The Effects of a School-Based Mental Health Program on Students’ Knowledge, Behavior, and Depression: A Quasi-Experimental Study in Four Indonesian High Schools

Main Article Content

Indri Yunita Suryaputri
Rofingatul Mubasyiroh
Prisca Petty Arfines
Rika Rachmalina
Sri Idaiani
Nikson Sitorus
Bunga Ch Rosha
Enung Nur Khotimah
Diana Setiyawati

Abstract

Schools play a crucial role in promoting the mental health of children and adolescents. This study aimed to examine the effectiveness of a mental health program by evaluating changes in knowledge, behavior, and mental health outcomes of students before and after the intervention. The study employed a pre-and-post-test quasi-experimental approach in four selected high schools in Bogor. It evaluated changes in knowledge, behavior, and mental health outcomes of students pre-and-post the intervention. The study assessed mental health literacy, anti-bullying education, and creating a positive school environment. Data were collected in July and October 2019, with 476 out of 495 students completing both pre- and post-tests. In the intervention group, there was an improvement in knowledge, as evidenced by a decrease in the risk of “having a lack of knowledge” from the pre-test (OR = 1.8, 95% CI [1.2, 2.6], p = .004) to the post-test (OR = 1.2, 95% CI [0.9, 1.8], p = .284). During the pre-test period, students in the intervention schools had a higher risk of experiencing bullying (OR = 1.4, 95% CI [0.9, 2.3], p = .133). However, after the intervention, their risk of being bullied decreased (OR = 0.9, 95% CI [0.6, 1.6], p = .810). The risk of having no peer support also decreased from OR = 1.6, 95% CI [0.5, 5.8], p = .467 to OR = 1.1, 95% CI [0.3, 4.3], p = .933. The condition of depression in the intervention group improved, with an OR = 1.0, 95% CI [0.6, 1.8], p = .924 at the pre-test and an OR = 0.8, 95% CI [0.4, 1.6], p = .511 at the post-test. These findings underscore the significance of initiatives focused on improving student mental health.

Article Details

How to Cite
Suryaputri, I. Y., Mubasyiroh, R., Arfines, P. P. ., Rachmalina, R. ., Idaiani, S., Sitorus, N., Rosha, B. C., Nur Khotimah, E. ., & Setiyawati, D. (2023). The Effects of a School-Based Mental Health Program on Students’ Knowledge, Behavior, and Depression: A Quasi-Experimental Study in Four Indonesian High Schools. Journal of Population and Social Studies [JPSS], 32, 243–261. Retrieved from https://so03.tci-thaijo.org/index.php/jpss/article/view/269755
Section
Research Articles
Author Biography

Indri Yunita Suryaputri, National Research and Innovation Agency, Indonesia

Corresponding author

References

• Allen, K. A., Vella-Brodrick, D., & Waters, L. (2016). Fostering school belonging in secondary schools using a socio-ecological framework. Educational and Developmental Psychologist, 33(1), 97–121. https://doi.org/10.1017/edp.2016.5

• Araya, R., Fritsch, R., Spears, M., Rojas, G., Martinez, V., Barroilhet, S., Vöhringer, P., Gunnell, D., Stallard, P., Guajardo, V., Gaete, J., Noble, S., & Montgomery, A. A. (2013). School intervention to improve mental health of students in Santiago, Chile: A randomized clinical trial. JAMA Pediatrics, 167(11), 1004–1010. https://doi.org/10.1001/jamapediatrics.2013.2361

• Bianchi, R., Verkuilen, J., Toker, S., Schonfeld, I. S., Gerber, M., Brähler, E., & Kroenke, K. (2022). Is the PHQ-9 a unidimensional measure of depression? A 58,272-Participant Study. Psychological Assessment, 34(6), 595–603. https://doi.org/10.1037/pas0001124

• BPS-Statistics Indonesia. (2020, April 29). Statistik Indonesia 2020 [Statistical Yearbook of Indonesia 2020]. https://seadelt.net/Asset/Source/Document_ID-462_No-01.pdf

• Breslau, J., Miller, E., Joanie Chung, W. J., & Schweitzer, J. B. (2011). Childhood and adolescent onset psychiatric disorders, substance use, and failure to graduate high school on time. Journal of Psychiatric Research, 45(3), 295–301. https://doi.org/10.1016/j.jpsychires.2010.06.014

