Mental health literacy amongst children with common mental health problems and their parents in Java, Indonesia: a qualitative study

Abstract

Background Optimising mental health literacy (MHL) at the individual and population level can be an effective mental health improvement and prevention tool. However, concepts of MHL are largely based on evidence from high-income countries. Little is known about the manifestation and role of MHL in countries where collectivist health and social cultures are dominant. Aim This study aimed to examine the MHL of Indonesian children and young people (CYP) with experience of common mental health problems and their parents. Methods Semi-structured interviews with 40 participants (19 CYP aged 11–15 with experience of common mental health problems and 21 parents) from three areas of Java, Indonesia. Data were analysed using framework analysis, informed by Jorm's 1997 Mental Health Literacy Framework. Results Parents and CYP demonstrated relatively low levels of MHL defined from a conventional perspective. Religiosity and spirituality were salient in participants' accounts, particularly parents, as were narratives about personal responsibility. These beliefs appeared to contribute to a high level of self-blame for mental illness, self-reliance for symptom management, the foregrounding of support from spiritual/traditional healers and a reduced propensity to access professional help. CYP were heavily reliant on family support, but parents often felt they were not best placed to communicate with their children about mental health. Providing trusted, technology-based sources of mental health information were advocated by CYP. Conclusion Robust efforts are needed to improve MHL in low- and middle-income countries drawing on culturally appropriate approaches to reduce stigma and optimise timely, effective help-seeking for CYP. Enhancing parental and family level literacy may be efficacious, especially when combined with mechanisms to facilitate open communication, as may the development of standalone interventions directly developed to reach younger generations. Future research may usefully establish the comparative efficacy and acceptability of these different approaches.

The lived experience of mental disorders in adolescents: a bottom‐up review co‐designed, co‐conducted and co‐written by experts by experience and academics

“…Taking care of a kid with a mental disorder is experienced as "mentally… and physically exhausting" 105 . Parents frequently perceive themselves as "alone as no one understands" 124 and prefer to "keep all" to themselves 125,126 .…”

“…122 . A sense of guilt often accompanies the parents' elaboration of the diagnosis ("I will always blame myself about that" 122 ), leading them to question their parenthood skills 122,132 ("Maybe because we didn't understand how to raise a child well" 125 ).…”

“…Given the uncertain causal pathways of most mental disorders, parents typically struggle to identify an established cause, and might end up blaming themselves, considering the disorder genetic 123,131 or a consequence of exposure to their behavior 105,108 : “ Is it something I did… when I was pregnant , or during the younger years ?”; “ What could I have done to prevent it ?” 122 . A sense of guilt often accompanies the parents’ elaboration of the diagnosis (“ I will always blame myself about that ” 122 ), leading them to question their parenthood skills 122,132 (“ Maybe because we didn't understand how to raise a child well ” 125 ).…”

Mental Health Awareness for Community Development among Parents towards Responsible Parenting

“…Enhancing parental and family literacy, particularly when combined with mechanisms to encourage open communication, as well as the development of stand-alone treatments targeted at younger generations. Improving mental health literacy (MHL) at the individual and population level can be a useful tool for improving and preventing mental illness (Brooks et al, 2022). The program includes lectures as well as information sharing through experiential learning.…”

Improving the Scope of Child Mental Health Interventions in Our Modern World

“…Whilst most therapists use accessible language and terminology, this can also be a problem in some contexts [ 22 ]. Stigma is a universal challenge across the world for the provision of child mental health services [ 23 ].…”