EVALUATION OF THE IMPLEMENTATION OF THE MENTAL HEALTH CORNER PROGRAM

AT PUSKESMAS BLAMBANGAN UMPU WAY KANAN 2021

Agnes Yarentine Putri Utami 1 , Samino 2 and Christin AF 3

Email: anesyarentine@gmail.com

ABSTRACT

Purpose : The purpose of this study was to evaluate the mental health corner program at the Blambangan Umpu
Health Center Way Kanan
Methods: Descriptive qualitative. Data collection techniques using in- depth interviews . The research targets were 5
informants consisting of the main informant (Head of Puskesmas) , key informant (performer of the mental health
corner program) and triangulation informants (family of person with mental disorder). Data analysis uses data
reduction, display and verification. The focus of the research includes evaluation on aspects of input,
process, output and outcome .
Results: In inputs component, energy involved is sufficient and has a high educational background, but officers have
not completed the training CMHN . Funds for activities are only sourced from BOK and insufficient funds have
resulted in a lack of outreach activities and data collection and case screening has not been maximized. In the
process component, it is known that program planning activities do not exist in the annual POA, early detection has
not been running regularly. Promotional activities for PWMD families have been running but still need supervision. At
the output component, coverage number of cases is still low , and the data PWMD has not been updated . The
outcome has described the impact of implementation of programs included in the mental health service in some
regions got the same treatment and monitoring so that the level of the patient's recovery is still minimal.
Conclusion : it means that the mental corner program at the Blambangan Umpu Public Health Center has not been
running well. The suggestion is do enhancing supervision, guidance and supervision, allocate proportionate budget,
improve the drug distribution system and equip officers with training CMHN .

Keywords : Evaluation and Mental health corner Program

Bibliography : 20 ( 2010 -2020)