• Bronfenbrenner, U., & Ceci, S. J. (1994). Nature-nurture reconceptualized in developmental perspective: A bioecological model. Psychological Review, 101(4), 568–586. https://doi.org/10.1037/0033-295X.101.4.568

• Cheung, A. C. K., & Slavin, R. E. (2016). How methodological features affect effect sizes in education. Educational Researcher, 45(5), 283–292. https://doi.org/10.3102/0013189X16656615

• Cipra, A., & Hall, L. (2019). COREMatters: A bullying intervention pilot study. RMLE Online, 42(4), 1–13. https://doi.org/10.1080/19404476.2019.1599244

• Evans, C. B. R., Fraser, M. W., & Cotter, K. L. (2014). The effectiveness of school-based bullying prevention programs: A systematic review. Aggression and Violent Behavior, 19(5), 532–544. https://doi.org/10.1016/j.avb.2014.07.004

• Farrington, D. P., & Ttofi, M. M. (2009). School‐based programs to reduce bullying and victimization. Campbell Systematic Reviews, 5(1), i–148. https://doi.org/10.4073/csr.2009.6

• Ferrari, A. J., Norman, R. E., Freedman, G., Baxter, A. J., Pirkis, J. E., Harris, M. G., Page, A., Carnahan, E., Degenhardt, L., Vos, T., & Whiteford, H. A. (2014). The burden attributable to mental and substance use disorders as risk factors for suicide: Findings from the Global Burden of Disease Study 2010. PLOS ONE, 9(4), Article e91936. https://doi.org/10.1371/journal.pone.0091936

• Ferrari, A., Santomauro, D. F., Herrera, A. M. M., Charlson, F. J., Erskine, H. E., & Whiteford, H. A. (2022). Global, regional, and national burden of 12 mental disorders in 204 countries and territories, 1990–2019: A systematic analysis for the Global Burden of Disease Study 2019. The Lancet Psychiatry, 9(2), 137–150. https://doi.org/10.1016/S2215-0366(21)00395-3

• Fraguas, D., Diáz-Caneja, C. M., Ayora, M., Durán-Cutilla, M., Abregú-Crespo, R., Ezquiaga-Bravo, I., Martín-Babarro, J., & Arango, C. (2021). Assessment of school anti-bullying interventions: A meta-analysis of randomized clinical trials. JAMA Pediatrics, 175(1), 44–45. https://doi.org/10.1001/jamapediatrics.2020.3541

• Gaffney, H., Farrington, D. P., & Ttofi, M. M. (2019). Examining the effectiveness of school-bullying intervention programs globally: A meta-analysis. International Journal of Bullying Prevention, 1(1), 14–31. https://doi.org/10.1007/s42380-019-0007-4

• Gaffney, H., Ttofi, M. M., & Farrington, D. P. (2021). Effectiveness of school-based programs to reduce bullying perpetration and victimization: An updated systematic review and meta-analysis. Campbell Systematic Reviews, 17(2), Article e1143. https://doi.org/10.1002/cl2.1143

• Gillham, J. E., Reivich, K. J., Freres, D. R., Chaplin, T. M., Shatté, A. J., Samuels, B., Elkon, A. G. L., Litzinger, S., Lascher, M., Gallop, R., & Seligman, M. E. P. (2007). School-based prevention of depressive symptoms: A randomized controlled study of the effectiveness and specificity of the Penn Resiliency Program. Journal of Consulting and Clinical Psychology, 75(1), 9–19. https://doi.org/10.1037/0022-006X.75.1.9

• Grande, A. J., Hoffmann, M. S., Evans-Lacko, S., Ziebold, C., de Miranda, C. T., Mcdaid, D., Tomasi, C., & Ribeiro, W. S. (2023). Efficacy of school-based interventions for mental health problems in children and adolescents in low and middle-income countries: A systematic review and meta-analysis. Frontiers in Psychiatry, 13, Article 1012257. https://doi.org/10.3389/fpsyt.2022.1012257

