Wiwin Putri Handayani1, Asmawati2, Welly3 AHoJ : Allied Health of Journal

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ISSN xxxx-xxxx (Online)
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THE RELATIONSHIP BETWEEN FAMILY INSTRUMENTAL SUPPORT AND FAMILY
ACCEPTANCE OF PEOPLE WITH MENTAL DISORDERS (ODGJ) AT THE MENTAL
POLYCLINIC AT THE ANDALAS HEALTH CENTER IN PADANG CITY IN 2023
Wiwin Putri Handayani1, Asmawati2, Welly3
STIKes Alifah Padang, JL. Khatib Sulaiman N0.52B Padang, 25137, Indonesia

Abstract
Mental disorders are disorders that occur in the brain which are characterized by
disruption of behavior, processes, thinking, emotions and perceptions which are
characterized by forms of behavioral deviation due to emotions and the discovery of
irregularities in behavior. In Indonesia, in 2022, it is estimated that there will be around 450
thousand (ODGJ) with severe, mental disorders caused by a lack of instrumental family
support in caring for patients. This can be seen from the lack of family acceptance of ODGJ
which is characterized by a lack of family involvement in caring for, providing attention,
giving encouragement, showing affection for ODGJ. . The aim of this research is to
determine the relationship between family instrumental support and family acceptance of
people with mental disorders (ODGJ) at the Mental Health Clinic, Andalas Health Center,
Padang City in 2023. Quantitative research method with cross sectional design. This
research was carried out in March-August 2023. Data collection was carried out in March-
August 2023, data collection was carried out on July 12 - August 4 2023. The population in
this study was 114 ODGJ, sampling using accidental sampling technique of 53 respondents.
Data were analyzed univariately and bivariately using the Chi-Square test. The research
results showed that 64.2% of family instrumental support was not supportive, and 71.7% of
family did not receive it. There is a relationship between family instrumental support and
family acceptance of ODGJ (p = 0.009) at the Andalas Mental Health Center, Padang City.
Based on the research results, it can be concluded that there is a relationship between family
instrumental support and family acceptance of ODGJ at the Andalas Mental Health Center,
Padang City. Advice, the person in charge of mental health is expected to provide health
education and provide mental health education to families in helping and caring for ODGJ

Kata Kunci : Dukungan Intrumental Keluarga, Penerimaan Keluarga

AHoJ : Allied Health of Journal Vol X No X 2023

Wiwin Putri Handayani1, Asmawati2, Welly3
INTRODUCTION
Mental disorders are disorders that
occur in the brain which are characterized
by disruption of behavior, processes,
thinking, emotions and perceptions which
are characterized by forms of behavioral
deviation due to emotions and the discovery
of irregularities in behavior. Mental
disorders are quite serious health problems
because their numbers continue to increase
every year (Puspitasari, 2017).
Based on a World Health Organization
report, the number of people suffering from
mental disorders in the world is estimated to
continue to increase from year to year,
around 450 million people. It was reported
that in 2019, data on people with mental
disorders was around 264 million people
and data on the number of people with
mental disorders in 2020 was estimated to be
around 300 million people. According to
Basic Health Research (Riskedas, 2020),
people with mental disorders (ODGJ) in
Indonesia are recorded to be increasing.
This increase was revealed by the increase in
the prevalence of households experiencing
people with mental disorders (ODGJ) in
Indonesia. The number is estimated to be
around 450 thousand (ODGJ) weight. The
impact of mental disorders will cause
viability and can reduce people's
productivity and cause quite a large cost
burden.
The prevalence of mental and emotional
disorders in the Indonesian population aged
over 15 years has also increased from 6% to
9.8% in 2018 (Riskesdas, 2018). The
provinces in Indonesia that have the highest
prevalence of mental disorders are Bali at
11.1%, Yogyakarta at 10.4%, while East
Java province reaches 6.45% (Ministry of
Health of the Republic of Indonesia, 2019).
Wahyu Setyowatiningsih et al, (2020). An
increase to 9th with the number of mental
disorders in second place at 9.1 per mil. In
2013, it can be seen that West Sumatra was
previously ranked ninth, but in 2018 it rose
to 7th with the highest prevalence of people
experiencing mental disorders. Sari et al,
(2018).
