JOURNAL OF INNOVATION AND DEVELOPMENT OF COMMUNITY SERVICE RESULTS

e-ISSN 3025-2334

Vol 1(2), December 2023, 80-86
DOI: https://doi.org/10.61650/jip-dimas.v1i2.218
a s s yf a . c o m

Perak District, Jombang Regency Mental Health Cadres Stabilising
Mental Disorder Assistance
Galuh Dwi Purwasih1, Yuli Ani Setyo Dewi 2, and Miftahillah 3
1 IAI Badrus Sholeh Purwoasri Kediri, Indonesia

2.3 STITNU Al Hikmah Mojokerto, Indonesia

* Corresponding author: galuhdwipurwasih3@gmai.com

KEYWORDS
Disruption Soul
Mental Health Cadre
Companion

SUBMITTED:08/28/2023
REVISED: 09/15/2023
ACCEPTED: 09/20/2023

ABSTRACT: A Person with adisturbed soul is aproblem That isreasonably severe and needs attention,
especially in the Perak sub-district. In realizing that the sub-district is always alert in handling
this to create a mentally healthy environment in the subdistrict. In subdistrict Silver, there is 13
Village includes, including Village Perak, Pagerwojo, Sumberagung, Kepuhkajang, Jantiganggong,
Sembung, Gadingmangu, Plosogenuk, Sukorejo, Kalangsemanding, Glagahan, Temuwulan, and
Cangkringrandu. Understanding family, which is minimal about maintaining the patient's soul,
makes Families tend to have a negative attitude towards people with a mental health condition.
This activity aims to obtain an overview of efforts to heal people with mental health conditions
and the obstacles they experience. This activity involved 25 people consisting of caring families,
mental health cadres, and the village government. The data collection techniques were
observation, interviews, and Forum Group Interview (FGI). The intervention methods used are
advocacy (advice) and psychoeducation with the Wilcoxon test (analyzing the results of paired
observations from two data, whether they are different or not). In psychoeducation activities, it
was discovered that participants' knowledge, understanding, and skills increased, as shown in the
change in scale score from 36.25 to 39.25. Families show behavioral patterns in providing care
and treatment for people with mental health conditions. Through counseling activities, a mental
health post can be formed that provides services every month to the families of people with a
mental health condition, one of which is Poskeswa Seroja. Through advocacy (advice) activities, a
mental health post can be created to provide monthly services to the patient's family.
© The Author(s) 2023.

1. INTRODUCTION
People with mental disorders/people with mental
health conditions are people who suffer from impaired
mental function, so they experience changes in behavior
(Melkonyan, 2022; Reed, 2019), thinking (Stein, 2020),
and feelings (Cree, 2018), which manifest in various
symptoms or changes in behavior that interfere with
their function as human beings (Ströhle, 2019; Vigo,
2019). Symptoms can be looked at as a sign that
someone is experiencing a mental disorder in a row that
interferes with creativity (Purwasih & Dewi, 2023;
Subramaniam, 2019).
Health, productivity, and relationships with other
people. Something that can be understood as a sign of a
mental disorder is irritability for no reason, worrying,
and feeling anxious for more than 2 days or 3 weeks
until it disrupts daily activities in relationships with
others (Carleton, 2020; Kumar, 2020). Grancini (2009)

revealed that the causes of mental disorders vary
greatly, and in some cases, the cause is unclear (Arango,
2018; Brådvik, 2018). Traumatic experiences that are
very difficult to forget and have long-term psychological
effects become stressors and cause a person to
experience mental disorders (Auerbach, 2018;
Wakschlag, 2019). Previously, people with mental
health conditions were recognized by specific
symptoms such as very drastic changes in mood
(Alonso, 2018; Black, 2019). excessive fear, isolating
themselves from social life, often feeling angry, and
often committing acts of violence that could not
differentiate between reality and fantasy (Khalsa, 2018;
Walker, 2020). These symptoms are also followed by
physical disorders such as headaches, digestive
disorders, and other physical disorders (Bell, 2019;
Usher, 2020).

This is an Creative Commons License This work is licensed under a Creative Commons
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Purwasih et al., ││ Perak District, Jombang Regency Mental Healt Cadres Stabilising...

