A Phenomenology Study View of Mental Health Enforcement in

Surabaya Urban Society

A Systematic Review

Nurul Arifah

, Merryana Adriani

and Hanik Endang Nihayati

Faculty of Nursing Universitas Airlangga, Kampus C Mulyorejo, Surabaya, Indonesia

Faculty of Public Health, Universitas Airlangga, Mulyorejo, Surabaya, Indonesia

Keywords: Phenomenology study, Mental health, Enforcement, Urban, Society.

Abstract: The mental health policies that are part of the national and regional health systems seek promotive and

preventive activities that are integrated in cross-sectoral programs and involve society participation. The

objective was to briefly describe the view of phenomenology study for the mental health enforcement in

Surabaya urban society. The key words used were mental health, enforcement, and urban society. Journal

articles search were done electronically using multiple databases, namely: DOAJ, Sage, Proquest, Medline,

Google Scholar, Science Direct and Elsevier. Limitation year used was 10 years (2007 -2017). From the

results obtained twenty literatures selected of journal articles from more than 600 journal articles found.

Twenty studies raised in this study support the study of phenomenology chosen as the research’s design.

Combined findings of this study provided reference for the view of mental health enforcement in Surabaya

urban society. The enforcement of mental health in urban society needs to be developed more widely and

deeply that can be applied in order to improve the high quality of individuals’ mental health in their life.

1 BACKGROUND

One of the factors causing the high number of the

recurrence rate of people with mental disorders is

the lack of family knowledge in dealing with mental

disorders patient when they are back to the

environment. According to Marasmis (2010), in

addition to somatic factors, psychological and socio-

cultural factors are also as a source of mental

disorders. Survey proved that 53% of the factors that

cause psychiatric disorders are derived from

processes that are interwoven in the family

(Wiliamson, et al., 2008). Basically, Roesmaladewi

(2010) added that the obstacle for the patient to be

healed, not only from within himself, but also is

precisely the majority of families and societies who

underestimate the problem.

The prevalence of mental disorders in Indonesia

is not much different from the prevalence in the

world. The incidence of mental disorders in

Indonesia based on RISKESDAS data is 4.6 / 1000

people (Balitbangkes, 2008). This figure is equal to

the median prevalence rate of mental disorders in the

world. In Indonesia is estimated about 1 million

people suffer from mental disorders (MOH, 2012).

In East Java, people with mental disorders

experienced a drastic increase in 2016. East Java

Province shows the number of 2.2 people based on

all East Java population of 38,005,413 lives, it can

be concluded that 83.612 lives have mental disorders

in East Java. In addition, national data on the

incidence of severe mental illness (schizophrenia) in

East Java is 1.4% and Surabaya accounted for 0.2%.

While emotional mental disorders (such as anxiety,

depression, etc.) by 35% and in Surabaya recorded

18.8%.

Mental health policies that are part of the

national and regional health systems seek promotive

and preventive integration across multiple cross-

sectoral programs and involve community

participation. One of the efforts that can be done to

support the recovery of patientswith mental disorder

according to Kepmenkes no 220 / Menkes / SK / III /

2002 is to involve community participation in

supporting the recovery of patients with mental

disorders. The phenomenological study of how

Arifah, N., Adriani, M. and Nihayati, H.

A Phenomenology Study View of Mental Health Enforcement in Surabaya Urban Society.

DOI: 10.5220/0008327404950499

In Proceedings of the 9th International Nursing Conference (INC 2018), pages 495-499

ISBN: 978-989-758-336-0

495

mental health enforcement in the Surabaya urban

city community becomes important primarily in

concerning with knowledge, trust, values, and

culture, patient and family backgrounds integrated

into planning, treatment, to participation in decision-

making related to mental health care. Therefore, the

study aims to briefly and clearly describe of how the

urban society of Surabaya got involved in the

enforcement of mental health regarding to those

several factors mentioned.

2 METHODS

Firstly, the source of references used in this study

was obtained specifically from the search engine.

DOAJ, Proquest, Medline, Google Scholar, Science

Direct and Elsevier by entering the keywords of

mental health, enforcement, and urban society were

some major databases for the literature search. Year

limitation used was 10 years from 2007 to 2017.

From the results obtained twenty literatures selected

of journal articles from more than 600 journal

articles found. From those articles obtained, the

article’s inclusion criteria were: 1) the

phenomenology study; 2) mental health

enforcement; 3) the urban society

The parameters used to determine influencing

factors of mental health enforcement in the urban

society was by using various keywords particularly

in a range of the concept of the mental health, family

and community centered, and the historical concept

of urban society.

3 RESULTS

From the sources related to several keywords using

in this systematic review, the importance in knowing

the mental health enforcement for the urban society

is in line with some findings of some studies.

The first reviewed study from Yearwood (2010)

noted that in 2001, non-communicable

neuropsychiatric disorders accounted for 12% of the

global burden of disease (GBD) worldwide and that

number is expected to increase significantly by

2020. One of the causes of this phenomenon is

supported by the result of the next reviewed study by

Schmidta, et. al (2017) who noted that neighborhood

context may make exposure to stressors and the

expression of stress-related outcomes.

Considering those real condition in society,

actually, family is the most important part in the

healing process of mental disorders. This is proved

by the statement that family support in the process

becomes a hope for patients with mental disorders

during their lifetime (Thalefi, 2017). Therefore,

Kwazulu (2015) added from his study that families

can also extend knowledge about mental disorders

and not stay away from their family members who

have mental disorder.

The importance of public education on the myths

and facts of mental illness can help suppress the

stigma faced by family members of mental disorder.

