"Doing My Profession is also Part of Worship": How Clinical Psychologists Address Aspects of Spirituality and Religion in Indonesia

Health Professionals' Attitudes Towards Traditional Healing for Mental Illness: A Systematic Review

Combining modern treatments with traditional healing approaches has been proposed as one way to address mental health problems, especially in low-income countries where the costs of pharmaceuticals often prevent or reduce their use. Despite health professionals' involvement being crucial for the integration of this approach, their involvement has been limited to date. This systematic review is designed to explore the attitudes of health professionals towards traditional healing practices for mental illness. The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) 2020 guidelines were followed. The studies were identified from Scopus, EMBASE, PubMed, PsycINFO, and the Web of Sciences. The qualities of the included articles were assessed using the Mixed Method Appraisal Tool (MMAT) Version 2018, and mixed-method synthesis was used to narrate the results. Of the 2115 identified articles, 36 were included in the data synthesis. From the extracted data, health professionals had negative, mixed, and positive views towards traditional healing approaches for mental illness. Their negative attitude towards traditional healing approaches were due to their concerns that traditional healing may cause harm to service users, and they have no trust in the scientific basis, education, or practices of healers. Despite the fact that it is crucial for healthcare professionals to comprehend the cultural backgrounds of those receiving mental health services in order to offer care appropriately, health professionals' negative and mixed attitudinal expressions towards traditional healing approaches limit their involvement. This might be improved by identifying barriers from the perspective of practitioners and creating culturally appropriate guidelines for communication and referral between traditional healing approaches and biomedical care.

Death, Funeral Rituals, and Stigma: Perspectives from Mortuary Workers and Bereaved Families

Deaths caused by COVID-19 have affected bereaved family members in several ways, including the inability to perform funeral rites and rituals. Understanding the dynamics and experiences of death and funerals of bereaved families and mortuary workers can lead to improvements in funeral services and the provision of social support for the affected families and mortuary workers. This study aimed to capture the experiences of mourning family members in Indonesia who lost a loved one due to COVID-19 and of mortuary workers who performed funerals according to COVID-19 protocols. Ten family members and 12 mortuary workers living in West Timor, Indonesia, were interviewed using a semistructured interview approach. Findings of the study show that mortuary workers were able to strictly implement the new funeral protocols. However, the rushed nature of these funerals led to resistance from families and prevented bereaved families from performing the usual cultural and religious funeral rituals. This, combined with stigma from their neighbors, led these families to have poor psychological wellbeing.

Preliminary Study of Cultural-Based Empathic Support to Reduce Perceived Stigma for Covid-19 Survivors and Families

This study aims to explore appropriate and meaningful forms of cultural-based support to support the recovery of COVID-19 survivors and the psychological well-being of families who are still vulnerable to receiving social stigma from society. The research method used is qualitative, which is carried out on respondents from religious practitioners, cultural practitioners, and psychologists who have direct experience with the community. The results of this study are expected to be used as guidelines for psychological treatment that can be used by related parties such as hospitals, educational institutions, the government and the private sector to accelerate the recovery process for Covid-19 survivors and their families. The results showed that: 1). Culture plays a very important role in providing social stigma and also in dealing with stigma itself; 2) Several cultural-based support practices are carried out to restore psychological conditions; 3) Empathic support which focuses on understanding the thoughts and feelings of survivors and families in their own perceptions is a concern in culture-based support practices. This study concludes that the practice of culturally based empathy support is meaningful to reduce and prevent the stigma felt by Covid-19 survivors and their families.

Predicting self-harm and suicide ideation during the COVID-19 pandemic in Indonesia: a nationwide survey report

BACKGROUND

It is estimated that 77.0% of suicide cases occurred in low-and-middle-income countries (LMICs), which would increase because of the COVID-19 pandemic and socioeconomic inequity. However, there is lack of reports on this topic from LMICs, especially during the pandemic. Therefore, this nationwide study aimed to explore self-harm and suicide ideation and its predictive variables during the pandemic in Indonesia as a MIC with the highest COVID-19 fatality rate in Asia.

METHODS

Non-random sampling online survey was conducted nationwide between 25 May and 16 June 2021. The collected data were demographic variables (i.e. age group), loneliness from social isolation using The UCLA Loneliness Scale Six Items (ULS-6), and self-harm and suicide ideation using item 9 of The Patient Health Questionnaire-9 (PHQ-9). Predictive model was analyzed using hierarchical logistic regression.

RESULTS

A total of 5211 participants from all 34 provinces in Indonesia completed the survey. Among 39.3% of them reported self-harm and suicide ideation during the pandemic, which significantly correlated with loneliness. The predictive variables associated with the likelihood of self-harm and suicide ideation were age, residence, job, religion, sex-gender, sexual orientation, HIV status, disability status, and loneliness. The predictive model showed a significant goodness-of-fit to the observed data (x² [ (15)] = 1803.46, p < .001), R_N² = .40.

CONCLUSION

Four out of 10 Indonesians experienced self-harm and suicide ideation during the COVID-19 pandemic, particularly people within the age range of 18-24, living in the Java Island, unemployed/student/retired and freelancer, women, members of minority and marginalized communities, and experience of loneliness during the pandemic.

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

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.

Effects of Spirituality, Knowledge, Attitudes, and Practices toward Anxiety Regarding COVID-19 among the General Population in INDONESIA: A Cross-Sectional Study

BACKGROUND

Currently, the determinants of anxiety and its related factors in the general population affected by COVID-19 are poorly understood. We examined the effects of spirituality, knowledge, attitudes, and practices (KAP) on anxiety regarding COVID-19.

METHODS

Online cross-sectional data (n = 1082) covered 17 provinces. The assessment included the Daily Spiritual Experiences Scale, the Depression, Anxiety, and Stress Scale, and the KAP-COVID-19 questionnaire.

RESULTS

Multiple linear regression revealed that individuals who had low levels of spirituality had increased anxiety compared to those with higher levels of spirituality. Individuals had correct knowledge of early symptoms and supportive treatment (K3), and that individuals with chronic diseases and those who were obese or elderly were more likely to be severe cases (K4). However, participants who chose incorrect concerns about there being no need for children and young adults to take measures to prevent COVID-19 (K9) had significantly lower anxiety compared to those who responded with the correct choice. Participants who disagreed about whether society would win the battle against COVID-19 (A1) and successfully control it (A2) were associated with higher anxiety. Those with the practice of attending crowded places (P1) had significantly higher anxiety.

CONCLUSIONS

Spirituality, knowledge, attitudes, and practice were significantly correlated with anxiety regarding COVID-19 in the general population.