Events that often occur in society today
are delays in recognizing mental health
problems and delays in bringing mental
disorder patients for treatment to health
facilities. This delay is greatly influenced by
the lack of involvement and support from the
families of mental disorders patients. To
increase family involvement and support,
families of mental disorders patients need to
be empowered.
In this context, families need correct
information and education regarding mental
health problems. Sari et al, (2018). Factors
that cause recurrence of mental disorders
are depressed mood, medication compliance,
drug side effects and factors originating
from the environment such as family support,
family knowledge, family emotions, family
burden and stigma (Hayat & Kusuma, 2021).
Management of mental disorders apart from
psychopharmacology, namely administering
medication and medical rehabilitation, but
the role of the family is needed for
socialization and prevention of relapse.
According to Ernia et al, (2020) in
Isnaeni, (2012) that family support is support
for individuals from family members and
people in the closest social environment that
makes individuals feel loved and
appreciated. Family support is very
important and necessary to prevent
recurrence in ODGJ patients who undergo
regular medical control.
According to Friedman (2010), the
support provided is in the form of
instrumental support, emotional support,
information support and appreciation
support. Instrumental support is support
provided directly by families to people with
mental disorders which includes material
assistance such as providing direct support
to patients by providing transportation when
patients want to seek treatment at health
services. Then emotional support, namely
support such as reminding patients to take
medication regularly, providing attention,
affection and concern to patients.
Information support that patients need, such
as providing information about health,
disease treatment, providing suggestions and
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Wiwin Putri Handayani1, Asmawati2, Welly3
advice regarding patient problems in taking
medication.
Family problems in caring for people
with mental disorders are the mental burden
of dealing with patient behavior, and the
social burden, especially facing stigma from
society about family members who have
mental disorders. The impact of the burden
felt by the family will affect the family's
ability to care for the patient. If the family is
burdened the family is unable to care for the
patient well (Permatasari, 2018).
The importance of working as a
supporter and providing instrumental
support means that family members who do
not work cannot fully provide effective family
acceptance for people with mental disorders,
so the solution is to leave people with mental
disorders at home without supervision,
which leads to the return of mental
disorders.
Instrumental support is a form of
support provided by the family regarding
assistance with energy, funds, or taking time
to help and listen to clients in expressing
their feelings (Hayat & Kusuma, 2021).
Instrumental Support is an economic
function and health care function applied in
the family to ODGJ. Family instrumental
support can be provided, such as by taking
the patient for control to the hospital and
preparing administrative documents for
outpatient needs, as well as informational
support, such as by recording the time of the
next visit and reminding the patient about the
time of the visit (Wahyu Setyowatiningsih et
al, (2020) .
The research results show that many
people with mental disorders do not comply
with control according to the specified time,
reaching 55.8%. Most patients do not
comply with control because they do not
come according to the schedule determined
by the doctor and some also exceed the
specified time limit because they forget and
some are also hampered by the
transportation costs that must be incurred to
go to the health service for treatment.
Family problems in caring for people
with disorders include mental burdens in
dealing with patient behavior, and social
burdens, especially facing stigma from
society about family members who have
mental disorders. The impact of the burden
felt by the family will affect the family's
ability to care for the patient. If the family is
burdened the family is unable to care for the
patient well (Permatasari, 2018).
The family's understanding of caring for
ODGJ is still not appropriate, giving rise to
negative attitudes towards patients. The
negative attitude given by families to ODGJ
can be seen from their opinion that the
illnesses that occur in ODGJ are permanent
illnesses or diseases that cannot be cured, so
families often leave the patient alone as long
as they don't bother them. The family also
considers that the symptoms that arise in
ODGJ patients are normal because the
patient is a mental disorder sufferer. Almost
all families are of the opinion that ODGJ
patients can only be a burden to the family
because they do not have the ability to care
for themselves so that the patient's family
does not accept families with mental
disorders (Dewi & Nurchayati, 2021).
