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Psychiatry Nursing Journal (Jurnal Keperawatan Jiwa)

This document summarizes a study that examined community perceptions around a halfway house for patients with mental disorders. The study used qualitative methods, conducting in-depth interviews with 10 community members living near the halfway house. The interviews explored participants' understanding of mental disorders, stigma, expectations, and experiences with patients. The analysis identified 8 themes, including themes on community understanding of mental disorders, stigma, responses, and expectations, as well as themes on preferred treatment, forms of care, and the role of nurses in care. The study aims to understand community perceptions that could influence support and care for mental health patients.

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0% found this document useful (0 votes)
137 views5 pages

Psychiatry Nursing Journal (Jurnal Keperawatan Jiwa)

This document summarizes a study that examined community perceptions around a halfway house for patients with mental disorders. The study used qualitative methods, conducting in-depth interviews with 10 community members living near the halfway house. The interviews explored participants' understanding of mental disorders, stigma, expectations, and experiences with patients. The analysis identified 8 themes, including themes on community understanding of mental disorders, stigma, responses, and expectations, as well as themes on preferred treatment, forms of care, and the role of nurses in care. The study aims to understand community perceptions that could influence support and care for mental health patients.

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verantika
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PSYCHIATRY NURSING JOURNAL

Journal Homepage: https://e-journal.unair.ac.id/PMNJ/index

(Jurnal Keperawatan Jiwa) This is an Open Access


article distributed
Vol. 3, No. 1, March 2021 under the terms of the
Creative Commons
Attribution 4.0 International
Laman Jurnal: https://e-journal.unair.ac.id/PNJ License
http://dx.doi.org/ 10.20473/pnj.v3i1.25984

Original Research
COMMUNITY PERCEPTION AROUND HALFWAY HOUSE ABOUT CARE OF
MENTAL DISORDERS

Farah Aulia Nughraini, Ah Yusuf, Ni Ketut Alit Armini


Faculty of Nursing, Universitas Airlangga, Surabaya, East Java, Indonesia

ARTICLE HISTORY ABSTRACT


Received: March 18, 2021
Introduction: The high stigma in community towards mental disorders does not only
Revised: May. 27 2021
Accepted: June 05, 2021 affect families and mental disorders patients but also on the patterns of care and care, for
Available online: June 06, 2021 example mental disorders patients are isolated so they do not interact with the
community with shackles. The purpose of this research is perceptions in the community
about how to treat patients with mental disorders.

CORRESPONDING AUTHOR Method: This study used a qualitative research design with a phenomenological
Farah Aulia Nughraini approach with ten participants. The technique of selecting participants was purposive
farah.aulia.nughraini- sampling with the criteria of men and women aged > 17 years, living around halfway
[email protected] house and who had interacted with mental patients at halfway house. Retrieval of data
Faculty of Nursing, Universitas on ten participants with in-depth interviews and field notes were then analyzed using the
Airlangga, Surabaya, East Java, Colaizzi method.
Indonesia
Results: In this study, 8 themes were identified, namely 5 themes (community
understanding of mental disorders, community stigma, community response, community
expectations and community experiences with mental patients) for the first specific
purpose and 3 themes (treatment, form of care and caregiver factors nurse) for the
second special purpose.
Conclusion: Community perception is influenced by several factors including the factor
of maintaining distance from mental patients, tolerance and support factors, social
limitation factors and factors of prejudice and misunderstanding. Future research can
explore in depth people's perceptions about the treatment of mental disorders patients,
more specifically, for example, the care of mental patients in hospitals and at home.
Keywords
mental disorders, community, perception, halfway house

Cite this as: Nughraini, F.A., Yusuf, A., Armini, N.K.A. (2021). Community Perception Around Halfway
House About Care of Mental Disorders. Psych. Nurs. J., 3(1). 10-14. doi.org/
10.20473/pnj.v3i1.25984

1. INTRODUCTION though there is a time limit for staying, except for


mental patients who need continuous assistance
Treatment of mental patients is not only in the (Yusuf et al., 2019). In halfway house, mental health
medical or mental hospital, but can also be done in patients still receive comprehensive
other health service settings such as community- psychopharmaceutical and other therapies (bio-
based health services. Community-based health psycho-socio-spiritual) such as spiritual healing and
services can be implemented in social services, social group activity therapy and generally halfway house
institutions and halfway house, each of which are are located in the community (Yusuf et al., 2015).
under the auspices of the Puskesmas. One type of Patients with mental disorders really need spiritual
community-based health service that is still rarely healing because it is important in interpreting their
applied is halfway house. A halfway house can help life amid the conditions they are experiencing (Yusuf
establish social relationships for mental patients even et al., 2017).

