The 5th International Conference on Public Health

 

Name of Conference:
The 5th International Conference on Public Health.

Venue and Date:
Best Western Premier Hotel, Solo, Central Java, Indonesia, on February 13-14, 2019.

Theme:
“Promoting Population Mental Health and Well-Being”

Background

1. Definition

Mental health has been defined by the World Health Organization as “a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community”. The positive dimension of mental health is stressed in WHO’s definition of health as contained in its constitution: “Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity” (WHO, 2014).

Mental health is a state of successful performance of mental function, resulting in productive activities, fulfilling relationships with other people, and the ability to adapt to change and to cope with challenges. Mental health is essential to personal well-being, family and interpersonal relationships, and the ability to contribute to the community or society (Healthy People, 2018).

At the other end, mental disorders are health conditions that are characterized by alterations in thinking, mood, and/or behavior that are associated with distress and/or impaired functioning. Mental disorders contribute to a host of problems that may include disability, pain, or death. Mental illness is the term that refers collectively to all diagnosable mental disorders (Healthy People, 2018).

Mental health and physical health are closely connected. It plays a major role in people’s ability to maintain good physical health. Mental illnesses, such as depression and anxiety, affect people’s ability to participate in health-promoting behaviors. If an individual does not have a healthy mental state it will be hard for that individual to live life to the fullest extent (Lando et al., 2006; Healthy People, 2018).

2. Traditional vs. Positive Mental Health Models

Historically, mental health has been viewed as the absence of mental disorder, despite conceptions that health, in general, is something positive and consists of well-being and not merely the absence of illness (Keyes and Simoes, 2012). The Traditional Mental Health Models are dependent on one-dimensional and negative indicators of diagnosis (i.e., psychopathology). Traditional mental health diagnosis generally uses negative psychopathology (PTH) indicator and takes the Diagnostic and Statistical Manual of Mental Disorders (DSM) as standards for psychological diagnosis. As a widely used diagnostic standard, DSM is playing a positive role in diagnosing and treating mental disorder. However, this diagnostic tool just defines whether there is a mental disorder or not in respect to mental health and relates it with negative results (Wang et al., 2011).

Mental health is thus deemed as an inferred by-product of “no mental illness”. Mental health and mental illness are deemed as two opposite poles of a continuum. The research into mental health is restricted in the psychopathology and focuses on mental disorder and neglects the patient’s capacity of self-restoration and self-upgrade (Wang et al., 2011).

On the other hand, the positive mental health views the individual’s overall psychological well-being. Rather than the absence of mental illness, mental health refers to the presence of positive characteristics. It is a positive sense of well-being, or the capacity to enjoy life and deal with the challenges an individual faces. It includes the way the individual feels about self, the quality of relationships, and ability to manage feelings and deal with difficulties (WHO, 2014; Canadian Mental Health Association, 2018; HelpGuide, 2018).

Good mental health is not just the absence of mental health problems. Being mentally or emotionally healthy is much more than being free of depression, anxiety, or other psychological issues (Canadian Mental Health Association, 2018; HelpGuide, 2018).

People who are mentally healthy have (HelpGuide, 2018):

– A sense of contentment
– A zest for living and the ability to laugh and have fun.
– The ability to deal with stress and bounce back from adversity.
– A sense of meaning and purpose, in both their activities and their relationships.
– The flexibility to learn new things and adapt to change.
– A balance between work and play, rest and activity, etc.
– The ability to build and maintain fulfilling relationships.
– Self-confidence and high self-esteem.

These positive characteristics of mental and emotional health allow an individual to participate in life to the fullest extent possible through productive, meaningful activities and strong relationships. These positive characteristics also help the individual cope when faced with life’s challenges and stresses (HelpGuide, 2018).

The Dual-Factor Model of Mental Health (DFM) is a new mental health concept and methodology that is made based on positive psychological concepts and relevant empirical evidences to solve the deficiency in traditional mental health models (Wang et al., 2011). The DFM is aligned with concepts of mental health identified by the World Health Organization (2014) as well as Corey Keyes (2002) description of “flourishing” and “languish”. Keyes conceptualizes health and illness as separate continuums wherein an individual with mental illness may “flourish” and conversely, someone without mental illness may “languish” with less than optimal health.

