Willenberg Lisa, Wulan Nisaa, Medise Bernie Endyarni, Devaera Yoga, Riyanti Aida, Ansariadi Ansariadi, Wiguna Tjhin, Kaligis Fransiska, Fisher Jane, Luchters Stanley, Jameel Aishah, Sawyer Susan M, Tran Thach, Kennedy Elissa, Patton George C, Wiweko Budi, Azzopardi Peter S
Global Adolescent Health Group, Maternal Child and Adolescent Health Program, Burnet Institute, Melbourne, Australia.
Department of Child Health, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.
Asian J Psychiatr. 2020 Aug;52:102148. doi: 10.1016/j.ajp.2020.102148. Epub 2020 May 6.
Poor mental health is a leading contributor to the burden of disease experienced by adolescents, including in resource constrained settings. However, little is known about how adolescents in these countries conceptualise mental health and its determinants which is essential to informing effective responses. This study aimed to explore how adolescents in Indonesia (a populous and rapidly developing country) conceptualise mental health and what they identify as important determinants. Eight focus group discussions (FGDs) were conducted with 86 Indonesian adolescents (aged 16-18 years), sampled from schools and community settings from Jakarta and South Sulawesi. FGDs were recorded, transcribed, translated and thematically analysed. Mental health was recognised as a significant concern by adolescents in Indonesia. Good mental health was conceptualised as emotional wellbeing and happiness. By contrast, poor mental health was predominantly described in terms of substantial mental illness manifesting as behavioural and physical disturbance. Further, poor mental health only happened to 'other' people, with stigmatising views prevalent. Absent from the discussions were common symptoms of poor mental health (stress, loneliness, poor sleep) and common mental disorders (e.g. depression, anxiety) or a conceptualisation that reflected poor mental health to be a normal human experience. Discussions around determinants of poor mental health suggested that family connections (particularly with parents), school pressures, and adverse exposures on social media were important drivers of poor mental health, with religion also surfacing as an important determinant. In highlighting mental health as an important issue for Indonesian adolescents, this study provides a foundation for targeted responses.
心理健康不佳是青少年疾病负担的主要促成因素，在资源有限的环境中也是如此。然而，对于这些国家的青少年如何理解心理健康及其决定因素，我们知之甚少，而这对于制定有效的应对措施至关重要。本研究旨在探讨印度尼西亚（一个人口众多且快速发展的国家）的青少年如何理解心理健康，以及他们认为哪些是重要的决定因素。我们与86名印度尼西亚青少年（年龄在16 - 18岁之间）进行了八次焦点小组讨论（FGD），这些青少年是从雅加达和南苏拉威西的学校和社区环境中抽取的样本。焦点小组讨论进行了录音、转录、翻译并进行了主题分析。心理健康被印度尼西亚青少年视为一个重大问题。良好的心理健康被理解为情绪健康和幸福。相比之下，心理健康不佳主要被描述为表现为行为和身体紊乱的严重精神疾病。此外，心理健康不佳只发生在“其他人”身上，污名化观念普遍存在。讨论中没有提及心理健康不佳的常见症状（压力、孤独、睡眠不佳）和常见精神障碍（如抑郁症、焦虑症），也没有一种反映心理健康不佳是正常人类经历的概念化表述。围绕心理健康不佳的决定因素的讨论表明，家庭关系（特别是与父母的关系）、学校压力以及社交媒体上的不良接触是心理健康不佳的重要驱动因素，宗教也作为一个重要决定因素出现。本研究强调了心理健康是印度尼西亚青少年的一个重要问题，为有针对性的应对措施提供了基础。