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PSYCHIATRY NURSING JOURNAL

According to Riskesdas 2018, cases of mental participants sign the informed consent, the work
disorders in Indonesia have increased and it is phase in which the researcher starts conducting in-
estimated that the number of severe ODGJ in depth interviews with the participants and also the
Indonesia is 450,000 people (Indrayani & Wahyudi, termination phase which is the final phase after the
2018). Based on a source from the Institute for Health participants answer all the questions and the
Metrics and Evaluation (IHME) in 2017, Mental researcher makes the next contract for data
Disorder causes Disability Adjusted Life Year (DALYs)
validation. Data were analyzed using the Colaizzi
in Indonesia, Schizophrenia type mental disorder
analysis technique. The research proposal has passed
ranks third after depression and anxiety where there
has been an increase from 1990 to 2017 the ethical test by the Health Research Ethics
(Ghebreyesus & Murray, J.L., 2017). In line with Committee of the Faculty of Nursing Universitas
Riskesdas 2018 data on mental health data, it shows Airlangga (Health Research Ethics Committee Faculty
that the prevalence of schizophrenia or psychosis of Nursing Universitas Airlangga) on October 30,
mental disorders in Indonesia has increased to 7% 2020 with certificate number 2120-KEPK.
and specifically in East Java has increased from 2013
to 6.4% in 2018 (Kemenkes RI, 2018). 3. RESULTS
The high stigma against mental patients in This research produced 8 themes with a distribution
society is caused by several factors such as cultural of 5 themes for the first special purpose and 3 themes
factors. Cultural factors shape perceptions, for the second special purpose. These themes include
expressions and search for alternative treatments so public understanding of mental disorders,
that culture has its own way of explaining mental community stigma against mental disorders,
disorders based on a series of practices in community response to mental disorders, community
determining causes, treatment-seeking behavior and expectations of mental disorders, community
cultural norms that affect individuals in the treatment experiences with people with mental disorders, care
and care of mental disorders patients (Naibili, 2019). for mental disorders, forms of care for mental
In addition, the poor acceptance by families and disorders patients and nursing factors.
communities of people with mental disorders has an
impact on patterns of care or care such as shackling Theme 1 : Community understanding of mental
that contains elements of coercion from family disorders
members, being treated harshly, not given good Theme 1 in the study is that participants
support and worse if the family is reluctant to bring express their understanding of mental disorders,
the sufferer home. Mental illness for treatment namely the definition of mental disorders, triggers of
(Herdiyanto, 2016). mental disorders, factors that cause relapse and
During the intial review, researchers symptoms of mental disorders. Following is the
discovered an unusual phenomenon. The participant's statement :
phenomenon is the location of a halfway house in the “…kind of mentally disturbed.” (P1)
middle of the community and patients with mental “… it could be beause the husband left or work
disorder can carry out activities such as shopping to problems” (P3)
interacting with the surrounding community. This “his wish was not fulfilled” (P8)
makes researchers interested in conducting research “digressively speaking, speaking carelessly”
on the perceptions of the community around the (P7)
halfway house. The purpose of this study is to “sometimes like that, talk to himself. Like a
understand deeply the perceptions of the community hallucinating person” (P8)
around the halfway house about mental disorders
and the treatment of mental disorders patients. Theme 2 : Community stigma against mental
2. METHODS disorders
This research is a qualitative type of research with a Theme 2 in this study is the participant's
phenomenological study approach. The sample in this statement about their opinion about mental disorders
and is still a stigma for mental disorders patients,
study were people who live around Rumah Singgah
namely the physical appearance of mental disorders
Al-Hidayah Mojokerto. The criteria for selecting the
patients expressed by participants as follows :
sample in this study were men and women aged > 17 “..like that fierce..” (P4)
years, living around halfway house and who had “…to bring a knife, so scary” (P6)
interacted with mental patients at halfway house. The “Yes so. When praying sometimes it is also
sample size in this study was determined using disturbed” (P1)
purposive sampling and obtained 10 participants. “like what, I was so worried” (P10)
The data collection process is divided into three “I must be afraid so I prefer to avoid” (P6)
stages, namely the preparation stage, the work stage
and the final stage or termination. In the work stage,
it is further divided into an orientation phase, namely
the initial phase which is carried out after the

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F. A. Nughraini, ET. AL.