Traditional mental health models used the one-dimensional perspective and placed the Subjective Well-Being (SWB) and psychopathology (PTH) symptoms on two opposite poles. However, the Dual-Factor Model of Mental Health insists from a more comprehensive perspective that mental health is not the absence of mental illness or the high SWB, but a complete state that integrates the absence of mental illness and the high SWB (Wang et al., 2011).

The Dual-Factor Model of Mental Health emphasizes that mental health is a complete state, which is to overcome the clinical deficiencies in traditional mental health PTH. It changes the one-dimensional model (there is/there is no mental illness) and is a self-improvement in the mental health research field (Wang et al., 2011). Figure 1 shows the dual factor model (DFM) of mental health and mental illness (Wang et al., 2011 based on Keyes and Lopez, 2002).

Figure 1 (1)

The DFM can distinguish the complete state from incomplete state of mental illness and mental health and make diagnosis, which will generate more effective prevention and intervention plans and thus improve the standards on relieving PTH syndromes.  This model not only emphasizes the important role of SWB in mental health, but also advocates PTH indicator. It further emphasizes the unsubstitutability and indispensability of the two indicators (Wang et al., 2011).

Incompletely mentally healthy people have low PTH and low SWB, which is called “vulnerable” by Suldo and Shaffer (2008), or “languishing” by Keyes (2002, 2007) called them as “languishing”. They were always overestimated by traditional mental health models since their PTH symptoms did not reach the PTH diagnosis standards. They were often excluded from the research and the service (Suldo and Shaffer, 2008).

Completely mentally healthy people have low PTH and high SWB, and Keyes (2002, 2007) also called them as “flourishing”. Complete mental health is a state that integrates high SWB and no recent PTH and is the optimal wellness of individuals. Therefore, individuals in this group can perform emotional vitality as well as good psychological and social functions. It can be forecasted that they will suffer no mental illness in the near future (12 months) (Keyes, 2007; Wang et al., 2011).

3. Why Is Mental Health Important?

The magnitude, suffering and burden in terms of disability and costs for individuals, families and societies, due to mental disorders, are substantial. According to  World Health Organization, one in four people in the world will be affected by mental or neurological disorders at some point in their lives. Around 450 million people currently suffer from such conditions, placing mental disorders among the leading causes of ill-health and disability worldwide. Depressive disorders are already the fourth leading cause of the global disease burden. They are expected to rank second by 2020, behind ischaemic heart disease but ahead of all other diseases. The burden of mental disorders is expected to rise significantly over the next 20 years (WHO, 2001).

Mental disorders affect several domains of daily functioning, with considerable limitations in personal and social life, but also with dramatic cutbacks in work productivity. Mood and anxiety disorders were associated with substantial levels of disability. Social, emotional and physical domains were affected (Bonnewyn et al., 2005). Problems with physical health, such as chronic diseases, can have a serious impact on mental health and decrease a person’s ability to participate in treatment and recovery (Lando et al., 2006; Healthy People, 2018).

The poor often bear the greater burden of mental disorders, both in terms of the risk in having a mental disorder and the lack of access to treatment. Constant exposure to severely stressful events, dangerous living conditions, exploitation, and poor health in general all contribute to the greater vulnerability of the poor  (WHO, 2001).

4. Mental Disorders, Stigma, and Human Rights

Mental disorders are inextricably linked to human rights issues. Persons with mental disorders often suffer a wide range of human rights violations and social stigma. In many countries, people with mental disorders have limited access to the mental health treatment and care they require, due to the lack of mental health services in the area in which they live or in the country as a whole (WHO, 2003).

WHO Atlas Survey showed that 65% of psychiatric patients are in mental hospitals  where conditions are extremely unsatisfactory. Many psychiatric institutions have inadequate, degrading and even harmful care and treatment practices, as well as unhygienic and inhuman living conditions. Poor treatment of mentally ill violates their human rights (WHO, 2003; VOA, 2011).

