"Disertasi ini mengkaji masalah kesehatan jiwa, khususnya masalah stres yang dialami oleh penduduk miskin yang tergusur oleh proyek pembangunan yang dilaksanakan di tempat tinggal mereka. Obyek penelitian adalah masyarakat Marunda Besar di Kelurahan Marunda, Jakarta Utara.
Kajian disertasi ini menunjukkan bahwa kompensasi material berupa biaya pindah tempat, yang kadangkala juga ditambah dengan penyediaan lokasi pemukiman baru sebagai suatu paket penggusuran, tidak menjamin penyelesaian masalah yang menimpa penduduk tergusur itu. Penggusuran ternyata memerlukan penyelesaian yang lebih terintegrasi, cermat dan penuh kepekaan, yang meliputi kesehatan jiwa mereka.
Peningkatan stres dan disintegrasi sosial-budaya terjadi pada pihak yang tergusur karena proyek pembangunan mengakibatkan perubahan lingkungan fisik dan sosial-budaya yang cepat. Terdapat lebih banyak respons maladaptif daripada respons adaptif, karena adanya keterbatasan kemampuan budaya masyarakat dalam beradaptasi terhadap berbagai tantangan kehidupan yang terlalu berat; yang muncul karena kehadiran proyek pembangunan dan segala akibatnya itu_ Karena itu kajian mengenai masalah stres yang dialami oleh masyarakat yang sedang membangun menjadi obyek yang relevan dan merupakan suatu tuntutan bags penelitian antropologi.
Penelitian ini mengacu kepada model teoritis yang dihasilkan oleh D.P. Lumsden mengenai sistem terbuka yang mengalami stres (amnen system under stress) dan teori integrasi-disintegrasi sosial-budaya yang diajukan oleh A.H. Leighton.
Untuk mengukur tingginya stres, digunakan instrumen penelitian Daftar Isian Kesehatan Cornell Medical Index (CMI) yang telah dimodifikasi oleh Direktorat Kesehatan Jiwa, Depkes RI untuk digunakan di Indonesia. Dengan memodifikasi pula indikator-indikator Leighton agar sesuai dengan konteks sosial-budaya masyarakat Marunda Besar, dapat dihasilkan perhitungan korelasi antara skor disintegrasi sosial-budaya dan skor CMI.
Dari penelitian ini telah diperoleh hasil yang mencakup empat pokok, yaitu:
Pertama, berbagai masalah lingkungan alam dan lingkungan sosial-budaya yang berat yang harus dihadapi oleh Marunda Besar, berpengaruh negatif pada kesehatan jiwa mereka.
Kedua, hasil pengukuran stres yang menggunakan kuesioner CMI menemukan adanya 73 orang dari 166 orang responden (43,98%) yang mengalami gangguan psikofisiologi yang bermakna. Angka persentasi ini cukup tinggi diperbandingkan dengan ukuran WHO yang menentukan prevalensi gangguan jiwa ringan dalam masyarakat pada umumnya hanya berkisar antara 40-80 orang di antara 1000 penduduk (4-8%).
Ketiga, perhitungan korelasi antara skor dieintegrasi sosial-budaya dan skor CMI lebih rendah (0,271) daripada penemuan hasil penelitian Leighton yang menunjukkan korelasi yang lebih tinggi (sekitar 0,45). Korelasi yang lebih rendah ini tampak berkaitan dengan konsepsi tentang nilai kebersamaan dan kekeluargaan yang menimbulkan rasa aman, yang sebenarnya bersifat semu.
Keempat, pembangunan di lingkungan itu ternyata telah menimbulkan penderitaan psikologi, sosial-budaya dan ekonomi pada penduduk setempat. Hal ini dapat dilihat sebagai kekurangtepatan orientasi pembangunan dalam bentuk model pembangunan yang mengutamakan manfaat ekonomi secara makro, umat kurang memperhatikan kepentingan masyarakat di tingkat mikro, spasial dan sektoral. Kajian tentang stres, disintegrasi sosial-budaya, dan respons maledaptif yang bersumber pada hambatan kemampuan budaya masyarakat dalam mengatasi berbagai tantangan dalam lingkungan, menunjukkan bahwa masalah kesehatan jiwa tidak dapat diabaikan dalam penanganan masalah penggusuran. Masalah penggusuran dan kesehatan jiwa harus diperlakukan sebagai bagian integral dari pelaksanaan proyek-proyek pembangunan.