The causes of mental disorders are very varied.
In some cases, the cause is not clear, and the
experience of trauma is difficult to forget and has
long-term psychological effects in more detail
(Hidayatullah et al., 2023; Saputri et al., 2023;
Tricahyono et al., 2023). Mental disorders are usually
caused by genetic factors, for example, hereditary
factors in the family, relatives who have mental
disorders, or brain damage (Hidayatullah et al., 2023;
Putriani & Mujahidin, 2023; Setyaningrum et al.,
2023). Chronic illnesses and use of drugs, bullying,
wrong parenting patterns, conflicts, and challenging
economic conditions, heavy psychological burdens,
psychological factors are usually from a bad
personality environment (Karunia et al., 2023; Putra
et al., 2023a). Some consider supernatural factors as
the cause so that treatment efforts are carried out,
such as rakyat, going to a shaman before the family
finally finds out information about the existence of a
mental hospital (Febrian et al., 2023; Kusnawan et al.,
2023).
Mental health workers by families in
Jatingganggong Village, Silver, Kepuhkajang, and 10
Other villages are still not optimal. According to
information from the local village head, the family
chose not to examine their family members who had
mental disorders and provided minimal care, one of
which was due to economic problems. This is in line
with those who found that caregivers have an
economic burden on the family, which has an impact
on the care of people with mental health conditions.
According to mental health cadres, families who care
for people with mental health conditions are still
oriented toward meeting their daily living needs as
long as they don't disturb their families and always
pay attention to them (Giovani et al., 2023; Kahlon,
2019; Rizdania et al., 2023a). With mental disorders
still relatively low due to low levels of family
education, the focus is still on fulfilling a whole life
daily.
Efforts have been made by village governments
in the Perak sub-district to facilitate picking up people
with mental health conditions who are raging or who
are almost recovered and taking people with mental
health conditions to mental hospitals or providing
routine treatment every month at the nearest health
facility or if there is a complaint. The establishment of
a mental health posyandu in the Perak sub-district,
supervised by village officials and health workers, has
been implemented from 2017 until now.
However,
returning
to
each
family's
understanding, it turns out that there is still a lack of
understanding regarding the care of people with
mental health conditions, which often gives rise to
negative attitudes (McKnight-Eily, 2021; Robillard,
2021; Trupin, 2017). Although No A Little also family
mental patients in the Perak sub-district who support
this poses (mental health posyandu) program in
treating patients with mental disorders (Pan, 2021a;
Sudiantini et al., 2023; Suharsiwi, Pandia, et al., 2023).
Understanding of the diagnosis received and minimal

mental health literacy result in the emergence of
stigma from family and community regarding the
mental health status of each individual (Darmayanti,
Hariyadi, et al., 2023; Suharsiwi & Choirin, 2023;
Zahroh & Hartiningtyas, 2023a). This fear encourages
families to hide the diagnosis of this mental disorder
from their family members to local communities.
Apart from that, fear of stigma also makes it difficult
for them to seek treatment.
This raises problems with mental patients who
come from the community or have minimal
knowledge about mental patients (Suharsiwi, Savitry
et al., 2023; Triono et al., 2023; Zahroh, Darmayanti,
et al., 2023a). Impact on the care of people with
mental disorders and efforts to optimize care. If this
happens, the optimization of care for people with
mental disorders must be improved further so that
care is more precise and the realization of a village
that is always alert and alert. Objective devotion This
is a description of efforts to heal people with mental
disorders and the obstacles they experience, as well
as designing and implementing intervention
programs to increase knowledge of family skills in
caring for people with mental disorders (Too, 2019;
Torous, 2020).

2. METHOD
Service with the title Stabilizing Mentoring Person
in Disturbance Soul Together with Mental Health
Cadres in Perak District, Jombang Regency, we focus
on caring for people with mental disorders by
families in various villages (Rizdania et al., 2023b).
Region subdistrict Silver. Technique data collection:
observation, interview, and focused group interviews.
Several participants were involved in the activity. This
amount was insufficient (Putra et al., 2023b; Zahroh &
Hartiningtyas, 2023b). More than 20 people consisting
of cadres, village heads, village assistants, sub-district
public relations, and police stations.
The interview method used is psychoeducation
and advocacy; psychoeducation aims to provide
information, namely a perception scale, about the
psychological condition of people with mental
disorders and their treatment, which is appropriate to
inhabitants And Perak sub-district government
(Kurniawan et al., 2023; Zain et al., 2023).
Psychoeducation for caring families to provide
psychological conditions for people with mental
disorders and treatment appropriate to family caring
regarding family problems, recognizing people with
mental disorders, managing family burdens, and
stress management family.

