Relationship Between Knowledge and Community Stigma with The Level of Family Efficacy in Treating Mental Disorders in The Barong Tongkok Health Center Work Area

Introduction: Mental health is one of the most important health problems in the world, including in Indonesia. People still have a low understanding of mental disorders. Objective: to determine the relationship between knowledge and community stigma with the level of family efficacy in treating mental disorders in the Barong Tongkok Health Center Work Area. Methods: The research design is a descriptive correlation with a cross-sectional approach. The population in the Working Area of the Barong Tongkok Health Center is 82 people. Using total sampling. The statistical test used is Chi-Square . Result and Discussion: There is a relationship between knowledge and family efficacy in treating mental patients (ρ-value = 0.00). There is a relationship between community stigma and the level of family efficacy in treating mental patients (ρ-value = 0.01). Conclusion: The stigma created by society towards people with mental disorders indirectly causes families or people around people with mental disorders to be reluctant to provide proper treatment


Introduction
Mental health is one of the important health problems in the world, including in Indonesia Mental health is still a concern today because of the lack of public concern for people with mental disorders such as discrimination and negative stigma against people with mental disorders (Aritonang, 2021) People with mental disorders are someone who experiences disturbances in thoughts, feelings, and behaviors that are seen in signs or symptoms that can interfere with the person's productivity socially and economically.In people with mental disorders, there are clinical symptoms in the form of syndrome and psychological that cause distress such as loss of comfort, the onset of pain, feelings of unease, organs that do not function optimally, and feel disturbed.These symptoms result in inability to live daily life properly (Rokhimmah &;Rahayu, 2020) The World Health Organization estimates that 450 million people suffer from mental disorders.WHO further stated that globally there are 35 million people with depression, 60 million people with bipolar affective disorder, 47.5 million people with dementia, and 21 million people with schizophrenia.Meanwhile, Basic Health Research (Riskesdas, 2018) explains that the prevalence of households with members who experience mental disorders.
Schizophrenia or psychosis of 7 per 1000.This rate increased from 2013 of 1.7 per 1000.This figure shows that mental health problems in Indonesia are increasing every year.The increase in mental health problems is inseparable from the lack of public knowledge and understanding in maintaining mental health (Central Statistics Agency, 2020).
People still have a low understanding of mental illness, in most of the population there is a negative attitude of society towards people with mental disorders.Society has very little knowledge of people with mental disorders.The higher the level of knowledge of society, the more positive the attitude of society towards people with mental disorders.This research shows a significant relationship between knowledge and people's attitudes (Ahmad et al., 2019) A person's knowledge can relate to a person's response to something.Public knowledge about mental disorders will produce a societal response to people with mental disorders.The resulting response can be either accept or reject.The response to reject people with mental disorders is characterized by discrimination in the form of stigma.Stigma is labeling, exclusion, and discrimination carried out by a person or group so that it can limit people who are stigmatized in socializing so that it can complicate their lives (Syamsiar, 2020) The stigma given by society is to consider people with mental disorders different from others.Some people assume that mental disorders are caused by interference by evil spirits that have entered the soul, so someone who has a mental disorder must be exiled or ostracized because it is considered a disgrace to the family.Assumptions that arise against people with mental disorders can cause negative stigma from society (Iwasil et al., 2019) Marselinus Febriadi, Badar, Gajali Rahman/KESANS People with mental disorders are considered frightening and can be dangerous to the surrounding community.They are also regarded as a disgrace in his family.Society's behavior towards people with unpleasant mental disorders can be in the form of discrimination, isolation, exclusion and even shackling (Elisia &;Rochmawati, 2014) The phenomenon of improvement the number of mental disorders in Indonesia, directly proportional to efforts to improve health services (Ahmad et al., 2019)

Method
This research was conducted in the Working Area of the Barong Tongkok Public Health Center.The research was conducted in February -May 2022.The study design is descriptive of correlation with a cross-sectional approach.The population in this study is people in the Barong Tongkok Public Health Center Working Area as many as 82 people.The sample used in this study was 68 people as research subjects.In this study, primary data were obtained using questionnaires directed to respondents.The data collected were analyzed univariately and bivariately using the chi square test to determine the relationship between knowledge and community stigma on the level of family efficacy in treating mental patients in the Barong Tongkok Public Health Center work area Result and Discussion 1.