A. Introduction
Currently mental disorders are a problem that occurs throughout the world. World Bank research
in 2015 in a number of developing and developed countries shows the Global Burden of Diseases caused by
mental health problems is 8.1%. Much higher than tuberculosis (7.2%), cancer (5.8%), heart disease (4.4%) or
malaria (2.6%) (Ministry of Health, 2020) . According to research World Health Organization ( WHO ) the burden
of mental illness as measured by productive days lost (DALY / dissability Adjusted Life years ) caused by a
mental health problem in 201 8 by 12.3% (WHO, 2018) .
Based on the Household Mental Health Survey (SKMRT) as quoted in the 2019 Mental Health
Infodatin conducted by the Research and Development Department of Ministry of Health indicates that the
prevalence of mental disorders in Indonesia amounted to 264 per 1,000 members of the household. Up to 2018 in
Indonesia number of people with severe mental illness has been very concern, namely 6 million people, or about
2.5% of the total population of Indonesia that number may be higher still because of mental patients are not
recorded. According to the Indonesian Ministry of Health, (2019) there are 185 out of 1000 adults in Indonesia
showing mental disorders. While mental disorders at the age of 15 years and over is 140 per 1000 people, and at
the age of 5-14 years the prevalence is 104 per 1000 population. Of this number, it turned out that only 8.3% of
patients were willing to seek treatment, most of them were reluctant or did not seek treatment at health facilities
and most of them did not have the money.
Data from Lampung Province Mental Hospital in 2017 recorded as many as 15.427 old cases, in
2018 there were 17.072 old cases and in 2019 there were 18.336 old cases (RSJ Prov Lampung, 2019) . Data
from the Lampung Province Mental Hospital in 2017 saw the addition of 2,044 new cases, in 2018 there were
2,167 new cases, and in 2019 there were 1,949 new cases. Data on the coverage of severe PWMD who received
health services in Lampung Province in 2019 was 67.2%. As for outpatient visits by district in 201 8 most of
Bandar Lampung 5,302, then the District Tanggamus as many as 2,140, 2,032 Central Lampung, South
Lampung 1,941 and the Waykanan by 1 . 131 (Lampung Provincial Health Office, 2019) .
The coverage of visits to mental disorders in basic health care facilities to the total visits to puskesmas
during 2019 in Lampung Province is 57.403 patients (Lampung provincial health office, 2019) . The overall mental
data in Waykanan Regency in 2018 was 487 people, in 2019 as many as 432 people and in 2020 it decreased to
341 people, the data at the same time places the coverage of PWMD patient visits in Way Kanan Regency
relatively low. Data coverage of mental disorders visit the show less than optimal implementing an program life in
Regency Way Kanan. The mental clinic or mental health corner program is not running because the screening or
finding of mental cases is not carried out . The existence of cases of mental disorders, the impact caused and the
lack of good handling must have become a program and even a priority to be able to provide services to those
(communities) who need mental health services and this step is carried out through the implementation of
community-based mental health services. Integrated services that bring specialists and optimizing the mental
health corner of the puskesmas can improve health services for patients with mental disorders.
The application of community-based mental health services at puskesmas should focus
on clinical activities / psychiatric corners in the form of mental health services which should begin to be integrated
with other health programs such as early detection of mental disorders, through home visits and home care in the
detection and treatment of mental disorders. found in their work area and provide follow-up mental health services
by involving families and the community (Pinilih et al., 2015) .
One of the efforts to improve mental health in the community, one of which is in Indonesia, is the CMHN
program. CMHN is a community-based mental health service approach, where all potentials in the community are
actively involved (Permenkes 406, 2009), as well as efforts to realize mental health services with the aim that
patients who are not treated in the community will get better services. The purpose of this study was to identify,
describe and analyze previous studies that examined various applications of CMHN to improve people's mental
health (Winahayu et al., 2014) .
Program can increase public knowledge about mental health, so the impact on mental health community's
concern. Another positive impact is the increase in family knowledge in the care of PWMD so that it creates good
attitudes and behavior in caring for PWMD at home. This can prevent the possibility of recurrence so that people
who experience mental problems do not need to be referred to special health services. And prevent recurrence in
post-treatment PWMD in the special service unit (RSJ).
Community-based mental health services are carried out through clinics / mental health corners, home
visits and integration services are continuously encouraged to be able to provide optimal mental nursing
care (Ministry of Health, 2019) . The problem of mental disorders is not solved by case detection, but a more
important and substantive step that needs to be done is to provide community-based mental health services. The
spearhead of community-based mental health services are health workers at puskesmas which are realized
through good performance, improving the quality of officers in understanding their duties and functions in
implementing community-based mental health services in their respective regions (Ministry of Health of the
Republic of Indonesia, 2020) .
Data mental illness that has been reported is only the case that stand out such as: epilepsy psikosa
( schizophrenia ). The efforts carried out are treatment, counseling, and monitoring the provision of existing
mental drugs. Certain severe psychiatric cases are referred to a mental hospital or psychiatrist. In
2017 number PWMD referred to the Mental Hospital amounted to 8 people, in 2018 amounted to 5 people and
2019 totaling 2 people. Meanwhile, the coverage of health services for severe PWMD in 2019 was only 412
(53.9%) out of 765 PWMD. The coverage of PWMD health services at the Blambangan Umpu Health
Center is 43.2% or under the coverage of the Kasui Public Health Center (56.8%) , Bumi Agung Health
Center (61.7%) and Bahuga Health Center (53.7%) (Waykanan District Health Office, 2020)
The success of the mental health service system depends on the components included in the health
service itself. The system is formed from subsystems that are interconnected and influence each other. The
