MERUJUK ORANG DENGAN SKIZOFRENIA KINI SEMAKIN MUDAH

Oleh: dr. Hafid Algristian,CHt,CI.

 

Proses merujuk pasien saat ini sudah semakin mudah yakni dengan mengoptimalkan peran Puskesmas (PKM), Klinik Umum (KU) dan Praktek Dokter Swasta (PDS), terutama yang bekerja sama dengan BPJS. Harapannya, keterlibatan ini bisa menjangkau pasien sampai ke pelosok sekalipun (demikian juga yang saya alami saat di Ponorogo, Jombang, Mojokerto, Gresik, Bojonegoro, Madiun, Madura. Penanganan pasien gangguan jiwa jadi makin menjangkau pelosok desa –selain karena “bisik-bisik” tetangga yang akhirnya terdengar oleh petugas kesehatan setempat).

 

Sekarang ini pelayanan kesehatan masyarakat (termasuk gangguan jiwa) dibagi tiga lapis, yakni Pusat Pelayanan Kesehatan Tingkat-1 (PPK-1, atau dikenal sebagai layanan primer) yang terdiri dari PKM, KU, Klinik Jamsostek, Dokter Keluarga, dan PDS yang bekerja sama dengan BPJS. Lalu PPK-2 (layanan sekunder) yaitu Rumah Sakit Pemerintah Kabupaten atau Kota, atau Rumah Sakit Swasta (minimal RS tipe B). Yang terakhir adalah PPK-3 (layanan tersier), yakni Rumah Sakit Daerah atau Propinsi (kalo ngga salah RS tipe A). Pada umumnya Rumah Sakit Jiwa adalah termasuk PPK-3.

 

Beberapa PKM (PPK-1) di pelosok desa sudah dilengkapi layanan untuk pasien gangguan jiwa, bahkan untuk rawat inapnya. Rumah Sakit tipe B (PPK-2) yang baru berdiri tiga tahun terakhir ini diwajibkan memiliki dokter spesialis psikiatri untuk memenuhi syarat pendirian RS tipe B (FYI, di dunia pe-Rumah Sakit-an, dikenal istilah “empat besar”, yakni layanan Bedah, Penyakit Dalam, Kandungan, dan Anak. Masing-masing diwakili minimal satu dokter spesialis pada bidang “empat besar” tersebut. Sekarang ini syarat pendirian RS tipe B sudah harus “lima besar”, termasuk Psikiatri).

 

Pengalaman kami di RSUD Dr. Soetomo Surabaya, yang merupakan rumah sakit rujukan tersier di Jawa Timur, proses mengobatkan pasien ada dua macam: yakni langsung mengantarkan ke sentra kesehatan terdekat, atau melalui proses rujukan dari PPK-1 hingga PPK-3.

 

Selain itu, masyarakat kini tidak perlu khawatir biaya pengobatan pasien yang tidak terjangkau karena BPJS kini menanggung biaya obat-obat untuk gangguan jiwa. Hal ini sangat berpengaruh pada keuangan sebuah keluarga, mengingat pengobatan pasien kadang membutuhkan jangka waktu yang lama, BPJS dapat membantu meringankan biaya pengobatan pasien.

 

Ohya, terapi pasien juga perlu diperhatikan. Terapi pasien skizofrenia pasca pasung atau rawat inap seringkali menonjol pada sisi psikososialnya. Sehingga sangat membutuhkan grup support atau komunitas seperti yang digagas oleh teman-teman SchizoFrendsCare ini. Keren banget, lho.

Semoga informasi ini bermanfaat, salam

 

dr. Hafid Algristian,CHt,CI.

Psychiatry Resident, Author
Trainer #EverlastingHappiness & #SmartParenting.

How many times have you typed I’m fine with tears running down your face?

 

You’re thinking about it. Ending your life. Stopping the pain. Doing it because you think it’s best for those around you. You’re tired of your shit being the cause of other people’s pain. Tired of fighting demons. Tired of… just tired.

