Learning model by using the tabletop is aimed to examine the response of mental health service towards the occurring disaster. Such training is expected to be attended by Health Office, Indonesian Red Cross, various NGO's of disaster sectors as well as Health Service provider. The more institutional representatives participating the training, the better it would be.

The training purposes briefly is as follow :

• To clarify the role and responsibility of many different components of mental health sectors in responding the disaster at any phase
• To practice the cooperation in responding the disaster
• Evaluating the experiences
• To anticipate the disaster with better preparedness in mental health sector in District/City provincial level
• Preparing sources of funding for mental health

Saturday, May 27, 2006 at 5.55 A.M , a tectonic earthquake occurred in Yogyakarta with arrange of 5,59 in the Richter's Scale. There was an enormous chaos occurred, the people was in confusedly panic due to the rumors saying that the earthquake would cause Tsunami, the city streets were in total chaotic traffic jam, many buildings were destroyed, a large umber of inhabitants were injured by pieces of building drops and it even caused death. DR, Sardjito hospital as a reference hospital was too busy taking care thousands of earthquake victims. Moreover, the day before it happened was a holiday and the earthquake shocked in the morning where many health staffs were not in duties. Only with all limited sources, all the best medical efforts were given to help the victims. The only concern is to focusing to maintain the health and secured physic.

At that time Mental SMF/Department of Dr. Sardjito Hospital/Medical Faculty of UGM were visited by colleagues of psychiatry from other cities to support the medical logistic and efforts. A psychiatry from Jakarta working for WHO, who knows well the psychiatry in Helth SMF/Department of Dr. Sardjito Hospital/Medical Faculty of UGM had offered a donation supports for Rapid Assessment on Mental Health on Needs and Resources (RAMH). Such planning was well agreed by Health Department/SMF, involving the residents, the psychiatry was organizing by dividing into 5 different regions of Yogyakarta to apply RAMH. It was found that after the earthquake, mental health and psychosocial problems were increasing, the press was interested to find out the accurate number of victims “having stress after the earthquake?”. Although RAMH had been applied, it was still difficult to find an accurate number of patients and kinds of mental disorder, however, with RAMH 3 suicidal cases had been identified.

In the first week, a meeting for mental and psychosocial disorder was held by Mental Health Directorate and WHO, it was located in Provincial Health Office, and was attended by Provincial Health Office, Hospital Representatives (Jogja and Klaten), universities, Representatives of PDSKJI (Psychiatry Organization) and NGO's. Several points were agreed.

Key Questions:

1. What is the behavioral map of mental health performer?
2. How did the situation happen according to the performer's point of view?
3. What are the roles of social network in emergencies?
4. Who organized the actions in the first emergencies?
5. Who should confirm it to press?
6. Who should perform the RAMH?
7. Who should organize the external supporting aids?
8. Who should responsible for the listing of mental and psychosocial disorder cases?

In the mental and psychosocial health coordination meeting, several points were agreed:

1. Central coordination office is in the Provincial Health Office
2. Provincial Health Office would be leading the mental and psychosocial health coordination
3. Coordination meeting would be held once in a week on every Saturday at 9 A.M
4. International organization would provide technical and donation supports for procuring handbook, books of guidelines, training or mental and psychosocial health workshop

Mapping was conducting to decide who, what and where the mental and psychosocial program would be applied

In several coordination meeting was led by international organization, due to the reason that Health Office had been overloaded with too may conducting health program.

The participants were largely decreasing and the field activity report had never been delivered to the Health Office

In the mean time, the socialization of advanced identification for mental and psychosocial disorder was conducted by dr, Sardjito Hospital in cooperation with International Organization (since 3 suicidal cases were found) by distributing thousand of leaflets to the public. The problems are: would the leaflet not causing more mass panic and make them felt to experience mental disorder?

Key Questions:

1. Who should be responsible as the coordinator of mental and psychosocial health?
2. Who should responsible in the mapping, of who, what and where should be working?
3. Who should responsible to collect the report data of mental and psychosocial health conducted by NGO?
4. Who should be responsible to distribute the information/promotion to the public about advanced identification of mental disorder?

When RAMH was being applied, there were mental and psychosocial disorder found such as insomnia (included nightmare), aggressive behavior, acute stressed, panic, depressive behavior, increasing sadness, desperate, mentally self raged, schizophrenia and acute psychotic. Psychosocial problems found were loosing the family/relatives and houses, the situation in the refugee camps, uneven supporting supplies distribution, security problems, uncertain future life, education and economic problems. Anti psychotic drugs had been widely distributed to the public with uncertain indications. Many supporting posts established for stress and mental disorder. Many NGO's and international organizations were focusing on the children but none gives intervention towards the problems of geriatric or old adults.

It was known that the data and advanced identification system of Health Clinic was inadequate. The doctors in Health Clinic could not identify the mental disorder due to the reason of less confident or have been forgotten the mental health diagnose methods. There were integration between Health Clinic and local Mental Hospital, however the psychiatry from Mental hospital more likely in charge to the patients. This disturbing finding had attracted an international organization to provide human resources and donation support for commencing the mental and psychosocial health training for psychiatry, doctors of Health Clinics and community figure.

Key questions:

1. Who should be responsible for mental and psychosocial health problems in the community after disaster?
2. What should be done and should not be done to anticipate the mental and psychosocial health problems?
3. What are the roles of Disaster Response Guidelines?
4. How should an integrated Health Clinics (mental and psychosocial health) perform?
5. Who should responsible for mental and psychosocial health training?
6. When should the mental and psychosocial health training be commenced?

On the months after, mental and psychosocial health problems has been increasingly complex. In the coordination meeting for mental and psychosocial health attended by organizations with programs, however the coordination remained in organized by international organizations. Mental and psychosocial health training for the community figure in fact was applied to the community figure who also gain such training of various program such as, Maternity, rehabilitation, etc, therefore the burden for community figure is large.

roblems in community: complains of pediatric patients gained less information access about rehabilitation, a complain from a couple of husband-wife ho could not perform their sexual activities since living in the refugee camps, rumors of westernization supports, watsan gender problem. Such problems had effected the international organization to held a workshop for mental and psychosocial health to gain the best formula or system for mental and psychosocial health with or without occurring disaster.

Key Questions:

1. How should the preparedness for mental and psychosocial health?
2. What is the best system for mental and psychosocial health? (with or without occurring disaster)