system consists of input , process, output , and output . (1) input is a system that will provide all inputs for the
functioning of a system, the input of health services includes the potential of the community, health workers and
health facilities. (2) The process is an activity to change an input into an expected result from the system, the
process in health services includes various activities in health services. (3) the output is the result obtained from a
process, the output of health services can be in the form of quality and affordable health services so that the
community recovers and is healthy. (4) the outcome is the result of the output, occurring in a relatively long
time. The impact of the health care system is that the community is healthy, the morbidity and mortality rates
decrease. (5) feedback is a result as well as input. Feedback in health services can be in the form of the quality of
health workers (Mustofa et al., 2017) .
Equitable mental health services is an important aspect that is measured by minimum service standards
regarding the type and quality of basic services. Along with the increase in education and socio-economic growth
of the community, public understanding should also increase. Quality mental health services will affect the
success of the program. Knowledge and skills of health workers, completeness of facilities/infrastructure, and
adequacy of funds. Mental health services like this are able to reduce or overcome mental health problems that
develop in an area or community group. For example, the implementation of the mental health corner which is
regularly scheduled and the utilization of the mental health corner program. Mental problems in the family are
always a problem, many people feel ashamed if there are household members who have mental disorders or
PWMD, this situation makes case finding difficult. If there are findings of the case is still blocked on a whim utilize
the program and the mental health corner drug-taking discipline. The obstacles above are external factors for
mental health service programs while internal problems are related to the mental health service
system. Therefore mental health problems are not only about no case findings, because the few cases can
describe the less than optimal detection of mental cases (Kurniati, 2016) .
The low number of cases of mental disorders can occur due to lack of attention and detection of mental
cases and their handling , therefore, in order to increase serious attention to mental health problems, it is carried
out through the application of community-based mental health care patterns ( Community Mental Health Nursing -
CMHN ). Integrated services that bring specialists and optimize mental health clinics to increase the findings of
mental disorders cases (Ministry of Health, 2020) .
Application of program which focused on the activities of the corner of the soul in the form of mental health
services should begin to do integrated with other health programs such as early detection of mental
disorders, through a home visit and home care in the detection and treatment of mental disorders were found in
the working area . The Blambangan Umpu Public Health Center is the health center with the largest
population compared to other health centers. In the process of implementing mental health services, in addition to
providing services at puskesmas, implementation instructions have been set through special home visits for
families with PWMD, in addition to home visits, integration and cooperation with various elements of society
needs to be built. This step is intended to improve case findings and improve the quality of mental service
programs (WHO, 2013) .
CMHN program expected positive impact on the development of mental health in the community and to
improve mental health in the community, whether it is done on a group of health center nurses, health workers
and groups of family or community group itself . The ability of nurses in implementing CMHN is the ability to use
the basic concepts of community health nursing, nursing care, recording reporting and monitoring evaluations,
and empowering mental health cadres. The ability of nurses in implementing CMHN is still low (Winahayu et al.,
2014) . This low ability is due to CMHN training only in a short time , and there is no continuous evaluation of the
implementation of CMHN. So it is hoped that the CMHN that has been running will be further improved on
monitoring the evaluation of the implementation of CMHN and further improving the CMHN training. For CMHN
activities, funds have been budgeted from the local government budget (APBD), but these funds are not a priority
as activities other activities. This is also because the mental health program is a community health center
development program. So it is hoped that although mental health is a development program, it still requires stable
funding and funding support from stakeholders is needed. The budget funding for the mental program itself has
only been specifically budgeted in 2019 from the APBN budget in the BOK fund, and for each health center itself
it receives an average budget of 20 million per year but not the same every year . So far, since the establishment
of the mental program in the Lampung area, there has been no program evaluation from either health NGOs or
 government health institutions and there has also been no related research in the Lampung area related to the
program (Ministry of Health RI, 2020) .
In fact, the mental health corner program has not been implemented at the Blambangan Health Center,
Umpu Way Kanan, even though based on a decree from the health office in 2012 the mental health program has
begun, and the officer in charge of the mental health service program has been assigned CMHN training for
mental health workers . The number of people in charge of the mental health corner program are 2 people who
have participated in the CMHN training . Based on the results of the pre-survey on September 11, 2020, it
is known that the mental health corner activities have not been carried out optimally as seen from the data
collection of mental cases, handling of PWMD, provision of mental service counseling rooms, provision of
complete facilities for mental health corner services, implementation, supervision and reporting . Whereas the
initial goal of the mental health corner itself was to make everyone achieve a good quality of life, and so thAT
PUSKESMAS could provide mental health services in an integrated, comprehensive and sustainable
manner. This situation is the reason for the researcher to focus on the implementation of the mental health corner
at the Blambangan Umpu Way Kanan Health Center . The main focus of this study was to determine
the evaluation of the mental health corner program at the Blambangan Umpu Health Center Way Kanan .

