Electronic Theses and Dissertation

Abstrak

Remaja dengan Masalah Kesehatan Jiwa (MKJ) sering menghadapi stigma dari
teman sebaya (peer stigma). Membiarkan remaja dengan MKJ berjuang sendiri melawan
peer stigma sangat berbahaya. Peer stigma dapat menyebabkan penurunan self-esteem dan
self-efficacy, sehingga remaja dengan MKJ kehilangan motivasi, sulit membina hubungan
sosial, diperlakukan diskriminatif (bullying), performa akademik menurun, rentan dropout
dari sekolah, menghindari layanan kesehatan, kemampuan recovery menurun, serta
berpotensi mengalami gangguan jiwa berat dan bunuh diri. Intervensi anti-stigma sangat
penting dalam membantu penderita MKJ melawan stigmatisasi. Program edukasi untuk
meningkatkan Mental Health Literacy (MHL) merupakan model intervensi anti-stigma
yang popular dan sering digunakan. Namun model edukasi yang ditawarkan umumnya
menggunakan pendekatan kesehatan. Sangat jarang model intervensi menggunakan
pendekatan agama. Sementara agama memiliki kontribusi besar dalam pembentukan dan
penyebaran peer stigma. Penelitian ini bertujuan menguji efektivitas model intervensi antistigma melalui peningkatan MHL berbasis kesehatan dan Islam dalam meminimalisir peer
stigma pada remaja. Penyusunan model intervensi dilakukan melalui studi kualitatif dan
tinjauan literatur yang kemudian disusun dalam dua modul (berbasis kesehatan dan Islam).
Program MHL dilakukan dalam 5 sesi dengan metoda presentasi, diskusi, simulasi, video
edukasi dan storytelling. Pengujian efektivitas program MHL dilakukan di tiga SMP di
Kota Banda Aceh dengan pendekatan cluster randomized controlled trial. Sekitar 180
responden yang terlibat dipilih secara multi-stage random sampling. Responden dibagi
dalam 3 kelompok penelitian, yaitu kelompok Anti-Stigma Intervention with Health
Approach (ASI-HA), kelompok Anti-Stigma Interventions with Islamic Approach (ASIIA) dan Control Group (CG). Pengumpulan data dilakukan tiga kali, yaitu: baseline, posttest, dan follow-up. Pengumpulan data menggunakan dua kuisioner pengetahuan yang
dikembangkan peneliti (berbasis kesehatan dan Islam) dan satu kuesioner peer stigma (peer
mental health stigmatization scale) yang sudah dikembangkan sebelumnya (existing).
Analsisis data dilakukan menggunakan paired sample t-test, Wilcoxon signed rank test,
independent sample t-test, Mann Whitney u test dan Generalized Estimating Equation
(GEE). Hasil menunjukkan adanya perbedaan yang signifikan nilai rata-rata pengetahuan
dan peer stigma pada kedua kelompok intervensi pada perbandingan antara baseline versus
post-test dan post-test versus follow-up. Perbedaan ini tidak terjadi pada kelompok kontrol
baik pada perbangdingan atanra baseline versus post-test, maupun post-test versus followup. Perbedaan nilai rata-rata pengetahuan dan peer stigma juga terjadi pada perbandingan
antara kelompok intervensi dengan kontrol pada baseline, post-test, dan follow-up.
Berdasarkan hasil penelitian dapat disimpulkan bahwa kedua model intervensi anti-stigma
efektif meningkatkan pengetahuan kesehatan jiwa dan meminimalisir peer stigma pada
remaja. Berdasarkan pengaruh intervensi (effect size), program MHL berbasis kesehatan
secara keseluruhan lebih efektif, namun MHL berbasis Islam pengaruhnya belum menurun
pada empat minggu paska intervervensi. Penggunaan kedua model intervensi tesebut dalam
upaya meminimalisir peer stigma pada remaja sangat baik karena kedua program ini
memiliki terbukti efektif menurunkan peer stigma. Kedepan, pengujian efektivitas
gabungan intervensi berbasis kesehatan dan Islam penting dilakukan untuk melihat apakah
efektivitasnya menurun, konsisten atau meningkat.

Kata kunci: Peer Stigma, Intervensi anti-stigma, gangguan kesehatan jiwa, remaja,
sekolah. `

Abstract Peers frequently stigmatize adolescents with mental health problems (MHP) (peer stigma). Letting adolescents with MHP face peer stigma on their own is extremely dangerous. Peer stigma undermines self-esteem and self-efficacy. Each of these factors leads to low motivation, difficulties in social relationships, discrimination (bullying), poor academic performance, a proclivity for school dropout, avoidance of health care, limited capacity to recover, and increasing the likelihood of severe mental illness and suicide. Anti-stigma interventions are essential for assisting adolescents with MHP in combating peer stigma. Today, educational programs to improve Mental Health Literacy (MHL) are one of the most popular and widely utilized for minimizing stigma. Yet, the MHL models that are offered are mostly based on health perspectives. While religion-based methods were seldom applied. Whereas religion has a substantial impact on the creation and spread of peer stigma. Therefore, this study aims to analyze the efficacy of the anti-stigma intervention model in reducing peer stigma in adolescents. MHL programs were developed using a qualitative method and a literature study, which were then recorded in two modules (health and Islamic-based). The MHL programs were delivered in five sessions using presentation, discussion, simulation, video-based education, and storytelling as methods. To investigate the efficacy of both MHL models, a cluster randomized controlled trial was used as a method. This study was conducted in three junior high schools in Banda Aceh. Around 180 participants were selected by multi-stage random sampling. The respondents were divided into three groups: those who received anti-stigma interventions with a health approach (ASI-HA), those who received anti-stigma interventions with an Islamic approach (ASI-IA), and those who did not (CG). Data was collected at three different times: baseline, post-test, and follow-up. Data were collected using two knowledge questionnaires developed by researchers (health-based and Islamic-based) and one existing questionnaire (peer mental health stigmatization scale). Data analysis was carried out using paired sample t-test, Wilcoxon signed rank test, independent sample t-test, Mann Whitney u test and Generalized Estimating Equation (GEE). The study findings showed that there were significant differences in mean knowledge and peer stigma scores in each group on baseline versus post-test, post-test versus follow-up. However, these differences did not exist in the control groups. On baseline, post-test, and follow-up, differences in mean knowledge and peer stigma were identified when the intervention groups were compared to the control groups. Based on the study findings, it is possible to infer that both antistigma intervention approaches are successful in increasing mental health knowledge and reducing peer stigma in adolescents. Based on the effect size of intervention in both MHL models, MHL based on health theories was more effective generally. Nonetheless, until the follow-up testing, the effect size of MHL based on Islamic perspectives rose continually, but MHL based on mental health theories did not. The utilization of these two MHL models in an effort to reduce peer stigma in adolescents is extremely beneficial because these two programs have been proven to be effective in reducing peer stigma. In the future, it is important to test the effectiveness of combined health and Islam-based interventions to see whether their effectiveness is decreasing, consistent, or increasing. Keywords: Peer Stigma, Anti-Stigma, Mental Health Literacy, Mental Health Problems, Adolescent, School.