ABSTRACT
Background: Mental health issues following the occurrence of disaster remain neglected area especially for older people group. The purpose of this study was to explore stakeholders’ perspectives on post-disaster management related to the elderly’s mental health needs.
Design and Methods: This qualitative case study was conducted between June and October 2020. The investigators conducted in-depth interviews with policymakers who were in charge of disaster management at national, provincial, and regional levels. The policymakers were selected through purposive sampling. A policy analysis was conducted by the investigators to answer the research question.
Results: The results were presented based on actor, content, context, and process. The actors engage in intersectoral collaboration between disaster agencies, health agencies, and social agencies. The content is largely comprehensive; however, the disaster management policy should not neglect to address mental health conditions after a disaster event. The context is the vulnerability and risk of the elderly in terms of experiencing physical and mental issues after a disaster, which should be considered by policymakers in Indonesia. The process is the development of disaster management policies, which are influenced by cultural, economic, political, and international factors.
Conclusion: This study reveals that stakeholders need to pay attention to the mental health issue of elderly in national and regional policy, particularly during post-disaster situations. In addition, posttraumatic stress in post-disaster situations should be highlighted in order to formulate a better aged care policy.
REFERENCES
Hikichi H, Aida J, Tsuboya T, et al. Can community social cohesion prevent posttraumatic stress disorder in the aftermath of a disaster? A natural experiment from the 2011 Tohoku Earthquake and tsunami. Am J Epidemiol 2016;183:902-10. DOI: https://doi.org/10.1093/aje/kwv335
Kompas.com [Internet]. [BNPB_2018 Jumlah Bencana Turun tetapi Korban Meningkat hingga 1.072 Persen (Number of disasters dropped but casualties increased by 1,072 percent)].[in Indonesian]. Available from: https://nasional.kompas.com/read/2018/12/19/17524741/bnpb-2018-jumlah-bencana-turun-tetapi-korban-meningkat-hingga-1072-persen
AHA Centre. Earthquake In Lombok, Indonesia. 2018. Available from: https://ahacentre.org/earthquake-in-lombok/
Asosiasi Alumni Program Beasiswa Amerika-Indonesia [Internet]. [Kajian: Penanganan Lansia Pasca Bencana di Lombok, NTB dan Sulawesi Tengah (Study: Handling the Elderly Post-Disaster in Lombok, NTB and Central Sulawesi)].[in Indonesian]. https://alpha-i.or.id/program-aktivitas/kajian-penanganan-lansia-pasca-bencana-di-lombok-ntb-dan-sulawesi-tengah/
World Health Organization. Older persons in emergencies: An active ageing perspective. 2008. Available from: https://extranet.who.int/agefriendlyworld/older-persons-in-emergencies-an-active-ageing-perspective/
Daddoust L, Khankeh H, Ebadi A, et al. The social vulnerability of older people to natural disasters: an integrative review. Health Emerg Disast Quart 2018;4:5-14. DOI: https://doi.org/10.32598/hdq.4.1.5
Johnson HL, Ling CG, Mcbee EC. Multi-disciplinary care for the elderly in disasters: An integrative review. Prehosp Disaster Med 2015;30:72-9 DOI: https://doi.org/10.1017/S1049023X14001241
Central Hume Primary Care Partnership. An age-friendly approach to disaster recovery. 2020. Available from: https://www.centralhumepcp.org/wp-content/uploads/2020/04/Central-Hume-PCP_Working-With-Older-People_Single.pdf
Alipour F, Khankeh H, Frekrazad H, et al. Challenges for resuming normal life after earthquake: a qualitative study on rural areas of Iran. PLoS Curr 2014;6. Erratum in: PLoS Curr 2015;7. DOI: https://doi.org/10.1371/currents.dis.b4e84b942500e2f8f260f3471b7ee815
Wakui T, Agree EM, Saito T, Kai I. Disaster preparedness among older Japanese adults with long-term care needs and their family caregivers. Disaster Med Public Health Prep 2017;11:31–8. DOI: https://doi.org/10.1017/dmp.2016.53
Parker G, Lie D, Siskind DJ, et al. Mental health implications for older adults after natural disasters – a systematic review and meta-analysis. Int Psychogeriatrics 2016;28:11–20. DOI: https://doi.org/10.1017/S1041610215001210
Aurizki GE, Efendi F, Indarwati R. Factors associated with post-traumatic stress disorder (PTSD) following natural disaster among Indonesian elderly. Work Older People 2020;24:27-38. DOI: https://doi.org/10.1108/WWOP-08-2019-0020
Cook JM, McCarthy E, Thorp SR. Older adults with PTSD: Brief state of research and evidence-based psychotherapy case illustration. Am J Geriatr Psychiatry 2017;25:522-30. DOI: https://doi.org/10.1016/j.jagp.2016.12.016
Efendi F, Indarwati R, Aurizki GE. Effect of trauma-focused cognitive behavior therapy on depression and the quality of life of the elderly in Indonesia. Work Older People 2020;24:149-57. DOI: https://doi.org/10.1108/WWOP-02-2020-0004
Buse K, Mays N, Walt G. Making health policy. McGraw-Hill Education; 2012.
Republic of Indonesia. Disaster Management Act. Law No. 24 of 2007 on Disaster Management. Republic of Indonesia; 2007.
