forum

komunikasi, atau kelompok peduli ODGJ;

c.

Menyediakan akses pelayanan yang berkesinambungan meliputi pengobatan, pemulihan psikososial, rehabilitasi, pendampingan, dan/ atau dukungan lainnya yang memadai bagi kepada ODMK atau ODGJ


d.

Meningkatkan jumlah puskesmas yang memberikan pelayanan kesehatan jiwa terutama untuk ODGJ;

e.

Meningkatkan cakupan pelayanan kesehatan jiwa dan ketersediaan tempat pelayanan kesehatan jiwa di rumah sakit;

f.

Menjamin ketersediaan obat untuk ODGJ;

g.

Menjamin ketersediaan peralatan kegawatdaruratan psikiatri

KEGIATAN UPAYA KESEHATAN JIWA DI KULON PROGO

Upaya Kesehatan Jiwa dilakukan melalui kegiatan: a. Promotif b. Preventif c. Kuratif

d. Rehabilitatif

PEMBENTUKAN TPKJM TINGKAT KECAMATAN TAHUN 2017 NO

KECAMATAN

TPKJM SUDAH

1

Temon

V

2

Wates

V

3

Panjatan

V

4

Galur

5

Lendah

V

6

Kokap

V

7

Pengasih

V

8

Sentolo

V

9

Girimulyo

V

10

Nanggulan

V

11

Kalibawang

V

12

Samigaluh

BELUM

V

V

Kebijakan Pemda terhadap pembiayaan pasien jiwa 1. BPJS : pemilik kartu BPJS 2. Jamkesda : penduduk Kulon Progo : a. Pembebasan biaya layanan puskesmas bagi semua warga Kulon Progo b. Pembiayaan rawat inap di RSUD : Rp 7.500.000 juta/orang/tahun

3. Jamkesus (Bapel jamkesos DIY) : pasien yang dirujuk ke RS Grasia dan RS dr Sarjito

DINAS KESEHATAN 1. Pertemuan TPKJM 2. Refreshing keswa bagi dokter umum Puskesmas 3. Refreshing keswa bagi pemegang program keswa Puskesmas 4. Bimbingan teknis ke Puskesmas 5. Pertemuan surveilans keswa 6. Koordinasi penanganan kasus pasung dengan RSJGrhasia

7.Sosialisasi Pergub DIY no 81 tahun 2014 tentang Pedoman Penanggulangan Pemasungan

PUSKESMAS 1. Deteksi dini gangguan jiwa 2. Konseling bagi penderita gangguan jiwa 3. Pengobatan bagi penderita gangguan jiwa 4. Kunjungan rumah ke penderita jiwa 5. Rujukan kasus gangguan jiwa ke RSUD Wates dan RS Grhasia / RSUP dr. Sardjito 6. Pembentukan dan pembinaan Desa Siaga Sehat Jiwa (DSSJ)

3 desa di wilayah Puskesmas Galur II : Banaran, Kranggan, Nomporejo

Puskesmas 7. Pelatihan kader : Puskesmas Temon I, Pengasih II, Pengasih I, Lendah I, Galur II 8. Family Gathering : Puskesmas Galur II, Galur I 9. Self Help Group (SHG) : Puskesmas Galur II 10. Psikoedukasi : Pusk. Galur II 11. Institusi Penerima Wajib Lapor (IPWL) : Pusk. Wates 12. Rehabilitasi rawat jalan bagi pecandu NAPZA : Pusk. Temon I

Bentuk Terapi Rehabilitasi

1. Living Skills (ketrampilan hidup) 2. Learning Skills (ketrampilan belajar) 3. Working Skills (ketrampilan kerja)

RSUD WATES 1. Pengobatan penderita jiwa 2. Konseling 3. Pelayanan Psikologi

4. Rujukan ke RSJ Ghrasia / RSUP dr. Sardjito 5. Menyediakan tenaga ahli untuk transfer of knowledge 6.Bekerjasama dengan dinas kesehatan untuk melakukan pembinaan kesehatan jiwa di masyarakat

7.Melakukan promosi kesehatan jiwa melalui kegiatan PKMRS (Penyuluhan Kesehatan Masyarakat)

Kegiatan Promotif, Preventif,Rehabilitatif RSUD Wates

PAGUYUBAN PANDAWA • Dibentuknya beberapa kegiatan yang positif dalam

mendukung perawatan penderita gangguan jiwa • Meningkatkan pengetahuan keluarga penderita gangguan jiwa • Sebagai sarana promosi kesehatan jiwa kepada masyarakat

• Meningkatkan pengetahuan keluarga pasien gangguan jiwa dalam merawat dan menghadapi pasien

