Implementation Services For Psychosocial Rehabilitation. Health is an important part of human life, because if the body is healthy, one can live a productive and quality life. According to the Health Act No. 36 of 2009, health is a healthy condition, both physically, mentally and socially, which allows everyone to live productively socially and economically.
Mental health according to the Mental Health Act No. 18 2014 is a condition where an individual can develop physically, mentally, spiritually, and socially so that the individual is aware of his own abilities, can overcome pressure, can work productively and be able to contribute to his community. Understanding mental health according to WHO that mental health is a condition in which a person is able to understand his potential, able to face life’s challenges, can work productively and be able to contribute to his environment (Anonim, 2001).
A person’s health condition can be disrupted, both physically and mentally. Disorders in a person’s mental condition are called mental disorders. Mental disorders are disorders in thoughts, feelings and behaviors that cause disability in life and cause suffering for someone.
One of the most severe mental disorders that causes disability or hindrance is schizophrenia. Schizophrenic patients often fail in carrying out social functions, face problems related to interpersonal skills, have poor social skills, and experience cognitive function deficits, so that eventually they experience social isolation that causes their quality of life to be bad.
The scope of mental health services is not only a mental disorder but also includes problems related to improving quality of life and psychosocial problems that often occur (Anonim, 2006b). People with mental health problems need psychosocial support in addition to mental health professional assistance.
Law No. 40 of 2009 concerning Hospitals states that mental health efforts are aimed at ensuring that everyone can enjoy a healthy mental life, free from fear, pressure and other disorders that can interfere with mental health. Mental Hospital provides comprehensive services for people with mental disorders, including promotive, preventive, curative and rehabilitative services. Rehabilitation is a series of coordinated efforts consisting of medical, social, educational and vocational efforts, to re-train someone who is a handycap to be able to achieve functional abilities at the highest level possible (Anonim, 1983). Rehabilitative services for people with severe mental disorders including schizophrenia are psychiatric rehabilitation or psychosocial rehabilitation.
Psychosocial rehabilitation is a service activity that aims to help individuals with mental disorders to develop the emotional, social and intellectual skills needed to live their daily lives in the neighborhood. Psychosocial rehabilitation is an effort to restore mental health and improve life skills so that people with mental disorders are able to carry out activities of daily living as well as efforts in the process of social integration, active social roles and improvement of quality of life (Anonim, 2012b). Psychosocial rehabilitation is intended so that people with severe mental disorders can adapt back to the surrounding social environment, be able to be independent, and be able to take care of themselves and not be a burden on the family and society.
Psychological rehabilitation efforts aim to achieve as much physical and mental improvement as possible, placement / distribution in work with maximum capacity, self-adjustment in personal and social relations satisfactorily, so that it can function again as an independent, self-sufficient or independent and useful community member (Anonymous , 1983). The process of psychosocial rehabilitation is carried out in 3 stages: the preparation stage, the placement / distribution phase and the supervision phase, as well as sociotherapy activities. The types of rehabilitation carried out include training in cognitive skills, training in social skills and vocational training (Anonim, 2009c).
Prof. Mental Hospital Dr. V.L. Ratumbuysang North Sulawesi Province has existed since 1934 with the name Door Gangshuis Voor Krankzinmgen, Huise Witte or White House. In 1951, changed its name to the Manado Central Mental Hospital, as the Technical Implementation Unit of the Directorate General of Medical Services of the Indonesian Ministry of Health. In 2000 the Central Manado Mental Hospital was handed over to the North Sulawesi Provincial Government as a follow-up to the implementation of regional autonomy. In the North Sulawesi Provincial Regulation No. 15 of 2002 which regulates the legality of this institution as the North Sulawesi Provincial Government Work Unit then in 2002 the Hospital Management Agency nomenclature was established Dr. V. L. Ratumbuysang. In 2008 the name of the hospital changed again with Regional Regulation No. 4 of 2008, became the Regional Special Hospital of North Sulawesi Province. In 2011, through the Regional Regulation Number 6 of 2011, the name changed again to Rumah
Mental Pain Prof. Dr. V.L. Ratumbuysang North Sulawesi Province.
Psychiatric / Psychosocial Rehabilitation Service at Prof. Mental Hospital Dr. V.L. Ratumbuysang has been implemented since the 1980s, to provide skills to mentally ill patients, especially skills in the field of work (working skills), living skills and learning skills. However, entering the 2000s, these activities began to experience a significant decline after a system change in the government that imposed regional autonomy and this affected the preparation of the budget for psychosocial rehabilitation activities which resulted in a decrease in the quality of psychosocial rehabilitation services. In early 2013, psychosocial rehabilitation services began to be revived because rehabilitation is an activity that is very important for people with mental disorders to restore individuals both their rights and functions as independent and useful citizens and to revive their confidence so that they can improve their quality of life.
Based on factual observations that the author did, it was found that psychosocial rehabilitation services at Prof. Mental Hospital Dr. V.L. Ratumbuysang North Sulawesi province has not been running properly. The stages of the rehabilitation process activities, namely the preparation stage, placement stage and supervision phase as well as sociotherapy activities, have not run optimally so that there are still many people with severe mental disorders who do not have the skills to work, are unable to socialize and are unable to be independent when they return to their family or community, so they will remain a burden for families and communities and become a national burden.
This is evident from the results of the initial survey that the author conducted in November 2014 at the psychosocial rehabilitation installation of RSJ Prof. Dr. V. L. Ratumbuysang, namely data on psychosocial rehabilitation process activities in 2011 to 2014 (October) found that in 2011 and 2012 only Christian worship activities were carried out which was one of the activities in occupational therapy. In 2013 and 2014 there was an increase in rehabilitation services in occupational therapy and the number of rehabilitant / mental patients who participated in the rehabilitation process, namely TAK activities (group activity therapy), art therapy activities, sports therapy activities such as table tennis and badminton, flower arranging activities , ADL therapy activities (activity daily living) and game therapy activities (games), while sports therapies such as soccer and volleyball can not be implemented anymore because the area for sports is increasingly narrow because there are additional mental and non patient care buildings soul. Vocational training (work training) has also not been implemented yet because of inadequate facilities, infrastructure and facilities and the unavailability of special staff to train the work of mental illness sufferers.
Considering the importance of rehabilitation efforts for people with severe mental disorders to restore individuals both their rights and functions as independent and useful citizens, can improve their social skills