For example, people can be overmedicated to keep them docile and easy to manage. There have been documented cases of people being tied to logs far away from their communities for extensive periods of time and with inadequate food, shelter or clothing. They can be locked in cells or restrained for days and months without food and water, without any human contact and leaving people to urinate and defecate in the very places where they are sleeping (WHO, 2003; VOA, 2011).

Often people are admitted to and treated in mental health facilities against their will. Issues concerning consent for admission and treatment are often ignored, and independent assessments of capacity are not undertaken. This means that people can be locked away for extensive periods of time, sometimes even for life, despite having the capacity to decide their future and lead a life within their community. Inpatient places should be moved from mental hospitals to general hospitals and community rehabilitation services (WHO, 2003).

For example, “pasung”, an Indonesian term refering to a confinement for people with mental illness, remains awfully existent in Indonesia. Being a developing country, a large chunk of less privileged families do not find a better way than chaining mentally ill people or hemming them in somewhere for an unknown time span. Due to lack of eduction and wrong belief, mental illness is sometimes considered as a punishment from Almighty (Azeem, 2013). Figure 2 shows “pasung”, the practice of confinement for people with mental illness (Azeem, 2013).

Figure 2

According to a study, the main reason for increasing practice of pasung in Indonesia refers to the lack of governmental interest in this issue and thereby much of the illness burden is born by the affected families and communities. Government supply of the needed psychiatric assistance is lacking (Azeem, 2013).

5. Prevention and Treatment of Mental Health

Treatments are available, but nearly two-thirds of people with a known mental disorder never seek help from a health professional. Some mental disorders can be prevented; most mental and behavioral disorders can be successfully treated; and that much of this prevention, cure and treatment is affordable (WHO, 2001).

Despite the chronic and long-term nature of some mental disorders, with the proper treatment, people suffering from mental disorders can live productive lives and be a vital part of their communities. Over 80% of people with schizophrenia can be free of relapses at the end of one year of treatment with antipsychotic drugs combined with family intervention. Up to 60% of people with depression can recover with a proper combination of antidepressant drugs and psychotherapy. Up to 70% of people with epilepsy can be seizure free when treated with simple, inexpensive anticonvulsants (WHO, 2001).

The Dual-Factor Model of Mental Health has its practical implications for psychological prevention and intervention. The DFM emphasizes positive prevention and advocates to use the aforesaid two-dimensional (PTH and SWB) classification standard to identify which individual need improve the SWB in order to actively prevent mental illness and which individual need intervention, especially to identify incompletely mentally healthy group and those suffering incomplete mental illness, so as to effectively solve the problem that traditional one-dimensional PTH indicator system eliminates incomplete mental health from prevention and intervention and to make such prevention and intervention more specific and better targeted (Suld dan Shaffer, 2008).

6. Investment in Mental Health

World Health Organization reports that mental health efforts are under-invested. The size and effectiveness of the investment in mental health do not match with the magnitude of mental health burden. Currently, more than 33% of countries allocate less than 1% of their total health budgets to mental health, with another 33% spending just 1% of their budgets on mental health. About 25% of countries do not have sufficient medicines to treat schizophrenia, depression and epilepsy at the primary health care level. There is only one psychiatrist per 100 000 people in over half the countries in the world, and 40% of countries have less than one hospital bed reserved for mental disorders per 10 000 people (WHO, 2001).

As former WHO Director General, Lee Jong-wook, has emphasized it, there is an urgent need to increase investment in mental health including financial and human resources. A higher proportion of national budgets should be allocated to developing adequate infrastructure and services for mental health. At the same time, more human resources are needed to provide care for those with mental disorders and to protect and promote mental health (WHO, 2003).

Investment in mental health should be able to provide services, treatment, and support to the nearly 450 million people suffering from mental disorders larger than they receive at present. This investment should include services that are more effective and more humane; treatments that help them avoid chronic disability and premature death; and support that gives them a life that is healthier and richer – a life lived with dignity. Greater financial returns can be expected from increased productivity and lower net costs of illness and care (WHO, 2003).