PAGUYUBAN SEHAT JIWA PANDAWA RSUD – WATES Mulai Tahun 2012

Kegiatan Penyuluhan Jiwa di Lingkungan RSUD-Wates

KEGIATAN KUNJUNGAN RUMAH RSUD-WATES

• Dilakukan pada pasien yang mengalami berbagai hambatan dalam pengobatan

PROGRAM 100 HARI KERJA BUPATI

KULON PROGO BEBAS PASUNG

Kasus Pasung Bp. D (Pusk. Lendah II)

Kasus Pasung Bp M(Pusk. Pengasih II)

Kasus Pasung Bp R (Pusk. Wates)

Kasus Pasung Bp. S (Pusk. Kalibawang)

Kasus Pasung Bp S (Pusk. Kokap II)

Kasus Pasung Bp S (Pusk Lendah I)

Kasus Pasung Ny. S (Pusk Nanggulan)

Kasus Pasung Bp T (Pusk Girimulyo II)

Kasus Pasung Bp U (Pusk. Temon I)

KEGIATAN EVALUASI BEBAS PASUNG

BHAKTI SOSIAL HKN KE ODGJ PASCA PASUNG (20-10-2017)

RUJUKAN ODGJ KE RSJ GRHASIA OLEH TPKJM KEC KALIBAWANG ( 3-11-2017)

KEGIATAN KESWA TH 2017 NO

KEGIATAN

FREKUENSI

SUMBER DANA

1

Rakor & pembinaan keswa

2 kali

APBD II

2

Rakor NAPZA

2 kali

APBD II

3

Sosialisasi NAPZA

1 kali

APBD II

4

Sosialisasi keswa

1 kali

APBD II

5

Bimtek keswa

4 kali

APBD II

6

Konsultasi ke Dinkes DIY

7 kali

APBD II

7

Konsultasi ke Kemenkes

1 kali

APBD II

8

Workshop deteksi dini gg. jiwa

1 kali

DAK NON FISIK

9

Evaluasi Target Bebas Pasung

1 kali

DAK NON FISIK

10

Sosialisasi RBM

1 kali/ 2 Puskesmas

APBD I

Rencana Program Peningkatan Pelayanan Kesehatan Jiwa Pemda Kulon Progo

Rencana Program Jiwa

Rencana Program Jiwa

KESIMPULAN • Upaya kesehatan jiwa harus diselenggarakan secara terintegrasi, komprehensif dan berkesinambungan oleh Pemerintah, Pemda, dan Masyarakat agar dapat tercapai terwujudnya derajat kesehatan yang setinggitingginya

Langkah-langkah Pencegahan (Prevention approach and evidence based information about mental heath treatments)

Smoking and Mental Disorder

Indonesia's smoking epidemic 0an old problem gett ing younger Many male smokers now start their habit at age seven, with activists blaming weak regulations and the t obacco industry Kate Hodal in Jakarta Thu 22 Mar 20 12 16.39 GMT

Too Young

A cloud of sm oke hovers above his sm all f ram e, a cigarette dangling at his lips. As he blow s rings high above his head, 14-year-old Faisan explains w hy he has just bough t his third cigarette of the day. "When I have a problem t o solve – and I have so m any problem s at school – I have a sm oke," he says. "It relaxes m e and m akes m e forget." In m ost other coun tries, the f act Faisan is an underage and regular sm oker w ould be startling. But in Indonesia, he is but one of thousands ac ross the archipelago – a nation of islands w here nearly 70% of m en aged 20 and over sm oke, and w here the average starting age has f allen f Indonesia's rom 19 a decade ago t o epidemic just seven 0 t oday, say. smoking an oldactivists problem gett ing

Indonesia's smoking epidemic 0an old problem getting younger

Many maleyounger smokers now start their habit at age seven, with activists blaming weak There is no m inim um age lim it on sm oking or buy ing cigarettes in Indonesia, w hich M any male smokers now start their habit at age seven, with activists blaming weak regulations and the t obacco industry explains w hy vregulations ideos ofand smthe okin g Indonesian t oddlers exist on YouTube – such as that of tw ot obacco industry year-old Sum atran Ardi Rizal, w ho r egularly sm oked 40 cigarettes a day before undergoing Hodal in Jakar ta Kate HodalKate in Jakarta Thu 22 Mar 20 12 16.39 GMT treatm ent. Thu 22 Mar 20 12 16.39 GMT A cloud of rings high

A cloud of sm ok e hovers above his sm all f ram e, a cigaret te dangling at his lips. As he blow s rings high above his head, 14-year-old Faisan explains w hy he has just bough t his t hird sm oke above his sm allt of ram e,anda Icigarette cigarett e ofhovers t he day. "When I have a problem solve – have so m anydangling problem s at at his lips. As he blow s school – I have a sm oke," he says. "It relaxes m e and m ak es m e f orget ." above his head, 14-year-old Faisan explains w hy he has just bough t his third

