INTRODUCTION
Mental health has an important role for humans as well as physical
health in general. Mental health is also an aspect that affects other lives, if
mental health is well maintained then one's abilities will work more optimally.
A healthy mental condition cannot be separated from good physical health (Afsharnia et al., 2016). Various
studies show the results that there is an interaction between a person's
physical and mental health, where individuals who suffer from physical illness
indicate a psychological to mental disorder. Conversely, individuals who have
mental disorders show impaired physical functioning. Health and illness are
biopsychosocial conditions that are integrated into human life (Solli & Barbosa da Silva, 2012). The introduction of the concept of health and illness, both
physically and psychologically is part of human recognition of his condition
and how he adapts to the surrounding environment.
Good mental health is a condition where individuals are free from
all kinds of mental disorders, and function normally in carrying out life,
especially in adjusting to deal with problems that may be encountered.
According to WHO, mental health is a state of well-being that is recognized by
individuals in which there are abilities to manage normal life stressors, to
work productively and productively, and to participate in their communities (Ridlo, 2020).
It is important to pay attention
to the mental pandemic of the younger generation, considering that the younger
generation is the driver of the economy in the future. Ironically, the impact
of the COVID-19 pandemic is only focused on infected cases, so that the problem
of mental anemia is forgotten (Smith & Nichols, 2015). Data compiled by the Indonesian Association of Psychiatric
Doctors (PDSKJI) from April to August 2020 shows 3,443 people who underwent
self-examination complained of psychological problems. About 47.9% of them
showed anxiety symptoms, 36.1% depressive symptoms and 16% psychological
trauma. In fact, 49% of respondents who indicated depression had thoughts of
suicide or self-harm. This data is supported by data from the UI COVID -19
Response Team which shows people with symptoms of depression touched more than
35% during a pandemic, 2-3 times higher when compared to depression during
other non-pandemic disasters (Arda Jiter, Muhammad Iqbal Fasa, 2022). These data are in line with the results of investigations on
epidemic conditions, the level of anxiety can be much higher than before. There
has been a 20% increase in new patients every day being referred to a
psychiatrist during the pandemic. The number of mental health sufferers can
still increase because people are still reluctant to consult a psychiatrist.
This is due to the lack of understanding of mental disorders which are always
identified with madness (Helianti Utami, 2022). In
addition, ignorance in determining effective strategies in dealing with
situations that cause stress, or known as coping, can contribute to an increase
in the number of sufferers of mental health problems. There is evidence that
greater stress and trauma can result from a lack of development of appropriate
emotional reactions and coping techniques. Mental or mental health needs
attention because it plays a role in increasing the body's immunity. A healthy
mind will feel happy, and happiness will form the body's immune system. A
healthy mentality will make people ready to face challenges. It can be said
that a healthy soul is a requirement for survival to get through the pandemic
and become a resilient generation that is ready to face challenges in the
future. Therefore, for this
reason, there is a need for insight for the younger generation, especially
regarding mental health, and how to maintain health in order to be able to
overcome challenges during a pandemic (Sihombing & Simanjuntak, 2020). Moreover, based on that phenomenon regarding mental health and
COVID-19 pandemic, the purpose of this study is to determine the improvement
of millennial generation mental health due to the effects of the pandemic.
METHOD
This study applies the method of a systematic
review in which secondary data is collected, and is a synthesis of all
available relevant evidence that brings together all existing primary studies
for review. A systematic review differs from other types of literature review
in a number of key respects. This requires a transparent and reproducible
methodology that shows how studies were identified and the criteria against
which they were included or excluded. In addition to the synthesis of the study
findings, there must be an element of evaluation and quality assessment. The
systematic review methodology originated in medical and health research, but
has now been adopted by other disciplines, such as engineering, education,
economics and business studies (Hasanpoor et al., 2019).
Although a systematic review may be an
imprecise or unnecessary research methodology for answering many research
questions. A systematic review may not be recommended for various reasons.
Perhaps the topic is too new and there are not enough relevant published papers
to synthesize and analyze for a systematic review, or, conversely, many other
researchers have published systematic reviews on the topic. However, if the
scoping search appears to yield sufficient relevant studies for synthesis of
evidence, and demonstrates that no previous systematic reviews have been
published (or that previously published ones require updating or have
methodological weaknesses), a systematic review will likely be appropriate (Phillips & Barker, 2021).
RESULTS
AND DISCUSSION
Based on research on literature studies that
have been done, more than 450 million people worldwide live with mental disorders.
The prevalence of mental disorders in the world's population according to the
World Health Organization (WHO) in 2000 obtained data on mental disorders of
12%, in 2001 it increased to 13%. In 2002 survey results showed that 154
million people globally experience depression and 25 million people suffer from
schizophrenia, 15 million people are under the influence of illicit substance
abuse, 50 million people suffer from epilepsy and around 877,000 people die by
suicide each year. It is predicted that in 2015 it will be 15%, and in
developing countries the prevalence is higher (Purnawati et
al., 2022).
