Background : Good sibling relationships in adulthood are known to be a protective factor for mental health. The present study examined and compared the relationships of siblings with either a healthy brother or sister or one experiencing schizophrenia. Methods : In the first phase, we ran a statistical comparison of the two sibling groups on the quality of their sibling relationships (warmth, conflict, and rivalry), emotional distress, and self-esteem. In the second phase, we looked at whether the quality of the sibling relationship modifies the impact of having a brother or sister with schizophrenia on emotional distress and self-esteem. Results : Results showed that sibling relationships in schizophrenia are less warm and are characterized by heightened rivalry and conflict. In addition, analysis revealed a mediating effect of sibling relationship on the emotional distress of siblings with a brother/sister diagnosed with schizophrenia. Conclusion : More needs to be done to enhance the mental health of adults who have a brother or sister with schizophrenia, notably via their sibling relationships.

Background Various efforts have been made by the Indonesian government to improve mental health services. In 2014, the government established Law no 18, which is about mental health and the treatment of people with mental illness covered by the universal health coverage. However, many people still experience difficulty in accessing mental health services. In Indonesia, family plays the role of a caregiver to people with mental illness. Objective This study aims to identify the perceived barriers on mental health services by families whose members suffers from mental illness. Methods This study is a qualitative research study with a phenomenological approach. Sampling was conducted by purposive sampling with a sample size of 12 participants. Data were collected using semistructured in-depth interviews. Thematic analysis was performed using Colaizzi steps. Results The obtained results presented three themes. Theme 1, mental health service affordability; theme 2, mental health service availability; and theme 3, negative attitudes (stigma). Conclusion Families whose members suffered from mental illness still experienced barriers in relation to mental health services even with universal health coverage. Improved mental health services are related to the health insurance coverage, affordability, availability of mental health services and stigma reduction in the health professionals and wide community.

BackgroundTreatment of post-pasung (physical restraint) patients with mental disorders has become a new problem in Indonesia in its effort to free the country from the physical restraint programme. Problems emerge when the patient returns to the family and society at large, and families that refuse to allow the patient to come back home risk the possibility that the patient may eventually become a psychotic vagrant.AimsTo determine the appearance of families taking care of patients with mental disorders post-pasung.MethodThis study was qualitative research using a case study approach. The number of participants from six families was selected by purposive sampling. Collecting data was done by in-depth interview, and analysed thematically using Colaizzi steps.ResultsThe results showed that families coping when taking care of patients with mental disorders post-pasung comprise seven themes. The seven themes are formed by four categories, 19 sub-themes and 32 sections.DiscussionThe appearance of coping was the overall description of coping in the form of strategic process stages, the support of coping and meaning for what the families feel when they are taking care of a patient with a mental disorder post-pasung. The appearance of coping showed how the family chooses the mechanisms of coping to deal with stress and crisis.ConclusionThe coping mechanisms that families use when taking care of a patient with a mental disorder post-pasung were formed through stages of a strategic process. Families need coping strengthening interventions to provide optimal care for patients with mental disorders post-pasung.

This study aims to identify the relationship between caregiver burden of patients with schizophrenia and caregiver quality of life (QOL). A cross sectional study involving 222 caregivers patients with schizophrenia was conveniently recruited from the psychiatric clinic of a mental health hospital in Malang Indonesia. Caregiver Burden Inventory Scale and Schizophrenia Caregiver QOL was used to assess the level of burden and QOL among the caregivers respectively. Descriptive statistics was used to determine caregivers' socio-demographic characteristic and the level of caregivers' burden and QOL. Spearman Rho correlation test was conducted to determine the relationship of caregiver burden and caregiver QOL. About 59.6% of schizophrenia caregivers experienced moderate to severe level of burden. The results showed that there was a significant, strong and negative relationship between the caregiver burden and QOL (r = -0.434, p \ 0.001). Most of the participants reported emotional burden and moderate QOL especially psychological and physical QOL, well-being, relationships with friends, and material burden. The findings indicated the higher the caregiver burden, the lower the QOL experienced by family caregivers of individuals with schizophrenia. It is necessary to improve the mental health nursing services for schizophrenia caregivers by providing mental health counseling, and developing support groups for them.

ABSTRAK Indonesia memiliki lebih dari satu juta jiwa penderita gangguan jiwa yang tersebar di masing-masing provinsi. Perawatan bagi penderita skizofrenia tidak hanya dilakukan di rumah sakit saja, tetapi akan dilanjutkan setelah kembali ke keluarganya. Keluarga yang tidak mampu beradaptasi pada masalah perawatan penderita tersebut, maka masalah tersebut akan dianggap sebagai beban oleh keluarga. Acceptence and commitment therapy (ACT) merupakan salah satu terapi yang bertujuan untuk mengajarkan individu untuk menyadari (aware) dan dapat menggunakan cara pandang yang baru dalam berfikir untuk menghadapi sebuah permasalahan. Penelitian ini bertujuan untuk mengetahui pengaruh ACT terhadap beban yang dirasakan keluarga dalam merawat penderita gangguan jiwa. Jenis penelitian ini adalah quasi experiment pre-post test with control group. Jumlah sampel pada penelitian ini sebanyak 24 orang yang dibagi menjadi dua kelompok. Variabel independent pada penelitian ini adalah terapi ACT sementara variabel dependennya adalah beban yang dirasakan keluarga. Analisa data pada penelitian ini menggunakan uji t-test dan regresi linier. Hasil penelitian menunjukan tidak didapatkan perbedaan berarti pada kelompok kontrol setelah mendapatkan penyuluhan kesehatan (p=1,000). Pada kelompok perlakuan menunjukan perbedaan berarti setelah mendapatkan penyuluhan kesehatan dan ACT (p=0,000). Terdapat perbedaan yang bermakna antara kelompok kontrol dan kelompok perlakuan (p=0,000). Hasil uji regresi linier menunjukan bahwa faktor usia dan terapi ACT memiliki pengaruh sebesar 57,1% terhadap beban keluarga. Terapi ACT dapat membangun respon psikomotor keluarga menjadi lebih baik, sehingga mampu menurunkan beban yang dirasakan keluarga dalam merawat penderita skizofrenia di rumah. ABSTRACT Indonesia has more than one million people with mental disorders spread in each province. Treatment for people with schizophrenia is not only done in the hospital alone, but it will be continued after returning to the family. Families who are not able to adapt to the patient's care problem will consider the problem as a burden by the family. Acceptance and commitment therapy (ACT) is one of therapy that aims to teach the individual to be aware and use a new perspective in thinking to face a problem. This research aimed to know the effect of ACT on the burden felt by the family in caring for the patient mental disorders. The design used in this research was quasi-experiment pre-post test with control group. The numbers of samples in