Problems that will arise in family
members of people with mental disorders are
poor family acceptance caused by the burden
felt by the family in treating the patient,
namely the large medical costs that must be
incurred and the condition of the person with
mental disorders that does not heal, as well
as the lack of family trust. that the illness
experienced by people with mental disorders
is a form of witchcraft or interference from
spirits so that families do not take people
with mental disorders to health service
centers but instead take sick families to
intelligent people (paranormals).
Family acceptance is an attitude of
accepting other people without any
conditions or overall judgment (Wulandari
& Fitriani, 2020). Meanwhile, family
acceptance itself is part of a psychological
effect and family behavior in caring for
family members through care, support and
nurturing. Raffy et al., (2020). A positive
attitude in family acceptance of ODGJ,
including family behavior that helps patients
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Wiwin Putri Handayani1, Asmawati2, Welly3
to get better, will be able to prevent or
improve the health problems of ODGJ
themselves (Subardjo & Nurmaguphita,
2021).
In the acceptance stage, family members
accept various stigmas from society about
family members who experience mental
disorders. The stigma that society places on
ODGJ is due to the general public's lack of
knowledge about ODGJ, so that many people
still think that this disorder is a disease
caused by a curse.
According to (Wulandari & Fitriani,
2020) for families who have accepted and
understood ODGJ patients, it is sadness that
their loved one has a mental disorder. Here
the role of the family is very important in the
healing process for family members who
experience mental disorders. Sometimes
family members feel pressure. to
experiencing Trees so that family members
who experience mental disorders do not have
a support system in the healing process.
Good family acceptance can be due to
the family's awareness that people with
mental disorders are part of the family,
concern and the influence of open
communication between families towards
sick relatives, but on the other hand good
family acceptance can be due to the
condition of people with mental disorders.
started to improve.
Based on reports from the Health
Service, Padang City is in first place out of
19 districts/cities in West Sumatra, with
50,557 people. Based on data from the
Padang City Health Service (2022), of the 23
existing Community Health Centers, Andalas
Health Center has the highest number of
sufferers from ODGJ.
Based on an initial survey conducted on
March 30 2023 at the Jiwa Poli Pukesmas
Andalas, Padang City, interviews were
conducted with 10 families of ODGJ
patients. The results showed that 8 out of 10
ODGJ families said that often the control did
not match the schedule determined by the
doctor due to transportation costs and being
busy with work. his job. Of the 8 patients'
families, 4 of the patient's families said that
they sometimes forgot to give them food and
drink and also forgot to remind ODGJ to
take medication according to schedule
because they were busy and only bathed
ODGJ once a day, sometimes they didn't
even bathe ODGJ and the families of 4 of the
other 8 ODGJ said they let ODGJ wander
around and didn't only look for it when
eating and taking medicine. And of the 10
families of ODGJ, 8 said they did not know
the ODGJ's sleep schedule and said that
ODGJ slept when they were tired and
finished taking medication. And 2 out of 10
families provide support to ODGJ and
arrange eating and drinking as well as
providing advice and treatment
infrastructure and accompanying the patient
when carrying out repeated checks and
giving medication on time.
Based on this description, researchers
have conducted research on "The
Relationship between Family Instrumental
Support and Family Acceptance of People
with Mental Disorders (ODGJ) at the
Andalas Health Center, Padang City, Work
Mental Health Clinic."
RESEARCH METHODS
This research aims to determine the
relationship between family instrumental
support and family acceptance of people with
mental disorders (ODGJ) at the mental
health clinic at Andalas Health Center,
Padang City in 2023. The independent
variable is family instrumental support and
the dependent variable is family acceptance
of ODGJ. This type of research is analytical
and cross sectional. This research was
carried out in March-August 2023, data
collection was carried out for 17 days
starting from 12-24 July 2023. The
population of all families accompanying
ODGJ during repeated control at the
Andalas Mental Health Center in Padang
City was 114 people with a sample size of 53
people. Accidental sampling technique. Data
was collected directly from respondents by
conducting interviews. Data were analyzed
univariately and bivariately using the Chi-
Square test, p-value <0.05.
