Exploring Local Values and Beliefs to Develop School-based Mental Health Anti-Stigma: A Phenomenology Study

Aiyub Aiyub; Syarifah Rauzatul Jannah; Marthoenis Marthoenis; Asnawi Abdullah; Hizir Sofyan

doi:10.3889/oamjms.2022.10509

Authors

Aiyub Aiyub Graduate Program, Graduate School of Doctor Mathematics and Applied Sciences (DMAS), Universitas Syiah Kuala, Banda Aceh, Indonesia; 2Department of Psychiatry and Mental Health Nursing, Universitas Syiah Kuala, Banda Aceh, Indonesia https://orcid.org/0000-0003-1658-9211
Syarifah Rauzatul Jannah Department of Psychiatry and Mental Health Nursing, Universitas Syiah Kuala, Banda Aceh, Indonesia
Marthoenis Marthoenis Department of Psychiatry and Mental Health Nursing, Universitas Syiah Kuala, Banda Aceh, Indonesia
Asnawi Abdullah Department of Biostatistics, Faculty of Public Health, Univesitas Muhammadiyah Aceh, Banda Aceh, Indonesia
Hizir Sofyan Department of Statistics, Faculty of Math and Science, Universitas Syiah Kuala, Banda Aceh, Indonesia

DOI:

https://doi.org/10.3889/oamjms.2022.10509

Keywords:

Mental health, Mental disorders, Adolescent, Students, Mental health stigma, Qualitative study, Indonesia

Abstract

BACKGROUND: Students in middle-income countries frequently experience stigma related to mental disorders (MDs). Those with MDs are stereotyped as incompetent, uncontrollable, uncooperative, and dangerous. Stereotypes are predominantly formed and disseminated due to culture and beliefs. Therefore, it is essential to investigate, comprehend, and apply the local values and beliefs to increase the effectiveness of school-based anti-stigma programs.

AIM: This study aims to investigate the local values and beliefs related to mental health anti-stigma as early initiation of school-based anti-stigma development.

METHODS: This is an exploratory phenomenological study. A total of 30 informants were interviewed personally or participated in focus group discussions. Content analysis was performed to identify related sub-themes and themes.

RESULTS: This study identified seven themes and 15 sub-themes. The seventh theme included the importance of school-based anti-stigma, school-based anti-stigma approach, school-based anti-stigma method, media dissemination of school-based anti-stigma information, design of school-based anti-stigma information, the target group of school-based anti-stigma, and collaboration partners of school-based anti-stigma.

CONCLUSION: Adolescents in middle school frequently experience stigma regarding their mental health from their peers. Using both Islamic and mental health approaches, integrating internal and external stakeholders, dispelling unfavorable misconceptions and stereotypes, encouraging students to understand and empathize with others, and reducing the harmful effects of mental health stigma were found to help reduce the stigma of mental illness.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

Plum Analytics Artifact Widget Block

References

Ananta A, Arifin EN, Hasbullah MS, Handayani NB, Pramono A. Demography of Indonesia’s Ethnicity. Singapore: Institute of Southeast Asian Studies; 2015. DOI: https://doi.org/10.1355/9789814519885

Rochmawati E, Wiechula R, Cameron K. Centrality of spirituality/ religion in the culture of palliative care service in Indonesia: An ethnographic study. Nurs Health Sci. 2018;20(2):231-7. https://doi.org/10.1111/nhs.12407 PMid:29336107 DOI: https://doi.org/10.1111/nhs.12407

Pesurnay AJ. Local wisdom in a new paradigm: Applying system theory to the study of local culture in Indonesia. IOP Conf Ser Earth Environ Sci. 2018;175(1):012037. https://doi.org/10.1088/1755-1315/175/1/012037 DOI: https://doi.org/10.1088/1755-1315/175/1/012037

Bello H. Stigma in the Muslim community, a Hindrance to Seeking Help for Mental Health Issues. United States: Walden University; 2020. p. 1-18.