Too Poor to Smoke

This does not fit between desire and ability

Can not afford health insurance (BPJS) that is only 50 thousand rupiah per month

But ironically able to pay a cigarette that is expensive 300 thousand rupiah per month This is unmet need . with a reason to get happiness because the poor can be happy only through smoking They say: "I do not have luxury homes, luxury cars and can not eat well and recreation"

Cigarettes contributed poverty News : Kompas daily national Media ( July 2017)

We know almost half the population of Indonesia survives on less than US $ 1 a day But cigarettes are the second largest household expenditure

Tobacco control initiative at city and regency level KULON PROGO, YOGYAKARTA, INDONESIA

■ Establishing smoke free area for protecting women and children

■ By local government regulation No. 5/2014: Smoke free area 1. Ban all cigarette advertisement and releasing all existing cigarette advertisement (billboards and banners) 2. Ban all cigarette industries sponsorship for youth activities (music, sports, movies, art, educational, and scholarships) 3. Ban smoking in all public area (schools, religion area, health services, transportation services, government offices) 4. Establishing smoke free area taskforce

RELEASING AND REPLACING CIGARETTE ADVERTISEMENT

. Replacing Cigarette advertisement with health promotion baliho

Tahun 2013 Meningkat

(Orang miskin hidup boros : Rokok & Pulsa Dominan) Tabel 1. Total Pengeluaran Rumah Tangga Setahun Menurut Jenis Pengeluaran dan Quintile Pengeluaran Rumah Tangga di Kulon Progo Tahun 2013

Jenis Pengeluaran (1)

Quintile Pengeluaran Rumah Tangga per Tahun (Rp) Quintile 1

Quintile 2

Quintile 3

Quintile 4

Quintile 5

(2)

(3)

(4)

(5)

(6)

Jumlah (7)

A

Makanan

103,537,507,01 176,229,109,10 228,780,039,51 289,057,089,708 469,691,663,518 1 5 3

1,267,295,408,855

B

Non makanan

48,716,976,452 88,315,402,667

113,726,446,78 195,416,103,888 571,419,273,203 5

1,017,594,202,995

C

Total pengeluaran

152,254,483,46 264,544,511,77 342,506,486,29 1,041,110,936,72 484,473,193,595 2 1 8 2

2,284,889,611,848

1

Alkohol

2

Rokok

3,400,824,210

9,968,989,473 14,701,749,087

3

Sirih

1,989,433,539

2,182,530,305

1,851,662,403

2,556,307,557

1,332,105,162

9,912,038,966

4

Pendidikan

1,933,617,367

6,414,686,580

9,481,439,275

14,319,339,737

60,864,290,035

93,013,372,994

5

Kesehatan

1,954,889,538

7,476,080,984

4,765,496,854

15,351,421,831

43,132,818,824

72,680,708,031

6

Pulsa

1,842,256,763

4,067,417,213

5,574,301,868

9,946,649,874

28,430,289,195

49,860,914,913

0

0

0

0

82,403,316

21,094,943,319 47,408,918,301

Sumber: Survei Sosial Ekonomi Nasional (SUSENAS) 2013, BPS

Perda Kulon Progo No. 5 tahun 2014 tentang KTR (Kawasan Tanpa Rokok)

82,403,316

96,575,424,390

Program pencegahan merokok Di sekolah Kerjasama Pemda Kulon Progo dan Nanyang University

HASIL SURVEI Subyek 1408 siswa kelas 7 di 36 SMP

HASIL SURVEI Subyek 1408 siswa kelas 7 di 36 SMP

Tobacco control initiative at city level KULON PROGO, YOGYAKARTA, INDONESIA Target

Total

Public health

21

Smoke Free Area 21

%

Hospital

6

6

100

Elementary school

368

368

100

Religious facilities

1276

854

67

Government offices

46

36

74

Sub villages

937

16

2

100

This is the result data of the local regulations implementation in Kulonprogo In the schools and health facilities more easily but in other places still need a struggle

Antidepressant medication should not be used to reduce gambling severity in people presenting with problem gambling alone. It is however appropriate to prescribe Selective Serotonin Re-uptake Inhibitors (SSRIs) in people with comorbid depression and gambling disorder, but there is no evidence that this improves gambling outcomes.