As mentioned earlier, the stigma, discrimination, and human rights violations that individuals and families affected by mental disorders suffer are intense and pervasive. At least in part, these phenomena are consequences of a general perception that no effective preventive or treatment modalities exist against these disorders (WHO, 2004).

However, mental health issues can not be addressed by the provision of needed health care alone. Effective prevention can do a lot to alter these perceptions and hence change the way mental disorders are looked upon by society. However, human rights issues go beyond the specific violations that people with mental disorders are exposed to. In fact, limitations on the basic human rights of vulnerable individuals and communities may act as powerful determinants of mental disorders. Hence it is not surprising that many of the effective preventive measures are harmonious with principles of social equity, equal opportunity and care of the most vulnerable groups in society (WHO, 2004).

Examples of these interventions include improving nutrition, ensuring primary education and access to the labor market, removing discrimination based on race and gender, and ensuring basic economic security. Many of these interventions are worth implementing on their own merit, even if the evidence for their effectiveness for preventing specific mental disorders is sometimes weak (WHO, 2004).

As Benedetto Saraceno, Director Department of Mental Health and Substance Abuse, World Health Organization, Geneva, reminds it, the search for further scientific evidence on effectiveness and cost-effectiveness should not be allowed to become an excuse for non-implementation of urgently needed social and health policies. Indeed, innovative methods need to be found to assess the evidence while these programmes are designed and implemented. These methods should include qualitative techniques derived from social, anthropological and other humanistic sciences as well as stakeholder analysis to capture the complexity and diversity of the outcomes (WHO, 2004).

One of the models that has been developed to enhance positive population mental health is to support a flourishing, resilient and healthy community that cares for one another, to research and discuss mental health and wellness, to employ quality resources when required, and to realize positive mental health potential collectively. Specific characteristics of the model are as follows (Concordia University of Edmonton, 2018):

  1. Promoting strategies and programs for mental health and wellness
  2. Reducing stigma through awareness, education, and dialogue
  3. Developing early recognition systems for mental illness
  4. Aligning policies and procedures with the vision for promoting community-wide mental health
  5. Developing sustainable processes and structures to manage issues related to mental illness
  6. Providing direct service and support with individuals suffering from mental illness.

7. Summary

The suffering and burden of mental disorders are sizable and are expected to rise significantly over the next decades. The World Health Organization calls the abusive conditions endured by people with mental health conditions a hidden human rights emergency.

The Dual Factor Model of mental heath can help distinguish the complete state from incomplete state of mental illness and mental health and make diagnosis, which will generate more effective prevention and intervention plans and thus improve the standards on relieving psycho-pathology syndromes.

Stakeholders of population mental health, including government, international agencies, non-government organizations, private sector, health professionals, social organizations, society, academics, and researchers, all together have yet to pay more attention and exert their efforts to address the current and growing mental health challenges.

Aims:

The 5th ICPH seeks to address issues on how to prevent mental disorders in the communities and to improve population mental health by implementation of urgently needed social and economic policies that redress inequity, by creating supportive social environment, and by ensuring access to appropriate, quality mental health services.

Participants:

National and local leaders, social and health policy makers, health planners, public health professionals, psychiatrists, primary care doctors, allied health practitioners, social workers, allied health students, researchers, and academicians.

Programs:

The 5th ICPH consists of four core programs:

  1. Symposium
  2. Workshop
  3. Oral presentation
  4. Poster presentation

Participants of ICPH are welcome to submit abstracts of their research work and present in either the oral presentation or poster presentation formats. Bear in mind that all abstracts of research work in any branch of public health are welcome for submission. The abstracts include but are not restricted to the current ICPH theme “Promoting Population Mental Health and Well-Being”.

The collection of abstracts is published both in printed and electronic forms in the 5th ICPH proceedings 2019. Each abstract is assigned with Digital Object Identifier (DOI) and its metadata are sent to CrossRef. The printed ICPH proceedings are published and distributed to the participants at the time of the conference. After the conference, the electronic ICPH proceedings are downloadable from the ICPH website at www.theicph.com.