Theme 3 : Community response to mental “should be taken to Menur Mental Hospital


disorders rather than to a spiritual expert or dukun.” (P1)
Theme 3 in the study is the participant's “if in the hospital it has not been controlled at
expression of mental disorders patients which are all” (P10)
divided into two, namely psychologically and “if it is not bad, no need, just stay at home”
cognitively. The following is the participant's (P4)
statement : “When they are at halfway house, they are well
“I feel pity” (P1) cared for, until they are give books to read”
“… those of us who are sane must give in” (P3) (P2)
“I am in my right mind, I understand” (P2) “He continues to take sedative” (P10)
“But I don’t think he is a mental illnessl person. “What are you doing ? It’s useless to take it to
I only talk to,” (P10) a spiritual expert” (P3)
“If so, his thinking is not open.” (P8) “If not taken for treatment, it will get worse”
(P8)
Theme 4 : Community expectations for ODGJ
Theme 4 is the participant's expression of their Theme 2 : Forms of treatment for mental
hopes for mental illness patients which are divided disorders
into two, namely general expectations (get well soon, Participants in this study expressed their
get together with family, etc.) and hope for the opinions about the form of treatment for mental
treatment of mental patients. The following is the patients which were divided into two, namely
participant's statement : affection (emotionally and psychologically) and the
“get well soon” (P2) form of treatment for mental patients. Following is
“soon to meet the family...” (P1) the participant's statement :
“especially for her children and their families. “Who else but family, meaning family-centered
They must understand that their family support” (P6)
members have mental disorders” (P4) “Which definitely must be cared for by the
“anyways, both live. In order to have a future” family” (P7)
(P6) “In my opinion, number one is embraced and
“if they are cured, they can be accepted back affectionate” (P3)
like ordinary people” (P10) “Sometimes when asked to talk, they feel they
“There should be a special agency that have a friends” (P8)
handles it” (P5) “ … Invited to communicate like that,” (P1)
“…other than that, any education is given to “Yes, don’t ignore it” (P8)
return to normal …” (P8) “so if they are alone, they will contemplate”
(P10)
Theme 5 : Community experiences with mental “ …should be given a job such as making crafts
patients or others. This is so that they don’t daydream
Participants in this study expressed their so much” (P10)
experiences with people with mental disorders which “Needed rough could not, needed soft also
were divided into physical, verbal, unpleasant events could not” (P7)
and treatment experiences. The following is the
participant's statement : Theme 3 : Caregiver or nurse factors
“I have been stoned” (P7) Participants in this study expressed their
“When I pocked my child, a person with a opinion that caregiver or nurse factors to mental
mental disorder spat on it” (P5) patients, namely things that must be owned by nurses
“Like to touch” (P4) or caregivers. These things include in nature (patient,
“give advice : You don’t get angry” (P3) sincere and genuinely willing to serve), the treatment
“My child is carried” (P10) given and the behavior or attitude of the caregiver.
“Asking to be married” (P9) Following is the participant's statement :
“Not being taken to the hospital, only a “Indeed have to be patient with people like
sedative was bought” (P8) them” (P3)
“It is different if the mind is only focused on
The following are the themes for the second work, the important thing is that I have given
specific purpose identified in this study : it to eat. If it’s like that, it won’t work” (P3)
Theme 1 : Treatment for mental disorders “the nurse who work there should really be
Participants in this study expressed their willing to serve …” (P3)
opinion about treatment for mental disorders which “don’t ignore it they also need attention.” (P1)
is divided into two, namely a place of care for patients “Must be patient and painstaking” (P4)
with mental disorders and a form of treatment for
patients with mental disorders. Following is the
participant's statement :