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The measuring tool used to determine
participants' understanding before and after
psychoeducation was carried out was a perception
scale about mental disorders, which consisted of 14
statements. The measurement results are a score that
describes the perception of people with mental
disorders. Overall, the flow of community service
activities can be seen in Figure 1.

taken to a mental hospital. The Perak sub-district
mental health care team also evacuated people with a
mental health condition for treatment by
coordinating across sectors. The team of Perak subdistrict health workers also returned mental patients
to the community to monitor the condition of people
with mental health conditions after returning to the
public.
Inhibitor and Consequence which experience in
caring for the Patient's soul

Plan

Analysis

Quesioner

Figure 1. Channel activity Devotion to Public

Activities are carried out by making preparations
in advance, namely coordinating with the village
head, nurses, or Perak sub-district health workers
regarding the objectives of this community service
research. After obtaining permission, the next step is
to collect data using interview, observation, and
focused group interview methods. After collecting all
the data and information, the next step is to design
and implement interventions by providing
psychoeducation and advocacy.

3. RESULTS AND DISCUSSION
All community service research results are
presented by the objectives that have been
formulated, namely obtaining an overview of efforts
to heal people with mental disorders and the
obstacles they experience, as well as designing and
implementing intervention programs to increase
family knowledge and skills. A nurse is a disturbed
soul (Kim, 2020; Maben, 2020).
Tips for Stabilizing the Recovery of People with Mental Disorders
Based on the results of focused group interviews,
information was obtained that most families who care
for people with mental disorders take alternative
treatment such as shamans or kya (Darmayanti, Arif,
et al., 2023; Jannah et al., 2023; Rizki et al., 2023). Still,
some families take them to the nearest clinic for
appropriate medical treatment, and then the family
carries out treatment at home or provides routine
check-ups. Periodically (Ahmed et al., 2023; Mubarok
et al., 2023). The role of the family in caregiving can
influence numbers in reducing relapse rates, for
example, controlling mental states and supporting
emotions, helping in a way economy as well as
tolerating change in behavior (Ahmed et al., 2021;
Darmayanti, Suyono, et al., 2023; Mustafa et al., 2023).
One of the people experiencing mental
disorders in the Perak sub-district worked odd jobs to
be able to buy the drug. Subdistricts facilitate special
pick-up of patients who are going on a rampage to be

Economic growth is the most significant
inhibiting factor in preventing people with a mental
health conditions, especially in terms of meeting the
needs of mental patients because they do not yet have
a Healthy Indonesia Card. Access to the hospital is
quite far to travel, so the family also needs
transportation (Ridho’i et al., 2023; Sefira et al., 2024;
Zahroh, Darmayanti, et al., 2023b). Matter This has an
impact on families who end up with minimal care
because it takes a lot to pay for the treatment of
people with a mental health condition, such as buying
medicine, routine check-ups, and transportation costs
to get to health services. Especially for families who
have to take care of more than one family member
who is sick. Meanwhile, there are no other family
members who are willing to help with care and
treatment to support the recovery of people with
mental health conditions. There are also family
members who talk to people with mental health
conditions in high tones.
In other cases, family members do not live in the
same house as people with a mental health condition,
so they cannot control drug consumption. Nonadherent behavior with this medication has an impact
on relapse symptoms. Some people with mental
health conditions feel traumatized when they have to
visit the hospital. Negative family perceptions of
House Sick Soul make Families reluctant to have their
family members examined because they fear their
family members will be neglected or neglected (Firth,
2019; González-Blanco, 2020; Linardon, 2019). This
also has an impact on family members who refuse
offers of help from residents to take people with a
mental health condition to treatment. The side effects
of the medication taken make people with mental
health conditions increase their appetite and become
sleepy, resulting in problems in Which the patient is
unable to carry out self-care activities independently.
Being a caregiver for a person with a mental
health condition is not something that can be chosen
or planned so that it can experience deep burdens in
parenting, being able to do things that previously
could be done so that families feel that people with
mental health conditions only depend on their
caregivers, which results in a burden for the family.
The impact of the difficulties experienced by families
in caring for people with mental health conditions is
almost despair and overthinking to the point of
disrupting activities. Caring for people with a mental
health condition and carrying out work causes
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caregivers to experience stress and emotional
burdens such as dissatisfaction, anger, and stress
when they have to be responsible for caring for
people with a mental health condition. The burden
experienced by caregivers, if they do not receive
proper preventive attention and treatment, can hurt
their physical health. Psychological, emotional,
cognitive, social, and behavioral influences the role of
the caregiver. Families feel hurt when family
members who experience mental disorders are
bullied by their environment (Asgafi et al., 2023;
Choirudin et al., 2021; Jayanti et al., 2023). This
bullying causes people with mental health conditions
to be reluctant to socialize because they are
embarrassed and afraid of being rejected by their
environment. Discrimination from society is the
heaviest burden that must be accepted by people's
family and trigger emergency burden, physical
attacks, and emotional.
Psychoeducation intervention program
1.