Mental health disorders are conditions in which an individual has
difficulty adjusting himself to the conditions around him. The inability to
solve a problem causing excessive stress makes the individual's mental health
more vulnerable and eventually is declared to have a mental health disorder.
In Indonesia, based on the 2007 Riskesdas data, it is known that
the prevalence of emotional mental disorders such as anxiety disorders and
depression is 11.6% of the adult population. This means that with a total adult
population of approximately 150,000,000 Indonesians, there are 1,740,000 people
currently experiencing mental-emotional disorders (Princess et al., 2015).
In reality, COVID-19 does not only
affect people's physical health, but also affects other aspects of life. The
impact is quite felt on the mental health conditions of the people affected by
the pandemic. The living conditions since the COVID-19 pandemic have indeed
made many people's lives different. Changes that occur suddenly make it
difficult for people to adapt and cause stress and trauma. The amount of news
and information regarding the spread of COVID-19 that seems frightening has
made people feel anxious and worried (Nasrullah & Sulaiman, 2021).
As in many other countries, the COVID-19
pandemic brought many changes to society. The COVID-19 pandemic with massive
transmission of transmission and high mortality rates is causing problems that
lead to mental health disorders. This is due to the existence of a new habit
that must be carried out by the community, namely carrying out social
restrictions. In addition to having a direct impact on medical and health workers,
the increase in cases of mental health disorders is also felt by the community.
Problems that often occur include symptoms of anxiety, depression and trauma
due to COVID-19. In July 2020, a suicide case occurred in a COVID-19 patient in
Surabaya, East Java from the 6th floor of the hospital due to depression due to
seven swabs and the results were always positive (Hilmi & Febriansyah, 2021). This case
explains that the COVID-19 pandemic is triggering mental health problems at an
alarming stage. A survey on mental health through self-examination compiled by
the Indonesian Association of Psychiatric Specialists (PDSKJI) conducted online
explained that as many as 63 percent of respondents experienced anxiety and 66
percent of respondents experienced depression due to the COVID-19 pandemic.
The main anxious symptoms are feeling worried
that something bad will happen, worrying excessively, getting angry easily, and
having difficulty relaxing. While the main depressive symptoms that appear are
sleep disturbances, lack of confidence, fatigue, lack of energy, and loss of
interest. Furthermore, as many as 80 percent of respondents had symptoms of post-traumatic
psychological stress due to experiencing or witnessing unpleasant events
related to COVID-19. Severe post-traumatic stress symptoms were experienced by
46 percent of respondents, symptoms of post-traumatic stress were experienced
by 33 percent of respondents, mild post-traumatic stress symptoms were
experienced by 2 percent of respondents, while 19 percent had no symptoms. The
prominent symptoms of post-traumatic stress are feeling distanced and separated
from others and feeling constantly alert, cautious, and vigilant (Indonesian
Association of Mental Health Specialists, 2020). There are at least four main
risk factors for depression out of 14 that are commonly encountered, which
arise as a result of the COVID-19 pandemic, namely isolation and social
distancing, economic stress, stress and depression in health workers and stigma
and discrimination (Xiong et al., 2020).
Maintaining physical distance (physical distancing) raises a lot
of public anxiety. But in this case the vulnerability occurs in people who are
at risk of depression and individuals who live in solitude. Feelings of
alienation due to social distancing and self-isolation have disrupted normal
activities. The COVID-19 pandemic has triggered a global economic crisis that
is likely to increase the risk of suicide related to unemployment and economic
stress. Feelings of uncertainty, hopelessness, and worthlessness increase
suicide rates. In Tangerang City, for example, a 20-year-old youth allegedly
committed suicide because his workplace was not operating due to the COVID-19
pandemic situation, economic growth which declined drastically to minus 5.32%
in the second quarter of 2020 resulted in the possibility of Indonesia entering
the economic abyss (Purnawati et al., 2022).
Stress and trauma to health workers is also an important issue in Indonesia.
Global experience of mental health cases in Korea, Singapore, Taiwan and
several other countries has disrupted health services (Ghosh, 2021). The potential
for depression and suicide cases in medical and health personnel should also be
a priority. Apart from that, stigma and discrimination are also another part
besides the risk of duties that must be borne by medical and health personnel.
This stigma and discrimination have long-term risks to health (National
Collaborating Center for Determinants of Health (NCCDH), 2020).
CONCLUSION
Mental health policy is an important part of the policy to
accelerate the handling of the COVID-19 pandemic. Mental health problems are
closely related to the loss of community productivity and also the control of
the COVID-19 pandemic. If the government does not pay the necessary attention
to mental health issues, especially in integrating the implementation of policies
related to handling the COVID-19 pandemic, then the potential for post-demic
losses will be even greater. Governments should integrate mental health
services into community-based services as a way to ensure universal coverage of
mental health services. The participatory and bottom-up empowerment model is a
rational choice for overcoming the problem of resources and stigma as a barrier
to the success of mental health programs in Indonesia.
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