فقر و سلامت روان در اندونزی

Community and facility studies in developing countries have generally demonstrated an inverse relationship between poverty and mental health. However, recent population-based studies contradict this. In India and Indonesia the poor and non-poor show no difference in mental health. We revisit the relationship between poverty and mental health using a validated measure of depressive symptoms (CES-D) and a new national sample from Indonesia – a country where widespread poverty and deep inequality meet with a neglected mental health service sector. Results from three-level overdispersed Poisson models show that a 1% decrease in per capita household expenditure was associated with a 0.05% increase in CES-D score (depressive symptoms), while using a different indicator (living on less than $2 a day) it was estimated that the poor had a 5% higher CES-D score than the better off. Individual social capital and religiosity were found to be positively associated with mental health while adverse events were negatively associated. These findings provide support for the established view regarding the deleterious association between poverty and mental health in developed and developing countries.

Mental disorders are becoming a major burden for developing countries (WHO, 2001), where approximately 7% of the total burden of disease in 2010 is accounted for by various forms of mental and behavioural disorder (5% in 2000, 4% in 1990; IHME, 2013). It is estimated that the prevalence of common mental disorders in developing countries is as high as 20–50% in community and out-patient samples (Patel, Araya, de Lima, Ludermir, & Todd, 1999) or approximately 6–7% among the general population (Rai, Zitko, Jones, Lynch, & Araya, 2013). Yet among diagnosed cases, only 15–25% receive proper treatment (WHO, 2004) and the average amount of public investment in the mental health sector is just under 1% of the total health expenditure of many developing countries (Patel, 2007).