2. LITERATURE REVIEW
A. Health services
According to the Ministry of Health of the Republic of Indonesia ( 2009) , health services are every effort
carried out individually or together in an organization to maintain and improve health, prevent and cure
disease, and restore the health of individuals, families, groups and communities. Good health services must
have various basic requirements, namely:
a. Available and Continuous; the first basic requirement of good health care is health care must be provided
(available) in the community and are sustainable (continuous ).
b. Acceptable and Appropriate; the second major requirement of good health care is acceptable
(acceptable) by the community and are natural (appropriate).
c. Easily Achieved; the third basic requirement of good health care is easily reachable by the public. The
definition of achievement is seen from the point of view of location.
d. Easy to Reach (affordable); the fourth basic requirement for good health services is that they are easily
accessible (affordable) by the community. The definition of affordability is seen from the point of view of
cost.
e. Quality; the five basic requirements of good health services are quality . The definition of quality refers to
the level of perfection of health services which on the one hand can satisfy service users, and on the
other hand the procedures for its implementation are in accordance with the code of ethics
and standard provisions.

B. Health Service Standard

The development of the health care system, issues of policy and service standards are very
important. Service standards that are contextualized in mental health services can be used as a benchmark
for program evaluation that regulates aspects of input, process, output and outcome described by (Azwar,
2010) as follows:
1) Standar of inputs are important to be standardized considering the quality and quantity of service inputs
that differ between regions causes frequent inequality of access to quality services. Input is used as input
for the system to function. The input value obtained is less so that the process and output achievements
do not match. Input variables include :
a) Power, personnel or human resources involved in the Mental Health Effort program at Puskesmas.
b) Funds; funds received by the puskesmas to run the Mental Health Effort program come from the
Health Operational Costs (BOK) from the center. Funds that have been received by the Puskesmas
must be sufficient to run the program. These funds are used to meet the various needs of the
Puskesmas in running the program.
 c) Facilities; facilities are needed to support the implementation of the Mental Health Effort program in
the working area of the puskesmas. The facilities needed are the same as those for treating general
patients (no special equipment is needed) because they only treat patients with mental disorders who
have been controlled.
d) Method; the Mental Health Effort Program at Puskesmas must have an SOP. in the implementation
of a program, evidence of the implementation of a program is needed in the form of a report.
e) Market; The market in the soul program is the community itself.
2) Service process standards are important to set. However, the arrangement must be done carefully so that
the standard of service process does not prevent or limit local creativity in providing public
services. Variable Pro 's ice cover (Mustafa et al., 2017) :
a) Implementing Early Detection
Implementation of early detection is an activity to classify patients with mental disorders based on
psychological complaints whose frequency is continuous (dizziness, stomach pain, unable to sleep)
even though the patient is declared healthy at the time of physical examination. Classification (early
detection) can also be obtained based on the results of questions conducted in the consultation room
by health workers. Data for people with mental disorders can come from hospitals, community
reports, recordings by cadres, NGOs, nursing education institutions/academics and Puskesmas
officers. Implementation of early detection is carried out by health workers to patients with mental
disorders. Early detection is carried out every time an inspection is carried out. In addition, early
detection can also be done outside the Puskesmas, for example through screening at schools.
b) Enforcement of Diagnosis
Establishing a diagnosis is a step that is in line with early detection, namely identifying mental
disorders in patients based on certain criteria at the time of examination. Diagnosis is carried out by
health workers for patients with mental disorders.
c) Mental Health Counseling
Health counseling is provided by the Puskesmas through health workers, namely activities to
promote mental health and provide understanding regarding mental defense mechanisms to the
community. Important information to be conveyed in health education activities, especially those
related to mental health programs, is information about the importance of mental health and
environmental acceptance, both family and community.
d) Initial Management
Initial management is the stage of administering drugs according to the diagnosis obtained, both
mental illness and other physical diseases according to the patient's condition. Initial treatment is
carried out by health workers for patients with mental disorders. Initial management is carried out
every time an inspection is carried out.
e) Management of Referrals for Mental Disorders
Management of referrals for mental disorders is the management of service arrangements carried out
in stages between service units from various levels.
3) The standard outputs are to output from the services that have been implemented. Therefore, even though
the output standard is only an output, it also needs to be standardized, so that there is no plagiarism of
various official documents that have been produced from public services. Public service standards can be
defined as service provisions that are measurable and determined by the organizers or providers of public
services, so that these provisions must be obeyed by both the organizers and recipients of public services.
4) Standard Outcome is the result of output in a long time. Outcome evaluation provides an overview or
information related to mortality, changes in disease, productivity and others. Standards of public services,
at - least include:
a) Service Procedures. The service procedure is a service flow chart that must be made and standardized
by service providers and must be followed by service recipients including complaints.
b) Completion Time. Service completion time is the time span of service completion which is determined
from the time of submitting the application until the completion of the complaint.
 c) Service Fee. The service fee is the amount of the fee that must be paid by the service recipient,
including the details specified in the service delivery process.
d) Service Products. Service products are service products that will be received by service recipients in
accordance with predetermined provisions.
e) Facilities and Infrastructure. Provision of service facilities and infrastructure is a number of facilities and
equipment needed by service providers and adequate infrastructure to support the implementation of
public services.
f) Competence of service providers. The competence of service providers is a criterion of ability and
competence that must be possessed by service providers (knowledge, expertise, skills, attitudes, and
behavior) required by each service implementing section (Kurniati, 2016) .