ICPH Proceedings  is currently abstracted and indexed in Crossref (with DOI assigned to each abstract or article), OAIster (OCLC/ WorldCat), Indonesia One Search (IOS), Scientific Indexing Services, BASE, Neliti, Google Scholar, CABI’s Global Health, Microsoft Academic Search, Academic Resource Index, ResearchGate, and Index Copernicus International (ICI), and Thomson Reuters. We are making efforts to get it abstracted and indexed in even broader international databases

Reference:

Azeem A (2013). Pasung in Indonesia. http://tiptoevision.blogspot.com/2013/02/pasung-in-indonesia.html. Accessed in November 2018.

Bonnewyn A1, Bruffaerts RVan Oyen HDemarest SDemyttenaere K (2005).The impact of mental disorders on daily functioning in the Belgian community. Results of the study “European Study on Epidemiology of Mental Disorders” (ESemeD) Rev Med Liege. 60(11):849-54.

Concordia University of Edmonton (2018).  Mental health strategy 2017.

https://concordia.ab.ca/wp-content/uploads/2018/04/CUE-Mental-Health-Strategy-Aug-2017-Final.pdf. Accessed in November 2018.

Healthy People (2018). Mental health and mental disorders.

https://www.healthypeople.gov/2020/topics-objectives/topic/mental-health-and-mental-disorders. Accessed in November 2018.

HelpGuide (2018). Building better mental health. https://www.helpguide.org/articles/mental-health/building-better-mental-health.htm. Accessed in November 2018.

Keyes CLM (2002). The mental health continuum: From languishing to flourishing in life. Journal of Health and Social Behavior, 43, 207-222. doi:10.2307/3090197.

Keyes CLM (2007). Promoting and protecting mental health as flourishing: a complementary strategy for improving national mental health. American Psychologist, 62, 95-108. doi:10.1037/0003-066X.62.2.95

Keyes, C. L. M., & Lopez, S. J. (2002). Toward a science of mental health: Positive directions in diagnosis and interventions. In CR Snyder & SJ Lopez (Eds.): Handbook of positive psychology (pp. 45-59). New York: Oxford University Press.

Keyes CLM, Simoes EJ  (2012). To flourish or not: positive mental health and all-cause mortality. Am J Public Health. 102 (11): 2164-2172

Lando J, Marshall WS, Sturgis S, et al (2006). A logic model for the integration of mental health into chronic disease prevention and health promotion. Prev Chronic Dis. 3(2):A61.

Suldo SM, Shaffer EJ (2008). Looking beyond psychopathology: The dual-factor model of mental health in youth. School Psychology Review, 37, 52-68.

VOA (2011). WHO: Poor treatment of mentally ill violates their human rights.  https://www.voanews.com/a/who-poor-treatment-of-mentally-ill-violates-their-human-rights-135370328/149379.html. Accessed in November 2018.

Wang X, Zhang D, Wang J (2011). Dual-factor model of mental health: surpass the traditional mental health model. Psychology. 2 (8): 767-772.

WHO (2001). Mental disorders affect one in four people. http://www.who.int/whr/2001/media_centre/press_release/en/. Accessed in November 2018.

WHO (2003). Investing in mental health. http://www.who.int/mental_health/media/investing_mnh.pdf. Access in November 2018.

WHO (2004). Prevention of mental disorders. Effective interventions and policy options. https://www.who.int/mental_health/evidence/en/prevention_of_mental_disorders_sr.pdf. Accessed in November 2018.

WHO (2014). Mental health: a state of well-being. http://www.who.int/features/factfiles/mental_health/en/. Accessed in November 2018.

 

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INVITED SPEAKERS

Symposium (Day 1):

Professor Helen Herrman (Australia)

President, World Psychiatric Association Professor of Psychiatry, Orygen, The National Centre of Excellence in Youth Mental Health, and Centre for Youth Mental Health, The University of Melbourne. Director WHO Collaborating Centre in Mental Health Melbourne, Victoria, Australia.