Hartini N, Fardana NA, Ariana AD, Wardana ND. Stigma toward people with mental health problems in Indonesia. Psychol Res Behav Manag. 2018;11:535-41. https://doi.org/10.2147/PRBM.S175251 PMid:30464658 DOI: https://doi.org/10.2147/PRBM.S175251

Semrau M, Evans-Lacko S, Koschorke M, Ashenafi L, Thornicroft G. Stigma and discrimination related to mental illness in low-and middle-income countries. Epidemiol Psychiatr Sci. 2015;24(5):382-94. https://doi.org/10.1017/S2045796015000359 PMid:25937022 DOI: https://doi.org/10.1017/S2045796015000359

DeLuca JS. Conceptualizing adolescent mental illness stigma: Youth stigma development and stigma reduction programs. Adolesc Res Rev. 2020;5(4):153-71. https://doi.org/10.1007/s40894-018-0106-3 DOI: https://doi.org/10.1007/s40894-018-0106-3

Gronholm PC, Nye E, Michelson D. Stigma related to targeted school-based mental health interventions: A systematic review of qualitative evidence. J Affect Disord. 2018;240:17-26. https://doi.org/10.1016/j.jad.2018.07.023 PMid:30041074 DOI: https://doi.org/10.1016/j.jad.2018.07.023

Heary C, Hennessy E, Swords L, Corrigan P. Stigma towards mental health problems during childhood and adolescence: Theory, research and intervention approaches. J Child Fam Stud. 2017;26(4):2949-59. DOI: https://doi.org/10.1007/s10826-017-0829-y

Subu MA, Waluyo I, Nurdin AE, Priscilla V, Aprina T. Stigma, stigmatisasi, perilaku kekerasan dan ketakutan diantara orang dengan gangguan jiwa (ODGJ) di Indonesia: Penelitian constructivist grounded theory. J Kedokt Brawijaya. 2018;30(1):53. https://doi.org/10.21776/ub.jkb.2018.030.01.10 DOI: https://doi.org/10.21776/ub.jkb.2018.030.01.10

Kudva KG, El Hayek S, Gupta AK, Kurokawa S, Bangshan L, Armas-Villavicencio MV, et al. Stigma in mental illness: Perspective from eight Asian nations. Asia Pac Psychiatry. 2020;12(2):e12380. https://doi.org/10.1111/appy.12380 PMid:31922363 DOI: https://doi.org/10.1111/appy.12380

Dardas LA, Silva SG, Smoski MJ, Noonan D, Simmons LA. Personal and perceived depression stigma among Arab adolescents: Associations with depression severity and personal characteristics. Arch Psychiatr Nurs. 2017;31(5):499-506. https://doi.org/10.1016/j.apnu.2017.06.005 PMid:28927515 DOI: https://doi.org/10.1016/j.apnu.2017.06.005

Corrigan PW, Nieweglowski K. Stigma and the public health agenda for the opioid crisis in America. Int J Drug Policy. 2018;59:44-9. https://doi.org/10.1016/j.drugpo.2018.06.015 PMid:29986271 DOI: https://doi.org/10.1016/j.drugpo.2018.06.015

Link BG, Phelan JC. Conceptualizing stigma. Ann Rev Soc. 2003;27(1):363-85. https://doi.org/10.1146/annurev.soc.27.1.363 DOI: https://doi.org/10.1146/annurev.soc.27.1.363

Corrigan PW, Kerr A, Knudsen L. The stigma of mental illness: Explanatory models and methods for change. Appl Prev Psychol. 2005;11(3):179-90. https://doi.org/10.1016/j.appsy.2005.07.001 DOI: https://doi.org/10.1016/j.appsy.2005.07.001

Xu J, Zhang X, Ren Z, Luo Y, Li G. The antidepressant-like effect of vanillin aroma involves serum magnesium and brain BDNF. Neuropsychiatry (London). 2018;8(4):1400-4. https://doi.org/10.4172/neuropsychiatry.1000470 DOI: https://doi.org/10.4172/Neuropsychiatry.1000470

Oexle N, Müller M, Kawohl W, Xu Z, Viering S, Wyss C, et al. Self-stigma as a barrier to recovery: A longitudinal study. Eur Arch Psychiatry Clin Neurosci. 2018;268(2):209-12. https://doi.org/10.1007/s00406-017-0773-2 PMid:28188369 DOI: https://doi.org/10.1007/s00406-017-0773-2

Duxbury SW, Haynie DL. School suspension and social selection: Labeling, network change, and adolescent, academic achievement. Soc Sci Res. 2020;85:102365. https://doi.org/10.1016/j.ssresearch.2019.102365 PMid:31789197 DOI: https://doi.org/10.1016/j.ssresearch.2019.102365

Ndetei DM, Mutiso V, Maraj A, Anderson KK, Musyimi C, McKenzie K. Stigmatizing attitudes toward mental illness among primary school children in Kenya. Soc Psychiatry Psychiatr Epidemiol. 2016;51(1):73-80. https://doi.org/10.1007/s00127-015-1090-6 PMid:26154242 DOI: https://doi.org/10.1007/s00127-015-1090-6