Every night, every day, is a struggle. A goddamn fucking struggle. You wear a smile. You’re screaming inside. And no one can hear you. Not the fucking VA. Not your family. Not your friends. You’ve been cheated on. Left. Denied. Turned down. Turned away.

But you’re supposed to be okay.
You’re supposed to be better by now.
But you’re not.

No one can see you. Yeah, your buddies know this shit. But they don’t have to live inside your head. And everyone else?
“Go to counseling.”
“Take your meds.”
“Try to forget about it.”
You’ve heard it all. Just do something, fuck, anything, as long as we don’t have to deal with your pain. That’s what they’re thinking, right?

So, suicide.
Go out quickly.
No reason not to.
At least then the people you love won’t be hurt by your shit anymore. You’ll be free from these ghosts you can’t evade. The anger you can hardly contain. The scenes that flash before your eyes over and over and over and fucking over again and…

Give me one damn good reason to live, you plead. And silence echoes from the heavens.

Alone.
Lost.
Exhausted.
No end and no hope in sight that things will ever get better. That things can even get better.

You should’ve died down range. Would’ve been better than this internal hell.

And so you are thinking about it. You might have already tried. And for whatever reason, you found this article. These words. These thoughts that feel as if I’m reading your mind. And you feel a spark of recognition. Enough to keep you reading.

Because everyone talks about “suicide prevention” but no one gives a damn about you. “Call the hotline”, they say, as they hand you a flimsy card, turn and walk back into their comfortable lives. Twenty-two veterans a day.

You know what?
I’m tired, too.
I’m tired of hearing about good, caring guys like you who pulled the trigger, fastened the noose, and died believing they were alone in their pain. Died believing that suicide was the only way. Died believing that no one like me existed out here. Died without knowing how easily they could have lived. How if they had made one connection to one person who actually gave a damn about them, it would have made the difference. That one healing embrace would have been the turning point. A spark lighting up the dark.

Because it is the difference.
Your spirit doesn’t need a miracle cure. You’re not dying of cancer.
The wounds you bear are not unhealable. The pain you feel can be eased.
You CAN heal.
You can feel joy again. You can find a life that you live on purpose and with purpose. You don’t need a miracle cure. The power is within you.

But you are tired.
Worn.
Weary.
Exhausted.
Depleted.
You don’t have the strength to continue on alone.

That’s why you’re here. Now. Reading these words I’m speaking to you.
Because you need someone to take your hand and look you in the eyes and fight for you.

Yes, fight for you. You don’t need to be rescued. You need someone to fight this battle for your freedom with you. To be there when you can’t go on, to remind you of the light and joy and beauty and strength that’s still in you. To hold up a vision of you, whole, and remind you of what IS possible. To see, when you can’t see it yourself. To believe, when you can’t believe it yourself.

To fight for the light in you until you can feel it yourself.

Don’t.
Don’t be that guy I hear of tomorrow whose death causes his buddies to absorb the shock like another blast. Don’t be that death that makes it just a little bit harder for them to stay. Don’t be that death that lets war win, that lets the enemy win, years after they had their last chance.

You matter.
You matter to your buddies.
You matter to me.

You. matter. to. me.

I don’t care how broken you think you are. I don’t care how beyond hope you think you are. I am looking you in the eyes and telling you this:
I am here to fight this battle with you.
I see you.
You’re not invisible to me.
You can find healing.

So what do I want you to do?
Clasp my outstretched hand. Connect.
I will fight for your freedom. I will walk this path with you. You owe it to every single person who has ever loved you, living and dead, to give yourself this chance. You owe it to your buddies.

You owe it to me because I’m here, looking you in the eyes.
You owe it to yourself.

How many times have you typed I’m fine with tears running down your face?
You move on. You rise up. And you always being good.

http://lifeafterwar.org/2014/01/01/before-you-kill-yourself-read-this/

 

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