Mental health literacy of Indonesian health practitioners and implications for mental health system development.

Compared to other countries in the South-East Asian region, Indonesia's mental health system remains underdeveloped from significant treatment gaps, which subsequently contribute to human rights violations of mental health patients who do not receive adequate medical care. In line with the introduction of universal health coverage in 2014, the Indonesian government plans to redress this by delegating detection and early intervention of mental health services to health practitioners without specialist training in mental health, however, there is limited evidence that they can perform this role effectively. This study aims to evaluate current workforce capacity by assessing differences in mental health literacy between Indonesian mental health and non-mental health practitioners. Compared to non-mental health practitioners, mental health practitioners are significantly less likely to hold stigmatising views towards individuals with mental illness. They are also significantly more likely to correctly recognise symptoms of depression and schizophrenia and recommend and implement evidence-based interventions for these conditions. These findings suggest that task-shifting is unlikely to be an effective solution to reduce the mental health treatment gap, and it is recommended that mental health system reform in Indonesia should initially focus on expansion and retention of the specialist mental health workforce.

Stressful life transitions and wellbeing: A comparison of the stress buffering hypothesis and the social identity model of identity change.

The relationship between stressful life transitions and wellbeing is well established, however, the protective role of social connectedness has received mixed support. We test two theoretical models, the Stress Buffering Hypothesis and the Social Identity Model of Identity Change, to determine which best explains the relationship between social connectedness, stress, and wellbeing. Study 1 (N=165) was an experiment in which participants considered the impact of moving cities versus receiving a serious health diagnosis. Study 2 (N=79) was a longitudinal study that examined the adjustment of international students to university over the course of their first semester. Both studies found limited evidence for the buffering role of social support as predicted by the Stress Buffering Hypothesis; instead people who experienced a loss of social identities as a result of a stressor had a subsequent decline in wellbeing, consistent with the Social Identity Model of Identity Change. We conclude that stressful life events are best conceptualised as identity transitions. Such events are more likely to be perceived as stressful and compromise wellbeing when they entail identity loss.