Chan S, Quinn P. Secondary school students’ views of inhibiting factors in seeking counselling. Br J Guid Couns. 2012;40,(5):527-43. https://doi.org/10.1080/03069885.2012.719603 DOI: https://doi.org/10.1080/03069885.2012.719603

Thornicroft G. Stigma and discrimination limit access to mental health care. Epidemiol Psichiatr Soc. 2008;17(1):14-9. https://doi.org/10.1017/S1121189X00002621 PMid:18444452 DOI: https://doi.org/10.1017/S1121189X00002621

Mellor C. School-based interventions targeting stigma of mental illness: Systematic review. Psychiatr Bull (2014). 2014;38(4):164-71. https://doi.org/10.1192/pb.bp.112.041723 PMid:25237538 DOI: https://doi.org/10.1192/pb.bp.112.041723

Graneheim UH, Lundman B. Qualitative content analysis in nursing research: Concepts, procedures, and measures to achieve trustworthiness. Nurse Educ Today. 2004;24(2):105-12. https://doi.org/10.1016/j.nedt.2003.10.001 PMid:14769454 DOI: https://doi.org/10.1016/j.nedt.2003.10.001

Elo S, Kyngäs H. The qualitative content analysis process. J Adv Nurs. 2008;62(1):107-15. https://doi.org/10.1111/j.1365-2648.2007.04569.x PMid:18352969 DOI: https://doi.org/10.1111/j.1365-2648.2007.04569.x

Abdullah T, Brown TL. Mental illness stigma and ethnocultural beliefs, values, and norms: An integrative review. Clin Psychol Rev. 2011;31(6):934-48. https://doi.org/10.1016/j.cpr.2011.05.003 PMid:21683671 DOI: https://doi.org/10.1016/j.cpr.2011.05.003

Subu MA, Wati DF, Netrida N, Priscilla V, Dias JM, Abraham MS, et al. Types of stigma experienced by patients with mental illness and mental health nurses in Indonesia: A qualitative content analysis. Int J Ment Health Syst. 2021;15(1):77. https://doi.org/10.1186/s13033-021-00502-x PMid:34663399 DOI: https://doi.org/10.1186/s13033-021-00502-x

Pribadi T, Lin EC, Chen PS, Lee SK, Fitryasari R, Chen CH. Factors associated with internalized stigma for Indonesian individuals diagnosed with schizophrenia in a community setting. J Psychiatr Ment Health Nurs. 2020;27(5):584-94. https://doi.org/10.1111/jpm.12611 PMid:32009270 DOI: https://doi.org/10.1111/jpm.12611

Huggins A, Weist MD, McCall M, Kloos B, Miller E, George MW. Qualitative analysis of key informant interviews about adolescent stigma surrounding use of school mental health services. Int J Ment Health Promot. 2016;18(1):21-32. https://doi.org/10.1080/14623730.2015.1079424 DOI: https://doi.org/10.1080/14623730.2015.1079424

Samari E, Seow E, Chua BY, Ong HL, Abdin E, Chong SA, et al. Stigma towards people with mental disorders: Perspectives of nursing students. Arch Psychiatr Nurs. 2018;32(6):802-8. https://doi.org/10.1016/j.apnu.2018.06.003 PMid:30454620 DOI: https://doi.org/10.1016/j.apnu.2018.06.003

Al-Natour A, Abuhammad S, Al-Modallal H. Religiosity and stigma toward patients with mental illness among undergraduate university students. Heliyon. 2021;7(3):e06565. https://doi.org/10.1016/j.heliyon.2021.e06565 PMid:33842707 DOI: https://doi.org/10.1016/j.heliyon.2021.e06565

Laher S, Khan S. Exploring the influence of Islam on the perceptions of mental illness of volunteers in a Johannesburg community-based organisation. Psychol Dev Soc J. 2011;23(1):63-84. https://doi.org/10.1177/097133361002300103 DOI: https://doi.org/10.1177/097133361002300103

Ciftci A, Jones N, Corrigan P. Mental health stigma in the Muslim community. J Muslim Ment Health. 2013;7(1):17-32. https://doi.org/10.3998/jmmh.10381607.0007.102 DOI: https://doi.org/10.3998/jmmh.10381607.0007.102

Padela AI, Killawi A, Forman J, DeMonner S, Heisler M. American muslim perceptions of healing: Key agents in healing, and their roles. Qual. Health Res. 2012;22(6):846-58. https://doi.org/10.1177/1049732312438969 PMid:22393065 DOI: https://doi.org/10.1177/1049732312438969

Corrigan PW. Target-specific stigma change: A strategy for impacting mental illness stigma. Psychiatr Rehabil J. 2004;28(2):113-21. https://doi.org/10.2975/28.2004.113.121 PMid:15605746 DOI: https://doi.org/10.2975/28.2004.113.121

Thornicroft G. Shunned: Discrimination Against People with Mental Illness. United Kingdom: Oxford University Press; 2006.