Psychoeducation for representatives of residents
and sub-district government Silver

After
implementing
psychoeducation,
participants were asked to fill out a perception scale
about mental disorders, which consisted of 15
statements; there were only four alternative answers,
namely, agree, strongly agree, disagree, and strongly
disagree. Participants' post-test and pre-test results:

Based on the results of Figure 2, the average
score shows an increase from 36.25 to 39.25. Analysis
using the non-parametric 2-related sample test with
the Wilcoxon test showed a significant difference
between the pre-test and post-test scores. It can be
concluded that there is an increase in understanding
of
mental
disorders
after
being
given
psychoeducation (Dunning, 2019; Jamilian, 2019;
Parletta, 2019).

Figure 2. Perak sub-district mental health post

Figure 3. Advice and psychoeducation with residents, village officials, and
people with mental health conditions who have recovered

When carrying out personal/social education
(psychoeducation), there are participants who
believe that people with mental health conditions are
caused by possession by spirits, jinn, devils, and the
like and believe in rakyat or shaman treatment as an
alternative treatment for people with mental
disorders, paranormal treatment is the family's main
alternative for patients if unnatural behavior appears
which is believed to be interference from spirits the.
After being given psychoeducation about recognizing
that people with mental disorders are not caused by
spirits, new residents or families of people with
mental health conditions understand that it is a myth
that people with mental disorders are disturbed by
spirits and the like.

1) Personal/social education for families nurse person in
disturbance soul

Personal/social education for families caring
for people with mental health conditions runs
smoothly. The first psychoeducational material is
about the difficulties of caring for people with mental
health conditions. Participants provide input to each
other in caring for patients with mental disorders.
Some of the difficulties expressed by families in
caring for people with a mental health condition are
that they often ask and force them to buy something,
and the family is late in buying medicine until the
person with a mental health condition shows
symptoms. Recurrence is difficulty looking for
patients at home who walk or go without direction
(Aryaseta et al., 2023; In’am et al., 2023; Zahroh,
Rachmawati, et al., 2023).
The responses given to the participants can be
summarized as follows: providing understanding to
people with a mental health condition regarding their
current condition and not always fulfilling their
wishes, remembering routine control schedules and
monitoring medication administration regularly
without interruption, locking the house if the person
with a mental health condition is in the house alone
and supervise people with a mental health condition
when they are at home. All participants can receive
input from other participants (Muhammad et al.,
2023; Vidyastuti et al., 2018; Widodo et al., 2023).
Regarding treatment for people with mental health
conditions, three mental patients have been there for
three months. No delivery controls Because assume
the patient's condition is fine. Some have never
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controlled mental patients at all because they don't
have a Healthy Indonesia Card. The following three
patients every month still regularly deliver control
routine, And two patients, others new.
One week ago, I took the patient to a mental
hospital. One of the participants responded that if a
person with a mental health condition stops taking
their medication, they are worried that they will
return to their initial condition before taking the
medication or it will get worse. Participants even
responded that they do not need treatment in a
mental hospital but can be treated or treated At a
home-sick public health center by using a first health
facility referral letter. This was only discovered by
other participants; one of the other participants
immediately sought treatment.
After psychoeducation, participants know and
understand the characteristics of people experiencing
mental disorders and the importance of drinking
drugs as well as controlling the routine for the
patient's soul. Spicoeducational material The second
is to recognize the patient's soul and characteristics.
Then, participants share their knowledge and
participants can understand it and ask for books
containing material so they can be read and
understood at home; the third is the burden and
support of families in caring for people in disturbance
soul that is delivered controls routinely remind you to
take medicine, eat and shower soap, play And get
along outside House with neighbors, this can be
applied to people with a mental health condition who
have recovered, as well as providing direction or
advice to people with a mental health condition. After
psychoeducation, participants can state what they
should or should not do when treating people with a
mental health condition to minimize relapse.
Next is the fourth psychoeducational material,
namely regarding family stress management due to
caring for people with a mental health condition.
Playing and looking for entertainment at a neighbor's
or relative's house. The participants were not aware
of progressive muscle relaxation as a way to relieve
stress. The participants were trained to do or train
progressive muscles while playing relaxation music.
Mental health cadre members also provide
opportunities for participants To sing And jog
variations. Those who like or have the talent to sing,
even if they don't have the talent, are also welcome
(Hamadani, 2020; Pan, 2021b; Zheng, 2018).
Participants or families expressed feeling
worried when leaving people with a mental health
condition at home alone. The participants felt
comfortable and less worried after practicing the
progressive muscles by listening to music and singing.
Follow-up activities with Silver Critic health workers
were carried out in three psychoeducational weeks.
The local health nurse revealed that participants who
had not yet checked their family members who had
mental disorders were now starting to take care of
BPJS with the help of health workers, including a