Treatment For Gambling Disorder RECOMMENDATIONS The Royal College of Psychiatrists recommends the following:

1. Randomised controlled trials assessing the impact of psychological therapies and medication should be conducted in the UK rather than allowing US-based studies alone to inform clinical practice. The experiences of gambling-related harm and the use of gambling-related products and treatment provision differ widely from country to country, so it would be preferable to base national recommendations on UK-based research. 2. Gambling disorder is a mental disorder that needs to be regarded as an addiction like any other, with significant levels of harm to the individual and to society. Treatment services for problem gambling should have parity of esteem with other mental disorders, in particular alcohol, drug and tobacco addiction, and should be a core element of addictions treatment provision within the NHS. 3. Naltrexone, as the treatment intervention of choice for treatment-resistant pathological gamblers, should be made available to all patients whose lives are affected negatively by their illness. 4. NICE Guidelines for the treatment of gambling disorder are required to address a pathology that affects almost half a million people in England but has not been sufficiently prioritised by the NHS. 5. Training in identifying and treating problem gambling symptoms should be a component of all medical school curricula and the postgraduate psychiatry training curriculum. December 2016

Treatments and wellbeing Readable, user friendly and evidence based information about mental health treatments.

A|B |C |D |E |F |G |H |I |J |K |L |M |N| O| P| Q | R |S| T| U| V| W | X| Y| Z

A Alzheimer's: Drug treatments in Alzheimer's Antidepressants Antidepressants: key facts Antidepressants – coming off antidepressants Antipsychotics

B Being Seen and Heard: CD ROM Benzodiazepines

C Caring for young carers

Eating Disorder

Good Parenting Approach (Pengasuhan)

the earlier reports. Twenty-three services catered for both children and adolescents; 23 for adolescents only; 7 for children and adults (including one treating 13- to 25-year-olds); and 29 for adults only. One service did not provide information on the age range of people treated. The majority of services were led by a consultant psychiatrist (82%). Multidisciplinary teams included a wide range of health professionals, most commonly specialist nurses (81%) and clinical psychologists (76%); 54% of teams had a dietician, 51% had a psychotherapist, 49% had a social worker and 47% an occupational therapist. Therapeutic approaches used by services most often were: for anorexia nervosa – individual cognitive–behavioural therapy (CBT) (84%), nutritional advice and monitoring (82%) and family-based treatment (77%)

Therapeutic approaches

for bulimia nervosa – individual CBT (79%), self-help literature (67%) and selective serotonin-reuptake inhibitors (SSRIs) (65%)

for binge eating disorder – self-help interventions (58%), nutritional advice and monitoring (54%) and individual CBT (54%)

for eating disorder not otherwise specified (EDNOS) – individual CBT (67%), nutritional advice and monitoring (62%) and self-help interventions (54%)

for in-patients – nutritional advice and monitoring (63%), individual CBT (58%) and anxiety management/relaxation (54%).

Of 447 in-patient beds identified in the UK (226 NHS, 221 private sector), 330 (74%) were in specialist units (166 NHS, 164 private sector).

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Rekomendasi dari RC PSYCH Improving the lives of people with mental illness Improving the lives of people with mental illness

Cognitive Behavioural Therapy


This leaflet is for anyone who wants to know more about Cognitive Behavioural Therapy (CBT). It

This leaflet is for anyone who wants to know more about Cognitive Behavioural Therapy (CBT). It

discusses it works, is effects, used, its effects, its and side-effects, and discusses how ithow works, why it iswhy used,itits its side-effects,

alternative treatments. If you can't findcan't what you here, are alternative treatments. If you findwant what youthere want here, there are sources of further information at the endatofthe thisend leaflet. sources of further information of this leaflet.

What is CBT?

What is CBT?

It is a way of talking about:

Improving the lives of people with mental illness

It is a way of talking about:

how you think about yourself, the world and other people how what you do affects your thoughts and feelings.

how you think about yourself, the world and other people


CBT can help you to change how you think ('Cognitive') and what you

how what you do affects your thoughts and feelings.

do ('Behaviour'). These changes can help you to feel better. Unlike some

CBT cantalking help you to change how on you and what you of the other treatments, it focuses thethink 'here ('Cognitive') and now'

This leaflet is for anyone who wants to know more about Cognitive Behavioural Therapy

do ('Behaviour'). changes canonhelp you tooffeel problems and difficulties.These Instead of focusing the causes yourbetter. Unlike some

discusses how it works, why it is used, its effects, its side-effects, and

distress or symptoms in thetreatments, past, it looks it forfocuses ways to improve your state mind now. of the other talking on the 'here andofnow'

alternative treatments. If you can't find what you want here, there are problems and difficulties. Instead of focusing on the causes of your sources of further information at the end of this leaflet. distress or symptoms in the past, it looks for ways to improve your state of mind now. When does CBT help? CBT has been shown to help with many different types of problems. These include: anxiety, depression,

Perencanaan (perumahanlLH) Kota Berwawasan Kesehatan

Perencanaan (perumahanlLH) Kota Berwawasan Kesehatan

....Bedah Rumah murni Gotong Royong tanpa APBD di Kulonprogo

Angka Harapan Hidup di KP tertinggi 75 tahun

PERAN PEMERINTAH DAERAH DALAM MEMPERKUAT

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