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PSYCHIATRY NURSING JOURNAL

4. DISCUSSION cadres is in the form of education to the families of


mental disorders patients to always provide support
Social restrictions, discrimination and social isolation and acceptance such as motivating families to bring
are forms of public belief that mental patients are a mental disorders to health services. In addition to
threat and must be avoided (Purnama et al., 2016). families, the role of cadres is also important to
Not only in the aspect of social distancing, stigma also motivate the community to accept the presence of
hinders treatment and care for mental disorders mental patients and not to discriminate against them
because it makes families feel embarrassed and tends (Surahmiyati et al., 2017). Good family support will
to leave mental patients without proper care. This of certainly speed up the healing process for people with
course will make the patient's mental condition mental disorders because family is the closest person
worse and slow down the healing process. who can provide maximum care.
In another study, the families of mental Equally important, human resources and
patients with mental disorders felt stigma because training for health workers greatly influence the
they were discriminated against and shunned by the health services provided. The increasing prevalence
surrounding community (Fitryasari et al., 2018). The of mental disorders is also influenced by the lack of
stigma experienced by the families of mental skilled health personnel in the mental health sector,
disorders patients will certainly result in mental especially in handling mental patients. This can be
illness patients relapsing due to lack of internal caused by several factors, one of which is the lack of
support and decreasing the quality of life of mental experience of health workers in caring for mental
patients (Reong & Astuti, 2019). The general public patients (Lestari et al., 2020). Good nursing skills also
will also avoid mental patients because they feel affect self-management or good self-management so
anxious. This is in line with research conducted by that they do not always give harsh treatment to
Risna Rahmawati that most people will feel afraid, mental patients.
reject, avoid and discriminate against mental patients The community mentions several things that a
(R. Rahmawati, 2019). The feeling of anxiety that is mental health caregiver must have, including being
owned by the community is usually caused by sudden patient, sincere, truly devoted, not rude and always
changes in the behavior of mental patients, for paying attention. This is in line with research which
example those who laugh at first can quickly become says that nurses are required to have extra patience
crying and then laugh again. in carrying out various roles to find out what mental
The community response to mental disorders patients need (Faiqoh & Falah, 2017). Nurses must
patients identified in this study is that they are not also have the principle that the form of achievement,
like people with mental disorders, feel sorry for, reward, opportunity to advance or get an award is not
desire to give in, tolerate and have not open thoughts the main reason but rather social and humanitarian
of family or society due to rejecting mental disorders work which is the main foundation (Rahman et al.,
patients. This is in line with research conducted by 2016). Other studies that are in line also say that there
Usraleli et al that there are still people who have a is no need to commit violence against mental patients,
positive opinion of people with mental disorders, but the most important thing that nurses should do is
namely that people feel caring and feel sorry for to involve the community and families in treating
mental patients and their families because they mental patients so that they can prevent relapse and
should not be ostracized or exiled (Usraleli et al., accelerate the healing process (Lestari et al., 2020).
2020). Discriminatory treatment by family and A nurse who treats people with mental
society will hinder the healing process for mental disorders must have a patient, conscientious, diligent
patients. and loving attitude (Faradhila, 2017). This attitude is
Other studies also explain that the role of the needed so that nurses can provide maximum service
family is very important in fostering motivation so to people with mental disorders. Participants also
that patients with mental disorders can achieve their added that people with mental disorders should be
goals in the future (Farina et al., 2020). Participants ignored because they also need attention. The
consider that people with mental disorders also have attention that is meant here is to pay attention to the
the same rights and opportunities as normal people basic needs of patients with mental disorders such as
in general. Participants added that people with the need for self-care, nutrition, medication, worship
mental disorders are sick people so they must be (spirituality) and other needs because mental
taken for treatment so that they do not get worse. patients are also humans who have basic needs.
Research conducted by Deby Rahmawati shows that
people with mental disorders really need a medical 5. CONCLUSSION
rehabilitation program and social rehabilitation
where social rehabilitation aims to restore the social Based on the results of the study, it can be concluded
functions of people with mental disorders who can that there is still stigma in the community around the
then return to their family and community (D. halfway house such as feeling afraid, anxious,
Rahmawati, 2018). disturbed and judging people with mental disorders
In this study, participants said that treatment from their physical appearance. Even though there is
of mental disorders is mandatory and extra, this is in still stigma, the community also has hopes for mental
line with Sri Surahmiyati who stated that the role of patients such as being taken to health services, being

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F. A. Nughraini, ET. AL.

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