Based on the explanation above, this research refers to the evaluation of the corner program at the
Blambangan Umpu Health Center and is described in the following figure:

Figure 2. 1 . framework Thought

Puskesmas

Program Jiwa

Input Proses Output Outcome

This study refers to the framework of evaluation corner of the program carried out in health centers soul
Blambangan Umpu. The focus of the research is on service standards that are contextualized in mental health
services that can be used as benchmarks for program evaluation that regulates aspects of input ,
process, output and outcome . Service inputs are important to be standardized considering the quality and
quantity of service inputs that differ between regions causes frequent inequality of access to quality
services. Input is used as input for the system to function. Evaluation at the initial stage of the program aims to
ensure that the plans to be implemented are in accordance with the problems found which include existing
resources, funds, manpower, facilities and infrastructure. The value of the input can have an impact on
program implementation and program achievement targets.

Service process standards are important to set. However, the arrangement must be done carefully so that the
standard of service process does not prevent or limit local creativity in providing public services. Standard
output is to output from the services that have been implemented. Therefore, even though the output standard
is only an output, it also needs to be standardized, so that there is no plagiarism of various official documents
that have been produced from public services. The standard outcome is a result of the output in a long
time. Outcome evaluation provides an overview or information related to mortality, changes in disease,
productivity and others.

3. RESEARCH METHODS
A. Research Type
This research is a field ( field study research ) with descriptive design ( descriptive research ) in the sense of a
study to prioritize the picture of the existing events that took place in the present or the past (Moeloeng,
2016) . The approach used in this study is a qualitative approach. This approach is used because the data
obtained are descriptive data in the form of written and spoken words from people and in the form of
documents or observed behavior.
 B. Place and time of research
The research was conducted at the Blambangan Umpu Public Health Center, Way Kanan Regency. The time
of the research was carried out from June to August 2021.

C. Research subject
Research subjects in this study is that the informant consist of key informants, key informants and informant
triangulation. The main informant of this study was the Head of the Blambangan Umpu Health Center, the key
informant was the Head of the Mental health corner Program and the triangulation informant was the Head of
the Family who had family members with PWMD . The description of the informants is shown in the table
below.

