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Background: Stigma is one of the main factors causing pasung (physical restraint or confinement in Indonesian terms) in schizophrenia patients. It is the main obstacle to reducing the number of pasung throughout the world. Thus, there is a need for appropriate interventions to reduce stigma in schizophrenia patients who go through pasung. This study aims to identify multilevel stigma interventions in people with schizophrenia who go through pasung (physical restraint and confinement). It can be applied and adapted to various cultural contexts. Design and Methods: Quasi-experimental research with pretest and post-test analysis consists of 82 people with schizophrenia who go through pasung. Respondents were divided into the intervention group and the control group. A multilevel stigma intervention was given to the intervention group for three months.Results: There was a significant difference in the average stigma score in the control group (moderate category stigma) and the intervention group (mild category stigma) after multilevel stigma intervention (p-value = 0.04). The average stigma score of schizophrenia patients in the intervention group decreased by 8.2%, while the average stigma score in the control group increase of 20.4%.Conclusions: Multilevel stigma interventions are effective in reducing stigma in people with schizophrenia who go through pasung. We underline that multilevel stigma interventions through collaboration from various parties can provide great opportunities in stigma reduction programs in people with schizophrenia who go through pasung.

Introduction: The long-term care in schizophrenia patients can cause care burdens, which will relate to the family's decision to do pasung. The perceived burden will be even heavier because of the COVID-19 pandemic. This review aims to identify the family care burden affecting pasung in schizophrenic patients during the COVID-19 pandemic. Methods: This scoping review was conducted by searching four databases, namely ProQuest, Science Direct, and EBSCO, and Google Scholar in the past ten years. This study uses the PRISMA 2009 protocol in filtering articles from the database. Researchers summarize based on the significance value for quantitative research, based on themes’ qualitative research, and discussed factors mentioned which may influence the family. Thus, we obtained 15 articles for final review. Results: The results obtained that the subjective burden felt by the family is a feeling of worry and sadness due to the patient's aggressive behavior and the safety of the patient, family, and environment. The objective burdens most felt by families are financial burdens, both medical costs, transportation to reach mental health services, and the cost of daily living. The COVID-19 pandemic will affect both types of care burdens, thereby affecting the quality of care for families with schizophrenia patients in pasung. Conclusion: Schizophrenia patients are one of the populations that are vulnerable to COVID-19. Nurse plays a role in the ability to overcome the burden of schizophrenia care and improve adaptation to the current pandemic to create optimal mental health in the community.

Introduction: Suicide is a significant mental health problem in adolescents around the world that requires comprehensive treatment. This study aimed to examine the relationship between stress, anxiety, and depression with suicidal ideation in adolescents. Method: This research used quantitative methods with a cross-sectional approach. The number of respondents was 869 adolescents, with a total sampling technique. The instrument used to measure stress, anxiety, and depression is the Depression Anxiety Stress Scale (DASS-21), while the idea of suicide is measured using the Scale for Suicide Ideation (SSI) instrument. Results: The result of this study showed that teenagers who had suicidal ideation were 206 (23.7%) respondents, while 663 (76.3%) of other respondents did not have the idea of suicide. There was a significant relationship between suicidal ideation with stress levels (p-value 0.000), anxiety (p-value 0.000), and level of depression (p-value 0.000) in adolescents. Conclusion: Mental and psychological health support measures must be given to adolescents to prevent an increase in suicide ideas.

Schizophrenia is a chronic and multifactorial mental health problem that occurs in developing countries, including in Indonesia. Families with schizophrenia patients will feel the burden of care and lead to pasung, and supported by various factors. Pasung, by the family, aims to control the aggressive behavior of the patient. A systematic review was conducted by searching four online databases, namely ProQuest, Science Direct, and EBSCO, and Google Scholar in the past ten years. This analysis uses the PRISMA 2009 method and obtained 14 articles for final review. The results obtained are the internal factors that most influence on pasung is the aggressive behavior of schizophrenia patients, both towards themselves, family, or the environment. In comparison, the most influential external factor is the emergence of stigma against patients and their families. Both of these factors cause the family to decide to pasung on schizophrenia patients, associated with feelings of helplessness and hopelessness. Community mental health nursing (CMHN) plays a role in handling and preventing pasung, which must be supported by the government and the community. Increased knowledge about schizophrenia and pasung in community has an impact on improving the mental health status of the community. Optimal mental health is the right of everyone throughout the world, including in Indonesia.