Zeelen J, Wijbenga H, Vintges M, De Jong G. Beyond silence and rumor: Storytelling as an educational tool to reduce the stigma around HIV/AIDS in South Africa. Health Educ. 2010;110(5):382-98. https://doi.org/10.1108/09654281011068531 DOI: https://doi.org/10.1108/09654281011068531

Villagrana M, Guillen C, MacedoV, Lee SY. Perceived self-stigma in the utilization of mental health services in foster care and post foster care among foster care alumni. Child Youth Serv Rev. 2018;85:26-34. https://doi.org/10.1016/j.childyouth.2017.10.040 DOI: https://doi.org/10.1016/j.childyouth.2017.10.040

Rickwood DJ, Deane FP, Wilson CJ. When and how do young people seek professional help for mental health problems. Med J Aust. 2007;187(7):S35-9. https://doi.org/10.5694/j.1326-5377.2007.tb01334.x PMid:17908023 DOI: https://doi.org/10.5694/j.1326-5377.2007.tb01334.x

Amodeo AL, Picariello S, Valerio P, Bochicchio V, Scandurra C. Group psychodynamic counselling with final-year undergraduates in clinical psychology: A clinical methodology to reinforce academic identity and psychological well-being. Psychodyn Pract. 2017;23(2):161-80. https://doi.org/10.1080/14753634.2017.1308834 DOI: https://doi.org/10.1080/14753634.2017.1308834

Gatta M, Miscioscia M, Svanellini L, Spoto A, Difronzo M, De Sauma M, et al. Effectiveness of brief psychodynamic therapy with children and adolescents: An outcome study. Front Pediatr. 2019;7:501. https://doi.org/10.3389/fped.2019.00501 PMid:31956643 DOI: https://doi.org/10.3389/fped.2019.00501

Midgley N, O’Keeffe S, French L, Kennedy E. Psychodynamic psychotherapy for children and adolescents: An updated narrative review of the evidence base. J Child Psychother. 2017;43(6):1-23. https://doi.org/10.1080/0075417X.2017.1323945 DOI: https://doi.org/10.1080/0075417X.2017.1323945

Posmaningsih DA, Aryasih GA, Hadi MC, Marwati NM, Mallongi A. The influence of media booklet in behavior change of waste management in elementary school students South Denpasar, Bali. Indian J. Public Health Res Dev. 2018;9(8):1506-11. https://doi.org/10.5958/0976-5506.2018.009464 DOI: https://doi.org/10.5958/0976-5506.2018.00946.4

Prawesti I, Haryanti F, Lusmilasari L. Effect of health education using video and brochure on maternal health literacy. Belitung Nurs. J. 2018;4(6):612-8. https://doi.org/10.33546/bnj.176 DOI: https://doi.org/10.33546/bnj.176

Siregar Y, Rochadi K, Lubis N. The effect of health promotion using leaflets and audio-visual on improving knowledge and attitude toward the danger of HIV/AIDS among adolescents. Int J Nurs Health Serv. 2019;2(3):172-9. https://doi.org/10.35654/ijnhs.v2i3.213 DOI: https://doi.org/10.35654/ijnhs.v2i3.213

DeSmet A. Social media and lifestyles in youth mental health promotion. Lancet Child Adolesc Health. 2019;3(10):664-5. https://doi.org/10.1016/S2352-4642(19)30233-0 PMid:31420212 DOI: https://doi.org/10.1016/S2352-4642(19)30233-0

Mehmet M, Roberts R, Nayeem T. Using digital and social media for health promotion: A social marketing approach for addressing co-morbid physical and mental health. Aust J Rural Health. 2020;28(2):149-58. https://doi.org/10.1111/ajr.12589 PMid:31970832 DOI: https://doi.org/10.1111/ajr.12589

Richards AS, Bessarabova E, Banas JA, Bernard DR. Reducing psychological reactance to health promotion messages: Comparing preemptive and postscript mitigation strategies. Health Commun. 2022;37(3):366-74. https://doi.org/10.1080/10410236.2020.1839203 PMid:33106046 DOI: https://doi.org/10.1080/10410236.2020.1839203