In this case, another study showed that mental health

stigma is closely related to different mental health

care reforms (Sercu et.al, 2016). A care, in

philosophy, is known as a link between patient and

the family-centered care. The form of such care

focus on cooperation, dignity, respect, information

sharing, participation, and collaboration with

patients and families (Kuo et al., 2012; Wells, 2011;

Johnson, 2000). The care of patients and families is

relatively at the highest policy level in developed

countries and has the privilege point of most health

care systems that have led to the innovation of many

patient and family care agencies that provide some

resources and collect data on their application

(Abraham & Moretz, 2012). These several reviewed

studies shows how importance of mental health

within the society.

Related to this, this systematic review added

several studies which have points to widen the

indicators. From Gregório (2012), the priority-

setting research exercise highlighted a need for

implementing investments at the primary- care level,

particularly in the family health program; the urgent

need to evaluate services; and policies to improve

equity by increasing accessibility to services and

testing interventions to reduce barriers for seeking

mental health treatment. Then, Bee (2015) also

supported that involving users in mental health care-

planning is central to international policy initiatives

yet users frequently report feeling excluded from the

care planning process. The Mental Health Parity and

Addiction Equity Act of 2008, the Affordable Care

Act of 2010, and subsequent federal regulations

improve access to mental health services, but lack of

funding and poor enforcement of new rules continue

to hinder progress (Medford, et. al (2017). However,

result study from Sivris (2015) noted that in order to

get in progress to be achieved in this area, a holistic

and multidisciplinary approach was unanimously

suggested as a way to successful implementation.

Study from Meulen, et. al (2017) can be one of

option to measure the indicators of achieving the

optimal efforts for the application in society context,

INC 2018 - The 9th International Nursing Conference: Nurses at The Forefront Transforming Care, Science and Research

496

that usefulness of psychological resilience is limited

as a predictor of mental health disturbances (if any).

Thus, the protective value of psychological

resilience declined sharply over time. Then finally,

the other reviewed study made a sum that the

implementation of nursing care in the community

are interconnected with each other, because the

services provided must be comprehensive and

sustainable due to the needs of each individual are

different from each other, then the nurse must

behave according to the individual needs at that time

(Alligood, MR, & Tomey, A. M, 2010).

4 DISCUSSION

Mental health disorders (in the developing side)

significantly contribute to the global burden of

disease (GBD), which quantifies the effect of

mortality, morbidity, and disability for specific

diseases. This condition has correlation to several

factors. One of the main factors found in several

reviewed studies showed that the socially patterned

distribution of exposure to stressors may be

particularly relevant for understanding why

disadvantaged neighborhoods are associated with

worse mental health.

The society itself cannot be separated from the

concept of particular family living in such different

view of life. Most indicators mentioned in reviewed

studies noted that a family with member of mental

disorder one can be the source of another problem as

side effect. In handling several cases of mental

disorders within a family in the society, each person

need to be viewed holistically and comprehensively,

so the need for care and healing can be more

optimal. Mental Health Nursing is known as an

interpersonal process that seeks to not only enhance

but also sustain behavior so that the patients can

have their function as a whole human. When the

patients return to their family in hope that they

would have their functions back with the society

which accepts them again, mostly what happens in

real is not as which is expected. Several cases

reported that not only the society but also the smaller

circle of it (family) cannot totally ‘accept’ many

different conditions later in advance.

The health policies have basically been made

beyond the needs of relevant and beneficial

constructions for all individuals in society. Not only

in the small city or rural area, the big city or urban

area are having their own considerations for mental

health sectors which has promoted and applied.

However, the phenomenon which shows as if the

policies are not totally well implied continuously

burden the program of mental health enforcement in

society. Several indicators for this still cannot be

described and explained completely. In this case, the

role of all important persons in the stage of society

setting should be considered and evaluated.

In the term of public health centre, persons in

charge for this kind of program started from the

nurse and so another health provider exist. Nurses'

professional role perception is related to the quality

and safety of care. Community mental health sectors

include all levels and actions of mental health

nursing. It is a full service, ranging from specialist,

integrative, and community-focused of mental health

services. In addition, nurse in society (particularly in

urban area) could be determined as the key role to

apply and convey the message of mental health

enforcement. Any kinds of disturbance happen in the

society as a narrowing way of the implication of

mental health program in society can be range in

number related to the resilience of the people living

in the society. The wider and deeper descriptions for

the main efforts of mental health enforcement should

be the completion for the range of numbers reported.

Empowering all potentials and resources in the

society is also important to realize an independent

society in maintaining health. The enforcement of

mental health in urban society needs to be developed

more widely and deeply that can be applied in order

to improve the high quality of individuals’ mental

health in their life. Therefore, several reviewed

studies collected and summarized in this systematic

review can be some basic references in order to

enrich the phenomenology study of mental health

enforcement in urban society (particularly in this

case: Surabaya).

5 CONCLUSIONS

Mental health services focus on communities

starting from district-level services, public health

centre, groups with special needs, and families. This

service is known as community mental health

nursing (CMHN). The mental health services at

CMHN start from advanced, intermediate, and basic.

Providing health education to the patients, families

and communities that includes mental health

education, mental disorders overview, mental health

characteristics, some causes of mental disorders,

family functions and duties, and care efforts for

patients with mental disorder. Good practice

approaches in different countries and stressed the

A Phenomenology Study View of Mental Health Enforcement in Surabaya Urban Society

497

importance of a strong policy and enforcement

framework as well as organizational responsibility

Phenomenological studies of mental health

enforcement in urban society (in this case is the city

of Surabaya) are needed as an effort to know and

measure how the family in the community is able to

overcome mental health problems to maintain or

improve the quality of life of each family members.

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