The Status of Mental Health Promotion

Professor Joanna Nurse (UK)

Strategic advisor to the InterAction Council advancing a collaborative partnership on “One Health for People and Planet”. Medical doctor and training in primary health care, specialized in public health, and received a PhD in public policy.

Securing our Planet's Health - a Key to Our Own Mental Well-Being

Dr. Anne Claire Stona (France)

Global mental health policy maker and advisor, public health physician, working in France.

Effective Interventions to Reduce Mental Health-Related Stigma and Discrimination in the Medium and Long Term

Professor Nicola Reavley (Australia)

Centre for Mental Health, Melbourne School of Population and Global Health | Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Victoria, Australia

Mental Health Literacy and Mental Health Education Interventions

Professor Malin Eriksson (Sweden)

Professor in Public Health, Department of Social Work, Umeå University, Sweden.

Different Uses of Bronfenbrenner's Ecological Theory for Guiding Public Mental Health Policy and Practice

Professor Mehdi Ghazinour (Sweden)

Professor at Police Education Unit, Department of Social Work, Umeå University, Sweden.

The Relationship between Traumatic Stress, Family Resilience, Individual Resilience, and Mental Health

Prof. Haryono Suyono (Indonesia)

Former Head of the National Coordinating Board of Family Planning (BKKBN). Former Coordinating Minister of Population Welfare, Republic of Indonesia.

The Role of Family Planning Program in Promoting Population Mental Health

Prof. Aris Sudiyanto (Indonesia)

Department of Psychiatry, Dr. Moewardi Hospital/ Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia

Development of Community Mental Health Center in Solo City to Improve Mental Health Promotion and Prevention

Prof. Budi Anna Keliat (Indonesia)

Faculty of Nursing, University of Indonesia, Jakarta, Indonesia

Empowering Community to Stop “Pasung” (Confinement) of the Mentally Ill

Prof. Adang Bachtiar (Indonesia)

Chair of the Advisory Board, Indonesian Public Health Association (IAKMI). Faculty of Public Health, University of Indonesia, Jakarta.

New Approaches to Changing Stigmatized Attitudes and Beliefs towards Individuals with Mental Health Disorders


Workshop (Day 2):

Professor Joanna Nurse (UK)

Strategic advisor to the InterAction Council advancing a collaborative partnership on “One Health for People and Planet”. Medical doctor and training in primary health care, specialized in public health, and received a PhD in public policy.

How to Develop Safe Urban Design to Save Money and Improve Mental Health

Dr. Anne Claire Stona (France)

Global mental health policy maker and advisor, public health physician, working in France.

How to Conduct and Publish Systematic Review/ Meta-Analysis of Health Studies

Professor Nicola Reavley (Australia)

Centre for Mental Health, Melbourne School of Population and Global Health | Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Victoria, Australia

How to Conduct Mental Health First Aid

Professor Malin Eriksson (Sweden)

Professor in Public Health, Department of social work, Umeå University, Sweden.

How to Apply Grounded Theory Approach to Address Mental Health Issues in a Qualitative Research

Professor Mehdi Ghazinour (Sweden)

Professor at Police Education Unit, Department of Social Work, Umeå University, Sweden.

How to Strengthen Family Resilience to Protect Mental Health of Its Members Following Potentially Traumatic Events

Prof. Bhisma Murti (Indonesia)

Chair, International Conference on Public Health. Head, Master Program in Public Health, Graduate School, Universitas Sebelas Maret, Surakarta, Indonesia

How to Apply Structural Equation Model in Stata to Analyze Health Data

Dr. Hanung Prasetya (Indonesia)

Secretary, International Conference On Public Health. Founder and Owner, Sinergy Mind Health Indonesia. International Lisenced Master Practitioner of NLP, from The Society of NLP, USA. Lecturer, School of Health Polytechnics, Ministry of Health, Surakarta, Indonesia.

How to Heal Online Game Addiction

 

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