Result
The results of research on the characteristics of respondents showed that the most age category was early adulthood, which was between 26-35 years as many as 24 people (35.3%), the most gender was men, namely 36 people (52.9%).While in the last education category, the most are SMA (Senior High School) with a total of 28 people (41.2%) and the most work as entrepreneurs, namely 19 people (27.9%)The results of research on knowledge of mental disorders in residents in the Barong Tongkok Public Health Center Working Area, the most in the sufficient category, namely 29 people (42.6%).The results of research on community stigma against mental disorders in residents in the Barong Tongkok Public Health Center Work Area, mostly in the negative stigma category, namely 36 people (52.9%).The results of research on the relationship of knowledge with the level of family efficacy in treating mental patients, it was found that the most knowledge of mental disorders in the sufficient category and the level of family efficacy in the moderate category as many as 25 people (36.8%).Based on the results of the analysis conducted using Chi-Square test, obtained value ρ-value=0.00smaller than the value of α = 0.05 or (0.00 <0.05), that means there is a significant relationship between knowledge of mental disorders and the level of efficacy of families caring for mental patients.The results of research on community stigma with the level of family efficacy in caring for mental patients, it was found that the most was negative stigma and the level of family efficacy in the low category as many as 16 people (23.5%).Based on the results of an analysis conducted using the Chi-Square test, obtained a value of ρ-value = 0.01 smaller than the value of α=0.05 or (0.01<0.05), that means there is a significant relationship between community stigma and the level of family efficacy in caring for mental patients.

The Relationship of Community Stigma with the Level of Family Efficacy of Caring for Mental Patients
Marselinus Febriadi, Badar, Gajali Rahman/KESANS

Characteristics of Respondents
The results of research on the characteristics of respondents showed that the most age category was early adulthood, which was between 26-35 years as many as 24 people (35.3%), this was due to the average residents around the Barong Public Health Center Tongkok is at productive age.At that age, this research information can be obtained because the energy and mindset are still good.The highest gender is male at 36 people (52.9%).In line with the results of the latest population census, now the total number of men in Indonesia is more than the total of women (Central Statistics Agency, 2020).
So, it is natural if the residents around the Barong Tongkok Public Health Center also show the same data.While in the last category of education the most is SMA (Senior High School) numbering 28 people (41.2%), there is no high awareness in residents to continue higher education jenjaang.They prefer to work immediately rather than after long school (interview residents about the reasons for not going to college), they prefer to go directly into the world of work, some as employees or employees and other types of work or become entrepreneurs.So in line with the results of this study that the most citizens who work as entrepreneurs are 19 people (27.9%).
The researchers' assumptions of age, gender, education and type of occupation contribute to influencing societal stigma against mental disorders, thus impacting the efficacy of families caring for patients with mental disorders.

Relationship of Knowledge with Family Efficacy Level of Caring for Mental Patients
The results of research on knowledge of mental disorders in citizens, the most in the sufficient category, namely 29 people (42.6%).In line with the level of education received by residents in the Barong Tongkok Public Health Center Work Area, the most is SMA (41.2%).To just know, it is not enough, it needs the next level of knowledge in the form of deep understanding (Notoatmodjo, 2014).The results obtained with this category of sufficient knowledge are reasonable, because the level of education at the tertiary level of residents in the Barong Tongkok Public Health Center Working Area is not much, which is only 13.2% who continue their higher desert education.Even then, it is not necessarily their college that focuses on mental health.So it is very common if the level of knowledge of citizens about mental disorders is still categorized as sufficient.
The researchers' assumptions This indicates that a low level of education causes a person's knowledge to also be less abundant and less in-depth on a particular thing, in this case knowledge about mental health problems or mental disorders.
The results of research on the relationship of knowledge with the level of family efficacy in treating mental patients, it was found that the most knowledge of mental disorders in the sufficient category and the level of family efficacy in the moderate category as many as 25 people (36.8%).In this case, the better a person's knowledge, the level of family efficacy in treating patients who are experiencing mental disorders also increases (Livana et al., 2020) Based on the results of the analysis conducted using Chi-Square test, obtained value ρ-value = 0.00 is less than the value of α= 0.05 or (0.00 <0.05), that means there is a significant relationship between knowledge of mental disorders and the level of efficacy of families caring for mental patients.These results are in line with research conducted by (Rokhyati et al., 2019) There is a relationship between knowledge of mental disorders and the level of efficacy of families caring for mental patients.Qualified knowledge of psychiatric disorders gives adequate impetus to family efficacy in treating mental patients.
Similarly, research conducted by (Primary et al., 2017) Shows a significant correlation between knowledge and self-efficacy in families of patients caring for family members who experience mental disorders.Good knowledge of mental disorders will change our mindset towards people with mental disorders, because it will perceive that it happens because there is a problem in their mentality (Ahmad et al., 2019) The right perspective on people with mental disorders makes a person no longer worry about being with people with mental disorders, but grow pity so that they are willing to take good care of them.A good knowledge of mental disorders will view someone who has a mental disorder as someone who has a problem and must be helped, because they are people who are mentally "sick" even though they are physically fine If our way of thinking is positive towards people with mental disorders, there will be no more feelings of wanting to stay away, fear, wanting to laugh and other negative feelings, but the feelings that arise are love and seeing them as beings who need our help to heal from their mental disorders.
The assumption of researchers Good knowledge has a significant effect on the decisions that someone will make in responding to something.Related to that, the knowledge possessed determines a person's mindset to react or respond to an event.