Table. 1 Characteristics of Informants

Informant Age Education Position

Main
YS (Inf-01) 34 S2 Head of Blambangan Umpu Health Center
Key Age Education Position
KS (Inf-02) 46 S1 Program Performer
TY (Inf-03) 40 S1 Program Performer
Triangulation Age Education Position
GA (Inf-04) 51 senior High School PWMD Keluarga family
JN (Inf-05) 56 senior High School PWMD Keluarga family

B. Data Collection Method

In collecting or obtaining data, using several procedures, namely:
a) Observation; observation is done by observing and recording direct the research object, that is by
observing the activities mental health corner, so that researchers can determine the informant to be
studied and also to determine the positions, tasks, addresses, phone numbers of prospective informants
so easy to get information for research purposes.
b) Interview; In the collection technique using interviews, it is almost the same as a questionnaire. The
interviews were divided into 3 groups, namely structured interviews, semi-structured interviews, and
in- depth interviews . However, here the researcher chooses to conduct in-depth interviews, this aims to
collect complex information, most of which contains opinions, attitudes, and personal
experiences (Moloeng, 2016).

C. Data Analysis and Presentation

The data that has been collected is then clarified for analysis using an inductive analysis approach, that is,
starting from specific facts, concrete events, then from the specific concrete facts and events, generalizations
that have a general nature are drawn. . Furthermore, using data analysis developed by Miles and Huberman,
with three types of activities, namely; data reduction, data presentation, and conclusion drawing/verification as
intertwined before, during, and after data collection in parallel forms ( Hamidi , 20 1 4 ) .

4. RESEARCH RESULTS AND DISCUSSION

A. Research result
Result of interview to the informant arranged in the form of a matrix results as follows :

Informant
Input Key Main Triangulation
(Inf-01) Inf-02 Inf-03 Inf-04 Inf-05
HR Already there but still In accordance with Only one person - -
 need to be added educational has attended
background but CMHN training in
have not the province
received CMHN
training briefing
Fund Budgeted but not Budgeting is still Operational use is Direct visits to patients have
proportional because incidental only sourced from not been carried out
the source of BOK BOK
funds is not enough
Means The infrastructure is
Official vehicles, The facilities are Can't take the patient to the
sufficient office stationery and good but the mental health corner service
other equipment are distribution of drugs because of the patient's
available is still stalled condition
Method CMHN CMHN training The method used is The existence of the Handling
has not been the checklist method website cannot be yourself
implemented at the for case detection implemented,
district level purposes right?
Process
planner The plan has been Planning already There is already a
prepared, only a exists but needs plan
commitment to assistance from the
implementation has Department
been made
Case Case detection has Can be Operational funds
Detection been carried out with implemented but for case detection
complete facilities hampered by activities to villages
and equipment, but operational funds are limited
has not been carried and mileage
out continuously
Monitoring Occasional Monitoring activities Monitoring activities Only Providing
and monitoring is carried have been carried have been carried occasionally counseling
Evaluation out but not out out do but not
continuous supervision examining
PWMD
patients
Output
Achievement The target for case detection has not been Need to increase Didn't know there was a
Target achieved. Service is running the achievement mental health corner service
of case screening AT PUSKESMAS
Outcome
Social The patient's recovery Families feel the Productive family, Expect visits from health
Impact improves the quality burden is reduced in healthy family workers to monitor PWMD
of life for himself and the community regularly
his family

B. Discussion
Based on the matrix above, it can be seen the condition of the human resources who run the mental health
corner program at the Blambangan Umpu Health Center, Way Kanan Regency where the personnel
responsible for the mental health corner program have been determined but to cover program tasks that not
only provide services at Puskesmas but also conduct screening and case detection. mental disorders in the
work area of the Blambangan Umpu Health Center / therefore to meet these needs it is necessary to increase
the number of personnel in the mental health corner activities or programs whether through delegating tasks
to cadres through special decrees so that they can carry out their duties properly. The description of the
personnel or human resources seen from the educational background has met the criteria but they need to
receive CMHN training or technical guidance so that the mental health corner activities at the Blambangan
Umpu Health Center can carry out tasks based on understanding and improving community-based
mental health service skills .