• Guthold, R., Johansson, E. W., Mathers, C. D., & Ross, D. A. (2021). Global and regional levels and trends of child and adolescent morbidity from 2000 to 2016: An analysis of years lost due to disability (YLDs). BMJ Global Health, 6(3), Article e004996. https://doi.org/10.1136/bmjgh-2021-004996

• Hart, L. M., Cropper, P., Morgan, A. J., Kelly, C. M., & Jorm, A. F. (2020). Teen Mental Health First Aid as a school-based intervention for improving peer support of adolescents at risk of suicide: Outcomes from a cluster randomised crossover trial. Australian and New Zealand Journal of Psychiatry, 54(4), 382–392. https://doi.org/10.1177/0004867419885450

• Health Research and Development Agency, World Health Organization, & US Centers for Disease Control and Prevention. (2018, August 14). Global School-based Student Health Survey: Indonesia 2015. https://extranet.who.int/ncdsmicrodata/index.php/catalog/489/study-description

• Herrman, H., Saxena, S., & Moodie, R. (Eds.). (2005, January 1). Promoting mental health: Concepts, emerging evidence, practice: report of the World Health Organization, Department of Mental Health and Substance Abuse in collaboration with the Victorian Health Promotion Foundation and the University of Melbourne. World Health Organization. https://www.who.int/publications/i/item/9241562943

• Indonesia Ministry of Health. (2016). Perilaku berisiko kesehatan pada pelajar SMP dan SMA di Indonesia [Health Risk Behavior among junior and senior high school students in Indonesia]. World Health Organization. https://extranet.who.int/ncdsmicrodata/index.php/catalog/489/download/3800

• Indonesia Ministry of Health. (2019). Laporan Nasional Riskesdas 2018 [Riskesdas National Report 2018]. https://repository.badankebijakan.kemkes.go.id/id/eprint/3514

• Karyani, U. (2016). Merancang perubahan di sekolah untuk menjadi sekolah yang mempromosikan kesehatan mental [Designing changes in the school to become a school that promotes mental health]. Jurnal Indigenous, 1(1), 48–60. https://smartlib.umri.ac.id/assets/uploads/files/5d855-1782-7821-1-pb.pdf

• Katz, J., Knight, V., Mercer, S. H., & Skinner, S. Y. (2020). Effects of a universal school-based mental health program on the self-concept, coping skills, and perceptions of social support of students with developmental disabilities. Journal of Autism and Developmental Disorders, 50(11), 4069–4084. https://doi.org/10.1007/s10803-020-04472-w

• Kroenke, K., Spitzer, R. L., & Williams, J. B. W. (2001). The PHQ-9: Validity of a brief depression severity measure. Journal of General Internal Medicine, 16, 606–613. https://doi.org/10.1046/j.1525-1497.2001.016009606.x

• Kutcher, S., Wei, Y., McLuckie, A., & Bullock, L. (2013). Educator mental health literacy: A programme evaluation of the teacher training education on the mental health & high school curriculum guide. Advances in School Mental Health Promotion, 6(2), 83–93. https://doi.org/10.1080/1754730X.2013.784615

• Lai, E. S. Y., Kwok, C. L., Wong, P. W. C., Fu, K. W., Law, Y. W., & Yip, P. S. F. (2016). The effectiveness and sustainability of a universal school-based programme for preventing depression in Chinese adolescents: A follow-up study using quasi-experimental design. PLOS ONE, 11(2), Article e0149854. https://doi.org/10.1371/journal.pone.0149854

• Lindow, J. C., Hughes, J. L., South, C., Minhajuddin, A., Gutierrez, L., Bannister, E., Trivedi, M. H., & Byerly, M. J. (2020). The Youth Aware of Mental Health intervention: Impact on help seeking, mental health knowledge, and stigma in U.S. adolescents. Journal of Adolescent Health, 67(1), 101–107. https://doi.org/10.1016/j.jadohealth.2020.01.006

• Milin, R., Kutcher, S., Lewis, S. P., Walker, S., Wei, Y., Ferrill, N., & Armstrong, M. A. (2016). Impact of a mental health curriculum on knowledge and stigma among high school students: A randomized controlled trial. Journal of the American Academy of Child and Adolescent Psychiatry, 55(5), 383–391. https://doi.org/10.1016/j.jaac.2016.02.018

