The study was conducted by Ns. Thika Marliana, M.Kep and Dewi Nawang Sari, M.Kep from the Faculty of Health Sciences, Universitas Respati Indonesia; Dilara Sert Kasim, Ph.D., RN from the Nursing Department at Acibadem Mehmet Ali Aydinlar University; and Desmiwati, M.Kom, Ramadhani Ulansari, M.Kom, and F. Asisi Ricky Bayu Styanto, M.Kom from the Faculty of Information Technology, Universitas Respati Indonesia. Their findings arrive at a time when suicide remains one of the leading causes of death among young adults, according to the World Health Organization.
Rising Mental Health Risks in the Digital Era
University students worldwide face increasing levels of stress, anxiety, and depression. In Indonesia, academic pressure, social expectations, and persistent stigma around mental illness discourage many students from seeking professional help.
At the same time, students frequently turn to social media and online health websites to interpret their symptoms. This trend fuels self-diagnosis—where individuals label themselves with mental disorders without clinical assessment. Such behavior can intensify anxiety, reinforce misconceptions, and increase vulnerability to self-harm and suicidal ideation.
The research team from Universitas Respati Indonesia identified this gap as urgent: students need accessible, stigma-free mental health support that aligns with their digital habits.
How the Study Was Conducted
The researchers used a quantitative quasi-experimental design involving 174 university students aged 19–24 in Indonesia.
Participants were divided into two groups:
- Intervention group (87 students): Received telecounseling services via a mobile application based on a “confiding friend” model. The approach emphasized supportive, reflective, and non-judgmental communication grounded in psychiatric nursing principles.
- Control group (87 students): Received conventional mental health education through printed materials without access to telecounseling.
Before participation, students were screened using the Self Reporting Questionnaire-29 (SRQ-29) to ensure psychological stability.
Researchers measured three key variables:
- Self-diagnosis behavior
- Self-harm tendencies
- Intensity of suicidal behavior
Data were analyzed using comparative statistical methods with a 0.05 significance level.
Key Findings
The results show clear and statistically significant improvements among students who used telecounseling.
1. Reduction in Suicidal Ideation Intensity
- The intervention group showed a sharper decrease in suicidal behavior intensity compared to the control group.
- Post-intervention scores were significantly lower among telecounseling users.
- Statistical analysis confirmed meaningful differences between groups (p < 0.05).
2. Decrease in Self-Diagnosis Behavior
- Students who accessed telecounseling demonstrated a greater reduction in self-diagnosis tendencies.
- The mean pre–post difference in the intervention group was substantially larger than in the control group.
- Telecounseling reduced the tendency to match symptoms with online information and form independent diagnoses without professional validation.
3. Patterns of Risk Behavior
The study also documented behavioral trends among students:
- The most dominant self-diagnosis behavior was symptom matching based on online searches.
- The most frequently reported self-harm behavior was concealed physical self-injury.
- Suicidal threats and cues appeared more frequently than actual suicide attempts, indicating a “cry for help” phase where early intervention is still possible.
These findings suggest that many students are not yet in irreversible crisis stages but require immediate and responsive support.
Why Telecounseling Works
Telecounseling provides a confidential and flexible environment where students can express distress without stigma. Unlike one-way printed education, digital counseling allows two-way interaction, clarification, and emotional validation.
According to Thika Marliana of Universitas Respati Indonesia, telecounseling strengthens therapeutic relationships that function as protective factors against suicidal impulses. The intervention does more than deliver information—it reshapes cognitive patterns and improves mental health literacy.
The study shows that interactive digital support is more effective than passive educational materials in changing risky mental health behaviors.
Implications for Universities and Policymakers
The findings have direct implications for higher education institutions, healthcare professionals, and policymakers.
For universities:
- Integrate telecounseling into campus mental health services.
- Provide digital platforms that align with students’ communication habits.
- Implement early screening and intervention systems.
For policymakers:
- Expand digital mental health infrastructure in developing countries.
- Promote psychiatric nursing integration into telehealth systems.
- Address stigma through technology-based outreach.
For healthcare professionals:
- Use telecounseling as a preventive strategy, not only a treatment tool.
- Strengthen mental health literacy programs through interactive formats.
The study positions telecounseling as a scalable and sustainable mental health strategy in the digital era, particularly in low- and middle-income contexts.
Study Limitations and Future Research
The researchers acknowledge limitations. The quasi-experimental design did not use full randomization, and self-reported questionnaires may introduce bias. Future research should employ randomized controlled trials and longitudinal designs to assess long-term effects.
Further studies are also encouraged to examine peer-support integration and emotional regulation as mediating factors in digital mental health interventions.
Despite these limitations, the evidence clearly supports telecounseling as a practical and effective tool for suicide prevention among university students.
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