Clustering the Depression Prevalence in Indonesia Provinces through Natural Breaks Jenks Method

Depression has become a significant global health concern, ranking fourth among the world's diseases in 2022, according to WHO. In Indonesia, the 2018 Basic Health Research (Riskesdas) reported that over 12 million people aged ≥15 suffer from depression. Clustering provinces in Indonesia can assist the government in formulating appropriate policies and treatments for individuals suffering from depression.

The Natural Breaks Jenks method was applied to cluster the prevalence of depression across provinces, utilizing data from the 2023 Indonesia Health Survey. This method effectively grouped provinces into distinct categories based on varying levels of depression prevalence, allowing for a clearer understanding of regional disparities. By identifying these clusters, the analysis highlights the provinces with both high and low rates of depression, offering valuable insights into the geographic distribution of mental health issues. This approach not only helps pinpoint areas that may require more intensive mental health interventions but also aids in better resource allocation, ensuring that the government's mental health policies are tailored to the specific needs of each region. Moreover, the results of this clustering can serve as a foundation for future studies and public health strategies aimed at reducing depression across the country.

Our study reveals significant regional disparities in the prevalence of depression across Indonesia’s provinces. A low prevalence of depression was identified in 18 provinces, namely Bengkulu, Kepulauan Bangka Belitung, Kepulauan Riau, Kalimantan Tengah, Kalimantan Utara, Sulawesi Utara, Sulawesi Tenggara, Gorontalo, Sulawesi Barat, Maluku, Maluku Utara, Papua Barat, Papua Barat Daya, Papua, Papua Selatan, Papua Tengah, and Papua Pegunungan. These provinces show relatively lower rates of depressive symptoms, which may be influenced by factors such as socio-cultural dynamics, access to mental health care, and local community support systems.

In contrast, a medium prevalence of depression was observed in 11 provinces: Aceh, Sumatera Barat, Riau, Jambi, DI Yogyakarta, Bali, Nusa Tenggara Barat, Nusa Tenggara Timur, Kalimantan Barat, Kalimantan Selatan, and Kalimantan Timur. These areas display moderate levels of depression, potentially indicating a need for targeted prevention and intervention strategies to address underlying factors like economic stability and social cohesion.

The high prevalence cluster included 6 provinces: Sumatera Utara, Sumatera Selatan, Lampung, DKI Jakarta, Banten, and Sulawesi Selatan, where depression rates were notably higher. The elevated prevalence in these provinces may be attributed to factors such as urbanization, socio-economic disparities, and possibly limited access to mental health services.

Finally, a very high prevalence of depression was found in 3 provinces: Jawa Barat, Jawa Tengah, and Jawa Timur, suggesting a critical need for targeted mental health interventions. These densely populated regions may face unique challenges, including high levels of urbanization, economic inequality, and limited mental health infrastructure, which could contribute to the high rates of depression observed.

These findings highlight the importance of tailored mental health policies and interventions, with a particular focus on provinces with very high and high prevalence rates, to ensure effective resource allocation and improved mental health outcomes across the country. Further research into the specific socio-economic, cultural, and environmental factors in each region will be crucial to understanding the root causes of these disparities and designing effective solutions.

These results indicate that Indonesia has a higher number of provinces with low depression prevalence compared to those with high prevalence. This suggests that while there are regions with lower rates of depression, there are still significant areas where mental health issues need more focused attention. Given this, the government should prioritize provinces with very high depression prevalence to improve mental health outcomes in those areas. By focusing on these regions, the government can better allocate resources, implement targeted interventions, and provide necessary mental health services. Addressing the mental health needs of provinces with high depression rates is essential for reducing overall national mental health disparities and ensuring equitable access to mental health support across Indonesia. Additionally, understanding the socio-economic and cultural factors that contribute to higher depression rates in these regions will be crucial in designing effective and sustainable mental health programs.