• Moore, G. F., Cox, R., Evans, R. E., Hallingberg, B., Hawkins, J., Littlecott, H. J., Long, S. J., & Murphy, S. (2018). School, peer and family relationships and adolescent substance use, subjective wellbeing and mental health symptoms in Wales: A cross sectional study. Child Indicators Research, 11(6), 1951–1965. https://doi.org/10.1007/s12187-017-9524-1

• Mousteri, V., Daly, M., Delaney, L., Tynelius, P., & Rasmussen, F. (2019). Adolescent mental health and unemployment over the lifespan: Population evidence from Sweden. Social Science and Medicine, 222, 305–314. https://doi.org/10.1016/j.socscimed.2018.12.030

• Noboru, T., Amalia, E., Hernandez, P. M. R., Nurbaiti, L., Affarah, W. S., Nonaka, D., Takeuchi, R., Kadriyan, H., & Kobayashi, J. (2021). School-based education to prevent bullying in high schools in Indonesia. Pediatrics International, 63(4), 459–468. https://doi.org/10.1111/ped.14475

• Oberle, E., Guhn, M., Gadermann, A. M., Thomson, K., & Schonert-Reichl, K. A. (2018). Positive mental health and supportive school environments: A population-level longitudinal study of dispositional optimism and school relationships in early adolescence. Social Science and Medicine, 214, 154–161. https://doi.org/10.1016/j.socscimed.2018.06.041

• O’Connor, C. A., Dyson, J., Cowdell, F., & Watson, R. (2018). Do universal school-based mental health promotion programmes improve the mental health and emotional wellbeing of young people? A literature review. Journal of Clinical Nursing, 27(3–4), e412–e426. https://doi.org/10.1111/jocn.14078

• Patel, V., Kieling, C., Maulik, P. K., & Divan, G. (2013). Improving access to care for children with mental disorders: A global perspective. Archives of Disease in Childhood, 98(5), 323–327. https://doi.org/10.1136/archdischild-2012-302079

• Ruble, A. E., Leon, P. J., Gilley-Hensley, L., Hess, S. G., & Swartz, K. L. (2013). Depression knowledge in high school students: Effectiveness of the adolescent depression awareness program. Journal of Affective Disorders, 150(3), 1025–1030. https://doi.org/10.1016/j.jad.2013.05.033

• Salerno, J. P. (2016). Effectiveness of universal school-based mental health awareness programs among youth in the United States: A systematic review. Journal of School Health, 86(12), 922–931. https://doi.org/10.1111/josh.12461

• Shorey, S., Ng, E. D., & Wong, C. H. J. (2022). Global prevalence of depression and elevated depressive symptoms among adolescents: A systematic review and meta-analysis. British Journal of Clinical Psychology, 61(2), 287–305. https://doi.org/10.1111/bjc.12333

• Solmi, M., Radua, J., Olivola, M., Croce, E., Soardo, L., Salazar de Pablo, G., Il Shin, J., Kirkbride, J. B., Jones, P., Kim, J. H., Kim, J. Y., Carvalho, A. F., Seeman, M. V., Correll, C. U., & Fusar-Poli, P. (2022). Age at onset of mental disorders worldwide: Large-scale meta-analysis of 192 epidemiological studies. Molecular Psychiatry, 27(1), 281–295. https://doi.org/10.1038/s41380-021-01161-7

• Suryaputri, I. Y., Rosha, B. C., & Sari, K. (2013). Gender and other factors and risk of mental emotional problems among students in Indonesia. Health Science Journal of Indonesia, 4(2), 98–102. https://media.neliti.com/media/publications-test/62300-gender-and-other-factors-and-risk-of-men-5dd5df1b.pdf

• UNESCO. (2022). UNESCO strategy on education for health and well-being. https://unesdoc.unesco.org/ark:/48223/pf0000381728

• Zhang, Q., Wang, J., & Neitzel, A. (2023). School-based mental health interventions targeting depression or anxiety: A meta-analysis of rigorous randomized controlled trials for school-aged children and adolescents. Journal of Youth and Adolescence, 52(1), 195–217. https://doi.org/10.1007/s10964-022-01684-4