participant Who asked for help from the midwife
village to take his family members for treatment to a
mental hospital after not taking medication for 3
months. According to the information, previous
participants did not want their family members to be
included as mental patient participants, so their
family members were not willing to enter House Sick
Soul.
However moment, his family members are
willing to ask for help from mental health nurses or
mental health cadres to accompany family members
who are disturbed souls to House Sick Souls (Jamilian,
2019; O’Connor, 2020). From the total smaller
population of more than 27999 people, there are
approximately 180 people who experience emotional
or psychotic mental disorders. There were 20.8% of
residents with indications of mild neurosis, 2.2% of
residents with indications of severe neurosis, 0.5% of
residents with indications of psychoactive substance
disorders, and 3.7% of residents with indications of
psychotic disorders. At the end of the defense or
advice, the health posts can facilitate the care and
treatment of people with mental health conditions to
lighten the burden on the families caring for them.
Mental patient nurses said they would stabilize
assistance for mental patients with mental health
cadres in the sub-district Silver.

Figure 5. outbound activities in Wonosalam

2) Defense or advice
Defense or advice (Advocacy) begins by asking
participants to reveal the difficulties experienced by
families in caring for people with mental disorders, as
well as difficulties when delivering patients to
treatment (Akhfudi, 2009). The mental health nurse
revealed that the discourse regarding the formation
of a mental health post already existed and had been
realized, one of which was the Seroja Poskeswa in the
Perak sub-district, and had already formed an
organizational structure for social health cadres. To
date, all participants from various villages throughout
the Perak sub-district are very enthusiastic about the
existence of the Poskeswa lotus to benefit people with
mental disorders. Mental health post-activities are
carried out once a month. Keswa cadres visit the
homes of each person with a mental health condition
in their respective RT, one of which is a mental health
check, and the entire team of Keswa cadres reports
the results of their monitoring.

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4. CONCLUSION
From the various activities carried out, it is
known that problems with people with a mental
health condition from the family and community
have an impact on negative attitudes of the patient
soul, especially condition economics, and knowledge
about people with mental disorders is very minimal.
Treatment for people with a mental health condition
cannot be handled optimally due to limited costs,
one of which is not having BPJS and not having
regular check-ups at the nearest health facility or
hospital. After psychoeducation happens, increasing
knowledge, understanding, care, and treatment for
people with mental health conditions is more
optimistic, and families of people with mental health
conditions are starting to strive for healing by
providing treatment and routine check-ups. The
village community health cadres facilitated the
delivery of people with a mental health condition
who experienced relapse to the hospital, and
residents also provided medical assistance at the
nearest health facilities/puskesmas for people with
a mental health condition. Poskeswa activities have
succeeded in stabilizing assistance for people with
mental disorders and providing services and
activities every month for people with mental health
conditions, especially for patients who have
recovered. Suggestions for the Perak Jombang subdistrict government are that it is hoped to continue
to be actively involved in providing outreach about
people with mental disorders and supporting
postkeswa activities in the Perak sub-district. Mental
health cadres are expected to continue to provide
family support programs for people with mental
health conditions on a scheduled basis for families
who care for them. The community must participate
in supporting the recovery of people with mental
disorders by providing opportunities to get involved
in activities held in the sub-district so that people
with mental health conditions feel appreciated and
recognized for their existence.

5.

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