PROVISION OF ENVIRONMENTAL HEALTH AND SAFETY FOR PEOPLE WITH MENTAL DISORDERS

2016-11-06

en

Conference or Workshop Item

text

According to the Act of Republic of Indonesia No. 18 of 2014 about Mental Health, people with mental disorder are those who have disturbances in thought, behavior, and feeling that manifested by a group of symptoms and/or significant behavior changes, and can cause suffering and obstacles in their function as human beings. Data from the Health Department of Yogyakarta Special Region in 2015 showed that the number of visits for mental disorders in health services (community health centers and hospitals) was 72,558 or increase by 56.77 %, compared with that in 2014, i.e. 46,284. Mental disorder is more often studied and attributed to socioeconomic factors rather than to environmental factors that consist of physical, chemical and biological aspects. Biomedical model tends to see mental disorder as a type that the decrease of mental functioning is caused by physical disease or medical condition, instead of a psychiatric disease. Furthermore, mental disorder is frequently associated with brain injury. Physical or mechanical crash on head such as accident, fall, punch, and physical violence can lead to head injuries and brain trauma that may trigger mental disorders. A study that conducted by Orlowska, et al. (2014) in Denmark between 1987 and 2010 on 38,270 people with mental disorders, found that 1,304 (12%) of total people with schizophrenia (10,607) had previous head injury; meanwhile among people with depression (24,605), bipolar disorder (1,859), and organic mental disorder (1,199), the number of cases and percentages with previous head injury were 2,812 (11%), 191 (10%), and 322 (27%), respectively. The data shows the correlation between brain injury and mental disorder is significantly stronger. Chemical pollutants, especially lead and mercury, that enter human body through inhalation, skin, oral and placenta can interfere brain development in fetuses, infants, children, adolescents, adults and elderly people. The toxic metals will be distributed and accumulated in some human organs including the brain. The presence of heavy metals in brain will disrupt the function of nerves and brain. The main sources of lead pollution are paint, fluorescent bulbs, lead acid batteries, electronic waste and metal smelting. Survey that had been conducted in Sleman Regency in 2013 come to results that concentration of lead in used batteries is 12:45 µg/g; in Tube Luminance (TL) fluorescent lamps is 191.69 µg/g; and in Compact Fluorescent Lamp (CFL) is 2,392.54 µg/g. A research conducted by Blacksmith Institute in 2015 at Pesarean Village of Tegal Regency showed that lead level in the soil around the smelters of used lead acid battery and hazardous waste disposal sites were above the regulated threshold. The subsequent inspection of Blood Lead Levels (BLS) for adults in Pesarean showed that the majority (97.8%) of all respondents who are tested showed the levels exceeding the safe limit of BLLs (> 15 µg/g). Based on interviews with Pesarean Village’s officers, it was revealed that as many as 16 people have mental retardation (Down Syndrome) and aged between 2.5 – 30 years old. The study surprisingly found one family that four out of their six children were suffering with physical and mental disorders. Toxoplasma gondii and Plasmodium falciparum are parasites that can infect brain and cause cerebral toxoplasmosis and cerebral malaria. The ability of Toxoplasma to infect brain is thus consistent with this aspect of schizophrenia pathogenesis. Torrey and Yolken in 2003 wrote the results of their research that links between Toxoplasma gondii and bipolar disorder and schizophrenia are existed. They have reported two studies that adults who have schizophrenia or bipolar disorder had greater exposure to cats in childhood. In the first study that employed matched control design, the result showed 84 (51%) of the 165 people with mental disorder had owned a house cat in their childhood, meanwhile in the control group they were 65 (38%) out of 165. In the second study, with same study design, the results were 136 (52%) of the 262 affected versus 219 (42%) of the 522 matched controls owned a cat between birth and age of 13. In this context, the provision of environmental health and safety is needed to prevent and reduce risk factors of brain and mental disorders. Targets of the environmental health efforts are everyone, either healthy people or people at risk or people with mental disorders. Healthy people should be provided with safe and healthy environment in order to avoid and to protect them from the risk factors. In addition, people who are at risk of mental disorders are very sensitive and have high potential to be mentally disturbed. Therefore, the provision of more specific and more sufficient environmental health and safety aspects are essential for prevent the unwanted conditions. For affected people, it is important also that environmental health conditions that could accelerate the healing process and prevent the severity have to be provided. Meanwhile, environmental safety is important to protect the safety of sufferers as well as of the other people. Keywords: environmental health, environmental safety, mental disorder