Development Project, Relocation of Kampungs and Stress among the Marunda Besar Population, Northern JakartaThis dissertation examines the mental health problem, particularly stress, suffered by the poor facing relocation of their living quarters. The object of research was the population of Marunda Besar, Kelurahan Marunda, Northern Jakarta.The research pointed out that material compensation in the form of moving expenses which sometimes was supplemented by the preparation of new location as a relocation package, did not guarantee in solving the problems' faced by the people. It turned out that re-location needed a more integrated 'solution, which is meticulous and subtle, towards the people's mental health.An increase of the degree of stress and socio-cultural disintegration had been experienced by the relocated people, as the development project in the area created rapid environmental as well as socio-cultural changes. There were more maladaptive responses to these changing physical and socio-cultural environments than adaptive responses, since the existence of the project and its entire consequences had turned to be beyond the people's cultural ability to overcome_ Therefore the study on stress experienced by a developing community becomes a relevant one, which calls for an anthropological research.This dissertation is based on the theoretical model by D.P. Lumeden concerning an open system under stress and the theory of socio-cultural integration-disintegration put forward by A. H. Leighton.In measuring the degree of stress, the research instrument Cornell Medical Index (CMI) has been used. The instrument has been modified by the Directorate of Mental Health of the Department of Health of the Republic of Indonesia, for its use in Indonesia. With further modification on Leighton's indicators to make it relevant to the socio-cultural conditions of the Marunda Besar population, a correlation of the score of socio-cultural disintegration and CMI score could be made.Four major findings have been gained as the following:First, several grave environment as well as socio-cultural problems faced by the Marunda Besar population had a negative effect to the people's mental health.Second, the results of the measurement of stress utilising CMI research instrument had proven that 73 out of 166 respondents {43.98%) suffered from psycho-physiological disorders. The percentage is much higher compared to the WHO measurements stating that the prevalence of mild mental disturbances in a community ranges between 40-80 people in every 1000 (4%-8%).Third, the correlation between the socio-cultural disintegration score and the CMI score was lower (0.271) than the finding in the Leighton's study (around 0.45). The lower correlation is closely related to the conception on the people's cultural values of mutuality and brotherhood that create the sense of safety which is mostly imaginary.Fourth, the development around the area turned out to have caused psychological, socio-cultural as well as economic sufferings to the local population. This can be viewed as an improper development orientation relying on the macro-economic development model with an emphasis on economic growth and gain, less sufficiently concerns with the interest of people at the micro, spatial and sectoral dimensions. The research on stress, socio-cultural disintegration, and maladaptive responses due to cultural constraints in overcoming environmental barriers, showed that mental health problem in connection with the management of relocation of people's living quarters demands serious attention. Relocation and the mental health of the relocated people should be treated as an integral part of the implementation of development projects.Four major findings have been gained as the following:First, several grave environment as well as socio-cultural problems faced by the Marunda Besar population had a negative effect to the people's mental health.Second, the results of the measurement of stress utilising CMI research instrument had proven that 73 out of 166 respondents {43.98%) suffered from psycho-physiological disorders. The percentage is much higher compared to the WHO measurements stating that the prevalence of mild mental disturbances in a community ranges between 40-80 people in every 1000 (4%-8%).Third, the correlation between the socio-cultural disintegration score and the CMI score was lower (0.271) than the finding in the Leighton's study (around 0.45). The lower correlation is closely related to the conception on the people's cultural values of mutuality and brotherhood that create the sense of safety which is mostly imaginary.Fourth, the development around the area turned out to have caused psychological, socio-cultural as well as economic sufferings to the local population. This can be viewed as an improper development orientation relying on the macro-economic development model with an emphasis on economic growth and gain, less sufficiently concerns with the interest of people at the micro, spatial and sectoral dimensions. The research on stress, socio-cultural disintegration, and maladaptive responses due to cultural constraints in overcoming environmental barriers, showed that mental health problem in connection with the management of relocation of people's living quarters demands serious attention. Relocation and the mental health of the relocated people should be treated as an intregral part of the implementation of development projects."
