Author: Eduardo Renaldo & Eva Suryani
Mental health is a global problem. Mental health personnel faces critical challenges in delivery of care particularly in remote areas. Given the uneven knowledge/skill development and geographic spread of regional providers, The Substance Abuse and Mental Health Services Administration (SAMHSA) as one of the agencies within the U.S. Department of Health and Human Services aim to effectively target substance abuse and mental health services to the people most in need and to translate research in these areas more successfully and more rapidly into the general health care system.
Over the years, SAMHSA has extended their international activities and placing staff members regionally in the Southeast Asia (SEA) since January 2016. SAMHSA SEA’s work is to assist the PEPFAR missions in the region and the governments of the countries in SEA with developing and implementing evidence based, client centered and rights based policies, programming and services to address the issue of HIV with a focus on addiction as all of the countries in the SEA region have a concentrated HIV epidemic. This program covers 8 countries which are divided into 3 tiers (Tier 1: Cambodia, Laos, Thailand and Myanmar; Tier 2: Indonesia and PNG; Tier 3: China and India).
Many countries worldwide have been dealing with the health burden due to substances use and addiction. Comorbidities of substance use disorders (SUDs), such as mental problems and HIV infection, accounted for an even higher burden of disease. In Indonesia, people who inject drug (PWID) were most likely to access HIV testing and treatment when they accessed addiction treatment. Therefore, such treatment is essential to reduce both substance use and HIV related problems. However, it has been shown that the HIV care cascade of PWID in Indonesia was lower than the global commitment, especially the retention in the HIV treatment (55%) and viral suppression (20%). Moreover, mental problems related to substance use, especially methamphetamine, have been increasingly recognized in Indonesia. Unfortunately, studies on mental problems and substance use in the country are inadequate. Additionally, many health professionals in Indonesia only received a short training in addiction medicine and do not perceive addiction as a disease.
SAMHSA SEA Program started reaching out to Indonesia in 2018. This program proposed a recommendation to develop the HATTC Indonesia to improve HIV and substance use treatment that in line with the need to strengthen the treatment facilities in Indonesia. It has been planned to develop this center through a consortium of universities and government institutions which work in the issues of HIV and substance use treatment. The “Stakeholders Consolidation Meeting for the HIV-Addiction Technology Transfer Center (HATTC) Indonesia” was organized by the Atma Jaya Catholic University of Indonesia in collaboration with support from the Southeast Asia – HIV and Addiction Technology Transfer Center (SEA-HATTC) on 26th August 2018 at the Auditorium, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia. The objectives of the meeting are (1) to understand the current situation of substance use and HIV in Indonesia; (2) to identify the Consortium Chair and Vice Chair; and (3) to prepare for the Consortium plan in coming time.
From the year of 2018 to 2020, few trainings and meetings were held to create ongoing learning communities where health care academia, professionals, service providers, policy makers, and others who are interested in this field could receive support and develop skills needed to deal with addiction, HIV, and mental health issues. In 2020 HATTC Indonesia made a name change to Indonesian Consortium of Addiction Technology Transfer (ICATT) so that it is easier to remember but still includes the name of TTC to show that we are still part of ATTC loop. Our success is inseparable from those who support us from institutions such as universities, government agency, professional association, research center, service provider, community-based organization of drugs and HIV, and beneficiaries. ICATT activities were based on plans that have been made before, this includes:
Our workplan is a bit hampered due to the COVID-19 pandemic, but with good cooperation and communication between our team members we can find other options to overcome this problem. We work together with HIV Prevention Trial Network (HPTN) to organize Online Seminar titled "Global Access on ART: HPTN074 Recommendations and Challenges". We invited several speakers who are experts in their fields from The United States of America, Ukraine, Vietnam and Indonesia with intention to make greater insight about HIV condition and interventions designed in preventing the transmission of HIV in many countries. This seminar will certainly be an interesting topic for all of us whether it is a health professional participant, human resource manager, student, or someone who just wants to learn more.
Moreover, during this time of the pandemic we decided to conduct an online seminar which was held in collaboration between ICATT and Psychiatric Departement of Padjadjaran University and Hasan Sadikin General Hospital. This Online Seminar was held to answer the restlessness for HIV and addiction patients, who apparently have to struggle more in this COVID–19 era. To answer this questions, ICATT, chaired by dr. Eva Suryani, Sp.KJ held this online seminar and invited some experts in HIV and addiction from the members of ICATT. The member of committee in this seminar was Psychiatry Department Resident of Padjajaran University with the Chairman of the Committee was dr. Shelly Iskandar, Sp.Akp., Sp.KJ., M.Si., Ph.D. This online seminar was held via Zoom Meeting and Youtube Live platform. This event was held for 4 days (18, 19, 21, and 22 August 2020). There were around 400–600 participants who join the online seminar each day either in Zoom Meeting or Youtube Online. There were some problems during the Online Seminar, but the committee was able to overcome them, so that the Online Seminar could run smoothly and participants could play an active role during the discussion session.
The technology transfer center is one piece of moving on the system forward. Although there were some obstacles in implementation, these can be resolved with good cooperation from our team. Besides the many satisfying results of the events held we need to remember it is not just simplified training or technical assistance but there is about indirect benefits to the network such as having collaboration across the network to solve the problem of addiction, HIV, and mental health issues especially in outreach area. Despite these achievements, we still want to focus on several needs to expand our hub such as provide accessible information, basic competence, and integrate different policies concerning addiction, HIV, and mental health issues.
Indonesian Consortium of Addiction Technology Transfer (ICATT)
Pluit Raya 2, Jakarta 14440, Indonesia.
consortiumhattc [dot] id [at] gmail [dot] com