The implementation of the mental health corner program at the Blambangan Umpu Health Center is still
constrained by funding. The proportion of the budget for the activities of the mental health corner has not been
included in the Expenditure Budget Plan in the previous year, so that the distribution of the budget is
independent and the budget post for these activities has not been determined. So far, the budget for all
Community Health Center activities has been sourced from the BOK, even though funds have been obtained
from the Puskesmas capitation or other sources. The problem with this fund is not that there is no budget, but
that the budget item has not been determined which should have been planned beforehand. This funding will
ultimately disrupt the process of implementing the mental health corner program, especially if it is related to
drug financing, drug distribution, case detection or screening, visits or home visits to PWMD patients,
monitoring and supervision of PWMD patients.

The condition of the facilities for the implementation of the mental health corner program at the Blambangan
Umpu Health Center is relatively good, but the availability of facilities and infrastructure still requires
operational and other expenses. Therefore, this funding problem can be solved through a joint meeting to
produce a postal budget policy or health center expenditure plan within one year. This can be done if the work
plan has been prepared by the officers in charge of the program. The impact of the delay in the
implementation of the mental health corner service will have a direct impact on the continuity of detection
activities and patient visits because not all patients can come to the Puskesmas because their mental health
conditions are really not possible, so it requires the presence of health workers to the homes of PWMD
patients to provide counseling, care, treatment as well as supervision is carried out consistently and
continuously until PWMD patients develop.

The mental health service manual has actually been described in the community-based mental health service
guide, therefore technical guidance and debriefing for officers related to CMHN material is very
necessary. This step is important to do to improve skills and competencies in providing services to PWMD
patients. If the process of providing mental health services to the community is carried out, this knowledge and
skills can be given to the community, especially families who have PWMD members. Confinement, isolation
and inappropriate treatment behavior of PWMD patients can be avoided.

Early Detection of Mental Health Disorders is an effort to find cases of mental disorders early by health
workers which is carried out in an integrated manner with other basic services AT PUSKESMAS and its
network. Mental health efforts carry out activities to realize optimal health degrees for each individual, family
and community with promotive, preventive, curative and rehabilitative approaches that are carried out in a
comprehensive, integrated and sustainable manner. Performance achievement in providing health services for
severe PWMD is assessed by the number of severe PWMD (psychotics) in their working area who receive
preventive promotive mental health services according to standards within one year. The target for achieving
performance in mental health services for people with severe mental disorders according to work area
standards is 100 percent. Therefore, conducting early detection of mental health in the community, can
increase the knowledge of health workers about the importance of early detection of mental health in the
community, and the community is able to detect mental health early in their environment, so that patients with
PWMD can be treated immediately.
 The process aspect requires consistent and long steps. Policies for implementing mental health programs for
nurses who have been trained in mental health are based on needs assessments . The program is carried
out based on data on cases of mental disorders that occur based on cases and policy needs in the
region . Planning for the implementation of mental health development programs to adjust to the guidelines for
evaluating mental health programs so that evaluation of mental health programs can run in accordance with
the objectives of the program being implemented, but in the process it does not go well due to time problems
given the ability of the nurses themselves in implementing the results of the CMHN training so that the
planning of SOPs, mental polyclinic standards AT PUSKESMAS, supporting manuals for nurses can be
carried out carefully . Suboptimal monitoring and evaluation can lead to program success and achievement of
coverage targets. In general, it is described that the evaluation results of the implementation of the mental
health corner program at the Blambangan Umpu Health Center there is still much need for improvement both
in terms of planning policies, monitoring, evaluation, facilities and infrastructure supporting the program as well
as increasing knowledge and further training of mental nurses.