Ministry of Health of the Republic of Indonesia. [Rencana Aksi Kegiatan Penanggulangan Krisis Kesehatan Tahun 2015-2019 (Action Plan for 2015-2019 Health Crisis Management Activities)].[in Indonesian]. Jakarta: Ministry of Health; 2014.
Central Bureau of Statistics. [Statistik penduduk lanjut usia 2018 (Senior population statistics 2018)].[in Indonesian]. Central Bureau of Statistics; 2018.
Mahendradhata Y, Trisnantoro L, Listyadewi S, et al. The Republic of Indonesia Health System Review. WHO Regional Office for South-East Asia; 2017.
Koestoer R. Long term care for older people in Indonesia. The CMEA Republic of Indonesia (2014).
Putera RE, Nurasa H, Sugandi YS. Synergizing stakeholders in reducing risk of earthquake and tsunami-disaster in the most vulnerable area. Int J Adm Sci Organ 2016;23:5. DOI: https://doi.org/10.20476/jbb.v23i3.9176
Leonard P. Stakeholder Engagement Plan (SEP) Indonesia Disaster Resilience Initiatives Project (IDRIP)(P170874). 2019.
Republic of Indonesia. Disaster Management Regulation. Government Regulation No. 21 of 2008 on Disaster Management Administration. 2008.
Republic of Indonesia, Ministry of Social Affairs. Function and duty. 2020. Available from: https://kemsos.go.id/tugasfungsi
Republic of Indonesia, Ministry of Women’s Empowerment and Child Protection. 4 times more prone to violence, women must be protected. 2018. Available from: https://www.kemenpppa.go.id/index.php/page/read/31/1716/4x-lebih-rentan-kekerasan-kaum-perempuan-harus-dilindungi
Rosenkoetter MM, McDonough J, McCall A, et al. Flex-model for long-term assessment of community-residing older adults following disasters. Am J Recreat Ther 2016;15:31-46. DOI: https://doi.org/10.5055/ajrt.2016.0098
Pan American Health Organisation. Guidelines for mainstreaming the needs of older persons in disaster situations in the Caribbean. 2012. Available from: https://iris.paho.org/handle/10665.2/3525
World Health Organization. Fact sheets – Health emergency and disaster risk management (EDRM). 2013. Available from: https://www.who.int/publications/m/item/health-emergency-and-disaster-risk-management-(edrm)-fact-sheets
Kar N. Care of older persons during and after disasters: meeting the challenge. J Geriatr Care Res 2016;3:7-12.
Queensland Government. Role of local government in a disaster. Emergency services and safety. 2019. Available from: https://www.qld.gov.au/emergency/local-gov
Shi P. On the role of government in integrated disaster risk governance—Based on practices in China. Int J Disaster Risk Sci 2012;3:139-46. DOI: https://doi.org/10.1007/s13753-012-0014-2
Djalante R, Garschagen M, Thomalla F, Shaw R. Introduction: Disaster risk reduction in Indonesia: Progress, challenges, and issues. In: R Djalante, M Garschagen, Thomalla F, Shaw R, Editors. Disaster risk reduction in Indonesia. Springer; 2017. pp. 1-17. DOI: https://doi.org/10.1007/978-3-319-54466-3_1
Chen Y, He L, Zhou D. Consequences of post-disaster policies and relocation approaches: two communities from rural China. Disaster Prev Manag An Int J 2021;30: 340-53. DOI: https://doi.org/10.1108/DPM-11-2019-0347
Roudini J, Khankeh HR, Witruk E. Disaster mental health preparedness in the community: A systematic review study. Health Psychol Open 2017;4:2055102917711307. DOI: https://doi.org/10.1177/2055102917711307
Bodstein A, de Lima VVA, de Barros AMA. The vulnerability of the elderly in disasters: The need for an effective resilience policy. Ambient Soc 2014;17:171-88. DOI: https://doi.org/10.1590/S1414-753X2014000200011
Heagele T, Pacquiao D. Disaster vulnerability of elderly and medically frail populations. Health Emerg Disaster Nurs 2019;6:50-61. DOI: https://doi.org/10.24298/hedn.2016-0009
Shawar Y. Ingredients for good health policy-making: incorporating power and politics into the mix. Int J Health Policy Manag 2014;2:203-4. DOI: https://doi.org/10.15171/ijhpm.2014.45
Albrecht F. The social and political impact of natural disasters. PhD Thesis, Uppsala University; 2017.
Government of Indonesia, Ministry of Home Affairs. Project Report on Community Involvement in Disaster Management. 2020.
Regional Agency for Disaster Management (BNPB). [Buku Pedoman Latihan Kesiapsiagaan Bencana: Membangun Kesadaran, Kewaspadaan dan Kesiapsiagaan dalam Menghadapi Bencana (Disaster preparedness training manual: Building awareness, alertness and preparedness in facing disasters)].[in Indonesian]. 2017.
Auzzir ZA, Haigh RP, Amaratunga D. Public-private partnerships (PPP) in disaster management in developing countries: a conceptual framework. Proc Econ Finan 2014;18:807-14. DOI: https://doi.org/10.1016/S2212-5671(14)01006-5
Busch NE, Givens AD. Achieving resilience in disaster management: The role of public-private partnerships. J Strateg Secur 2013;6:1-19. DOI: https://doi.org/10.5038/1944-0472.6.2.1
Bahadori M. Khankeh HR. Zaboli R, Malmir I. Coordination in disaster: A narrative review. Int J Med Rev 2015;2:273-81.