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Wiwin Putri Handayani1, Asmawati2, Welly3
HASIL PENELITIAN
1. Analisis Univariat
a. Frequency Distribution of Family
Instrumental Support for ODGJ in
the Mental Health Clinic of Andalas
Health Center, Padang City, 2023
Based on the research results, it
can be seen that 64.2% of family
instrumental support does not support
ODGJ (people with mental disorders)
in the Psychiatric Polyclinic of
Andalas Health Center, Padang City in
2023.
b. Frequency Distribution of Family
Acceptance of ODGJ at the
Psychiatric Polytechnic of Andalas
Health Center, Padang City in 2023
Based on the research results, it
can be seen that 71.7% of family
admissions did not accept ODGJ
(people with mental disorders) at the
Psychiatric Polytechnic of Andalas
Health Center, Padang City in 2023.
2. Analisis Bivariat
The Relationship between Family
Instrumental Support and Family
Acceptance of People with Mental
Disorders (ODGJ) at the Psychiatric
Polytechnic of Andalas Health Center,
Padang City in 2023
Based on the research results, it can
be seen that the proportion of respondents
who have family acceptance is higher in
family acceptance that does not accept
with instrumental family that does not
support, namely 85.3% compared to
instrumental support that supports,
namely 47.4% for people with mental
disorders (ODGJ) at the Mental Health
Center Polyclinic. Andalas, Padang City
in 2023. Based on the results of the Chi-
square test, the p-value was 0.009
(p<0.05), it can be concluded that there is
a relationship between family
instrumental support and family
acceptance of people with mental
disorders (ODGJ) at the Mental Health
Center of Andalas City Health Center.
Padang in 2023.
DISCUSSION
1. Analisis Univariat
a. Frequency Distribution of Family
Instrumental Support for ODGJ in
the Mental Health Clinic of Andalas
Health Center, Padang City, 2023
Based on the research results, it
can be seen that 64.2% of family
instrumental support does not support
people with mental disorders (ODGJ)
at the Andalas Mental Health Center,
Padang City in 2023.
The results of this research are in
line with research conducted by
Yuliandri, et al (2021) which stated
that there were similarities in the
research results that more than half of
the respondents had non-supportive
instrumental support, namely 78.2%.
The results of research conducted by
Triyuliani (2020) stated that many
respondents did not support it, namely
69.7% at the Kampung Bangka
Community Health Center, South
Kalimantan.
Research conducted by Aldzima
(2020) entitled the relationship
between instrumental support and
family acceptance of people with
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Wiwin Putri Handayani1, Asmawati2, Welly3
mental disorders in the Jayabaru Aceh
Community Health Center work area.
The research results showed that more
than half of the respondents had poor
instrumental support, namely 56.5% in
the Jayabaru Aceh Community Health
Center working area.
The family is a small, open social
system consisting of a series of parts
that are highly interdependent and
influenced by both its internal
structure and its external environment.
Instrumental support includes the
provision of physical support such as
services, financial and material
assistance in the form of real
assistance (Instrumental support
material support). A condition where
objects or services will help solve
practical problems, including direct
assistance, such as when someone
gives or lends money, helps with daily
work, conveys messages, looks after
and cares for those who are sick or
depressed, which can help solve
problems. Real support is most
effective when it is appreciated by the
individual and reduces individual
depression with family support to
achieve practical goals and real goals
(Nuryanto, 2019).
The support provided is in the
form of instrumental support,
emotional support, information support
and appreciation support. Instrumental
support is support provided directly by
the family to people with mental
disorders which includes material
assistance such as providing direct
support. Then emotional support,
namely support such as reminding
patients to take medication regularly,
providing attention, affection and
concern to patients. Information
support that patients need, such as
providing information about health,
disease treatment, providing
suggestions and advice regarding
patient problems in taking medication.
Instrumental support is support
provided directly by families to people
with mental disorders which includes
material assistance such as providing
direct support to patients by providing
transportation when patients want to
seek treatment at health services. Then
emotional support, namely support
such as reminding patients to take
medication regularly, providing
attention, affection and care to
patients. Information support that
patients need, such as providing
information regarding patient
problems in taking medication.
The researcher's assumption is
that respondents have no instrumental
support because the family does not
help family members in living their
lives and the family does not provide
financial needs, food, drink and rest.