5. CONCLUSIONS AND SUGGESTIONS

A. Conclusion
a) . Input Component
1) Several informants stated that the personnel involved in implementing the mental health corner
program in the working area of the Blambangan Umpu Health Center in terms of number and level
of education were adequate and in accordance with the educational standards of the holder of the
mental health corner program, namely at least a D3 nurse education.
2) There are 5 personnel or human resources involved in the mental health corner program at
puskesmas, namely the head of the program holder, doctors, nurses, midwives, health promotions,
and health cadres.
3) Some informants explained that the officers holding the mental health corner program had never
attended and received CMHN training while holding the mental health corner program, but only
attended evaluation and socialization meetings about the mental health corner program.
4) According to the informant k urang inadequacy of funding for the program corner of the soul,
resulting in a lack of puskesmas officers to go down to the community to provide counseling and
data collection as well as the funding comes from the BOK it also makes p ime Frame networking
and discovery of mental disorders in the community is not maximized due to the lack of data
collection return home. Just waiting for someone to report and notification from the public.
5) According to the explanation of some of the informant's arana needed to support the implementation
of the program corner of life in the working area p uskesmas. Necessary facilities as a means to
deal with public patients because it only handles mental patients who already controlled, among
which 1 piece ambulances, laboratories for examination in case of infection in patients with mental
disorders, as well as drugs - drugs for patients with mental disorders.
6) Several informants stated that the mental health corner program had not been consistently
implemented in accordance with the SOP , besides that there was still different information from one
of the doctors and nurses regarding the SOP for the mental health corner program which should
have followed the accreditation of the Puskesmas that had been carried out previously.

2. Process Components
1) Some informants stated k egiatan planners a n in the implementation of programs in Puskesmas
Blambangan corner Umpu soul are not in the annual POA and in the implementation of n yes not as
planned, for example, just not the implementation of extension activities on mental disorders in the
community.
2) According to the informant, the implementation of early detection is an activity to classify patients
with mental disorders based on psychological complaints whose frequency is
continuous. Classification (early detection) can also be obtained based on the results of questions
conducted in the consultation room by health workers. K urangnya counseling to numb a r ga patient,
 networking, discovery and data collection of patients with mental disorders in the
community. Diagnosis is carried out by health workers for patients with mental disorders.
3) Some informants expect supervision from the health service to the puskesmas, while other
informants expect regular visits from the mental health officer to PWMD patients . The fact is
that monitoring of mental patients and checking, providing treatment information or the
characteristics of people with mental disorders and administering drugs to the patient's
recovery have not run optimally .

3. Output Component
Several informants stated that the number of findings was still low, and the data used were old data, no
updates, there were patients who had recovered but were still included in the data. And there are still
patients who are in pasung and it is proven that there is a lack of data collection, drug administration and
supervision of mental patients in the community. And from the health center, they rarely do re-data
collection for patients with mental disorders so thAT PUSKESMAS officers do not know if there are
patients who have not been registered or are in the process of treatment or even patients who have
recovered.
4. Outcome Component
According to the informant, the impact of the implementation of the mental program was included in the
poor group because not all villages received the same treatment and monitoring from the Puskesmas so
that the patient's recovery rate was still minimal.

B. Suggestion
1. For Way Kanan District Health Office
a. enhancing supervision, guidance and supervision in health centers related Umpu Blambangan
invention or crawl coverage PWMD
b. Allocate additional budget for the mental health corner program so that operations are not
constrained by costs
c. checking POA and SOP PHC Blambangan Umpu, so that the activities carried out in accordance
with the plan
d. Reforming drug distribution system of the City Health Office to the health center in order to avoid
delays.
e. Provide ongoing CMHN training related to mental health, both to cadres and Puskesmas officers.

2. For the Blambangan Umpu Health Center

a. Determining competent human resources through the issuance of task decrees in order to understand
their duties and responsibilities .
b. Involving human resources in CMHN training activities and socialization regarding the implementation
of the mental health corner program.
c. Make more efforts to detect mental disorders and carry out counseling to families of PWMD patients .
d. Provide understanding through outreach activities and socialization of the mental health corner
program to the community, especially the families of PWMD patients .
3. For the Community
It is hoped that the community can support and participate in the implementation of the mental health
corner program together in order to achieve the program's objectives, especially the reduction of cases in
the work area of the Blambangan Umpu Health Center because mental health diseases cannot be
separated from environmental influences that are under the control of the community itself.

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