The Relationship of Community Stigma with the Level of Family Efficacy of Caring for Mental Patients
The results of research on community stigma with the level of family efficacy in caring for mental patients, it was found that the most was negative stigma and the level of family efficacy in the low category as many as 16 people (23.5%).The stigma given by someone has a pattern that is directly proportional to the response or treatment we give to people with mental disorders (Syamsiar, 2020) When we look negatively, then we as a family will be more distant and give less attention and benefits to people with disorders during the healing process, in this case the efficacy we provide is low (Purwaningsih, 2017).It is important to give deep meaning to family members who are suffering from mental or mental problems.We need to take a stand from our heart to be sincere with great compassion, by remembering that he is part of our family and he is also the same human being as we come from the same and just creator (Syamsiar, 2020).
The researchers' assumption is that if we give a different meaning like this, then there will be no more negative stigma against people with mental disorders, here is no longer a low incidence of efficacy and here is no more neglect and neglect of people with mental disorders.
Based on the results of the analysis conducted using Chi-Square test, obtained value ρ-value = 0.01 is less than the value of α= 0.05 or (0.01<0.05), which means that there is a significant relationship between community stigma and the level of efficacy of families caring for mental patients.Results in line with research (Al Wasi et al., 2021) There is a relationship between community stigma and the level of family efficacy in caring for mental patients.
The act of caring for patients with mental disorders, starting from the stigma given to these mental disorders, the more negative a person's against mental disorders (Elisa, 2018), the lower the family's efficacy to care for family members who have mental disorders, on the other hand, if the positive stigma is given, the efficacy of families who care for mental patients increasingly has good hope for recovery or reduce the symptoms of mental disorders (Ahmad, M., Pulungan, 2019).
In line with research conducted by Farina, (2020) it was found that families who have a positive stigma while caring for people with mental disorders have good hope of recovery.Meanwhile, research (Hartatik, 2020) shows that negative stigma contributes to weakening family self-efficacy in treating people with mental disorders.Our perspective in giving judgment to someone who has a mental disorder, plays an important role in determining our inner decision to stigmatize.
The assumption of researchers that we should always have a positive view of people with mental disorders, because it will affect our readiness and treatment of those who are experiencing mental or psychiatric disorders.This behavioral process can make things worse for a person because of the bad stigma we pin

Conclusion
Public knowledge about mental disorders around the Barong Tongkok Public Health Center work area is in the sufficient category (42.6%).Community stigma against mental disorders around the Barong Tongkok Public Health Center work area is in the negative stigma category (52.9%).The efficacy rate of families treating mental patients around the Barong Tongkok Public Health Center work area was in the medium category (41.2%).There is a relationship between knowledge and the level of family efficacy in treating mental patients in the working area of the Barong Tongkok Public Health Center (ρ-value = 0.00).There is a relationship between community stigma and the level of family efficacy in caring for mental patients in the Barong Tongkok Public Health Center work area (ρ-value = 0.01).

Table 1
Knowledge of Mental Disorders

Table 2
Community Stigma Against Mental Disorders

Table 3
Family Efficacy RateThe results of the study on the efficacy of families treating mental patients in residents in the Barong Tongkok Public Health Center Work Area, the most in the medium category, namely 28 people (41.2%).

Relationship Between Knowledge and Community Stigma with The Level of Family Efficacy in Treating Mental Disorders in The Barong Tongkok Health Center Work Area KESANS, Vol. 1, No. 8, May 2022 818 Relationship of Knowledge with Family Efficacy Level of Caring for Mental Patients Table 4
Relationship of Knowledge with Family Efficacy Level of Caring for Mental Patients

Table 5
The Relationship of Community Stigma with the Level of Family Efficacy of Caring for Mental Patients