The family is just indifferent to the
family members of ODGJ and is not
regular in providing food and drink to
families with ODGJ. In essence, the
patient's family knows how to care for
them well, but they are just lacking in
treating them.
Based on the research results, it
was found that the family was not
supportive because the respondent
never helped the patient to bathe and
eat to be independent, the respondent
sometimes provided shampoo, soap
and toiletries specifically for the
patient. Meanwhile, respondents who
have instrumental family support are
supportive because respondents often
take sick family members to undergo
treatment, namely 50.9% and
respondents always invite patients to
family recreation to relieve boredom at
least once a month, namely 18.9%.
b. Frequency Distribution of Family
Acceptance of ODGJ at the
Psychiatric Polytechnic of Andalas
Health Center, Padang City in 2023
Based on the research results, it
can be seen that 71.7% of family
admissions do not accept people with
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Wiwin Putri Handayani1, Asmawati2, Welly3
mental disorders (ODGJ) at the
Psychiatric Polyclinic at Andalas
Health Center, Padang City in 2023.
The results of this research are the
same as research conducted by
Yuliandri, et al (2021) which stated
that there were similarities in the
research results that more than half of
the respondents had family recipients
who did not accept it, namely 64.2%.
The results of research conducted by
Triyuliani (2020) stated that many
respondents did not accept it, namely
66.2% at the Kampung Bangka
Community Health Center, South
Kalimantan.
Research conducted by Aldzima
(2020) entitled the relationship
between instrumental support and
family acceptance of people with
mental disorders in the Jayabaru Aceh
Community Health Center working
area. The research results showed that
more than half of the respondents had
less family acceptance, namely 71.6%
in the Jayabaru Aceh Community
Health Center working area.
Family acceptance is a family
treatment towards patients that is
given in the form of care, support, and
providing nursing care needed by
family members with mental disorders.
Acceptance is a form of family support
for other family members who have
problems, by providing emotional
support, to achieve the health and
well-being of family members who
have mental disorders in meeting their
psychosocial needs (Sartika, 2022).
Family acceptance is a family
treatment towards patients that is
given in the form of care, support, and
providing nursing care needed by
family members with mental disorders.
Acceptance is a form of family support
for other family members who have
problems, by providing emotional
support, to achieve the health and
well-being of family members who
have mental disorders in meeting their
psychosocial needs (Sartika, 2022).
The researcher's assumption is
that respondents do not accept family
members who are ODGJ, this means
the family feels burdened, the family
feels embarrassed by the occurrence of
mental disorders in one of their family
members. Not accepting family
members because the family is not used
to dealing with family members who
are ODGJ, the family feels burdened
and unable to take care of a family
with ODGJ.
Based on research, it was found
that respondents who did not accept
ODGJ members were because
respondents never invited patients to
family meetings to determine decisions,
respondents sometimes prepared work
for the future. Meanwhile, respondents
who accepted family members who
were ODGJ were because respondents
often did not take rights that did not
belong to them. and respondents also
always try to find out about the
disease.
2. Analisis Bivariat
The Relationship between Family
Instrumental Support and Family
Acceptance of People with Mental
Disorders (ODGJ) at the Psychiatric
Polytechnic of Andalas Health Center,
Padang City in 2023
Based on the results of the research,
it can be seen that the proportion of
respondents who have family acceptance
is higher in family acceptance that does
not accept with instrumental family that
does not support, namely 85.3%
compared to instrumental support that
supports, namely 47.4% for people with
mental disorders (ODGJ) at the Mental
Health Center Polyclinic. Andalas,
Padang City in 2023. Based on the results
of the Chi-square test, the p-value was
0.009 (p<0.05), so it can be concluded
that there is a relationship between family
instrumental support and family
acceptance of people with mental
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Wiwin Putri Handayani1, Asmawati2, Welly3
disorders (ODGJ) at the Mental Health
Center of Andalas City Health Center.
Padang in 2023.
The results of this research are the
same as research conducted by Yuliandri,
et al (2021) which states that there are
similarities in the research results that
there is a relationship between family
support and family acceptance with
ODGJ p-value 0.003 (p<0.05). The
results of research conducted by
Triyuliani (2020) stated that there was a
relationship between instrumental family
support and family acceptance with
ODGJ p-value 0.012 (p<0.05) at the
Kampung Bangka Community Health
Center, South Kalimantan.
Research conducted by Aldzima
(2020) entitled the relationship between
instrumental support and family
acceptance of people with mental
disorders in the Jayabaru Aceh
Community Health Center working area.
The research results show that there is a
relationship between instrumental support
and family acceptance with a p-value of
0.001 (p<0.05) in the working area of the
Jayabaru Aceh Community Health
Center.
According to Law Number 18 of
2014, people with mental disorders or
often abbreviated as ODGJ are
individuals who experience disorders with
their thoughts, feelings and behavior
which are manifested in the form of
symptoms and/or significant changes in
behavior, and can cause suffering and
obstacles in carrying out their functions
as human beings. .
Instrumental support includes the
provision of physical support such as
services, financial and material assistance
in the form of real assistance
(Instrumental support material support).
A condition where objects or services will
help solve practical problems, including
direct assistance, such as when someone
gives or lends money, helps with daily
work, conveys messages, looks after and
cares for them when they are sick or
experiencing depression which can help
solve problems. Real support is most
effective when it is appreciated by the
individual and reduces individual
depression with family support to achieve
practical goals and real goals (Nuryanto,
2019).
The researcher's assumption is that
there is a relationship between family
instrumental support and family
acceptance of ODGJ because family
instrumental support is one of the
supports provided by the family regarding
economic functions and nursing care
functions applied by the family to family
members who experience ODGJ. If the
family does not provide instrumental
support to families with ODGJ then the
family does not accept family members
who experience ODGJ, this is because the
family feels unable and feels burdened to
take care of families with ODGJ. There is
also a relationship because the family is
one of the people closest to ODGJ, and
ODGJ also feel comfortable if their own
family provides instrumental support to
ODGJ. The researcher's assumption is
that there is a relationship between family
instrumental support and family
acceptance of ODGJ because family
instrumental support is one of the
supports provided by the family regarding
economic functions and nursing care
functions applied by the family to family
members who experience ODGJ. If the
family does not provide instrumental
support to families with ODGJ then the
family does not accept family members
who experience ODGJ, this is because the
family feels unable and feels burdened to
take care of families with ODGJ. There is
also a relationship because the family is
one of the people closest to ODGJ, and
ODGJ also feel comfortable if their own
family provides instrumental support to
ODGJ.
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Wiwin Putri Handayani1, Asmawati2, Welly3
CONCLUSION
Based on the results of research that
researchers have conducted with the
research title "The Relationship between
Family Instrumental Support and Family
Acceptance of People with Mental Disorders
(ODGJ) at the Mental Health Center of the
Andalas Health Center, Padang City", it can
be concluded as follows:
1. As many as 64.2% of family instrumental
support does not support people with
mental disorders (ODGJ) in the
Psychiatric Polyclinic at Andalas Health
Center, Padang City in 2023
2. As many as 71.7% of family admissions
did not accept people with mental
disorders (ODGJ) at the Psychiatric
Polyclinic at Andalas Health Center,
Padang City in 2023. 2023
3. There is a relationship between family
instrumental support and family
acceptance of ODGJ (p=0.009) at the
Jiwa Polyclinic Andalas Health Center,
Padang City in 2023.
SUGGESTION
1. For Further Researchers
It is hoped that future researchers will
carry out further research using other
methods, such as conducting health
education about people with mental
disorders (ODGJ) and how to treat ODGJ
so that families have information and
understanding about ODGJ.
2. For STIKes Alifah Padang
It is hoped that the results of this research
can be used as a reading source to
increase insight for nursing students in
conducting further research on the
relationship between family instrumental
support and family acceptance of ODGJ.
3. For Andalas Padang Community Health
Center
Through the person responsible for
mental health, we can further increase
sources of information for the ODGJ
family in caring for or helping the lives of
ODGJ and it is hoped that this can be
done by providing health education about
people with mental disorders as well as by
providing education and education to
families in helping ODGJ.
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