Audiovisual Health Education Significantly Reduces Public Stigma Toward Persons With Mental Disorders in Indonesia

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A new study conducted by researchers Ellen Lombonaung and Fany Sabban from STIKes Maluku Husada reveals that community-based health education delivered through audiovisual media significantly reduces public stigma toward Persons with Mental Disorders (PMD). Published in the International Journal of Natural and Health Sciences in 2026, the research demonstrates how accessible video-based interventions can dismantle deeply rooted stereotypes, foster empathy, and encourage social inclusion. The study was carried out between April and May 2026 in Nania Village, Ambon City, Maluku Province, addressing an urgent public health challenge in regional Indonesia.

Background: The Burden of Public Stigma

Social stigma remains one of the greatest obstacles to mental health recovery globally and locally. According to the World Health Organization, approximately 450 million people worldwide live with mental disorders. In Indonesia, national health data indicates that roughly 1.7 million individuals live with mental health conditions. Rural communities often experience higher rates of extreme discrimination, such as physical restraint (pasung), due to a lack of accurate health information and pervasive fears that individuals with mental conditions are inherently dangerous or untreatable.

In Maluku Province, where emotional mental disorders affect an estimated 7.5% of the population aged 15 and older, public misconceptions frequently lead to social isolation and delays in medical treatment. Prior to this intervention, residents of Nania Village had never received mental health education via electronic or audiovisual platforms, creating a prime opportunity to measure the direct impact of modern educational tools.

How the Study Was Conducted

To evaluate changes in community attitudes, Ellen Lombonaung and Fany Sabban designed a quasi-experimental study using a One Group Pretest-Posttest model involving 35 adult residents of Nania Village. The study utilized a total sampling method to include all eligible village participants, representing a cross-section of age groups, educational backgrounds, and genders.

  • Baseline Assessment (Pretest): Participants' baseline attitudes were measured using the standardized Perception of Discrimination Devaluation Scale (PDDS), which categorizes stigma into low, moderate, and high levels.
  • Educational Intervention: Participants attended a comprehensive two-hour health education session utilizing structured audiovisual media. The video content explained the clinical definitions of mental disorders, biological and social causes, available medical treatments, and the vital role of community support.
  • Post-Intervention Assessment (Posttest): Immediately following the video presentation, participants completed the PDDS questionnaire again to evaluate changes in perception.
  • Data Analysis: The researchers analyzed the scores using the Wilcoxon Signed Rank Test to determine statistical significance.

Key Findings: A Dramatic Shift in Community Attitudes

The audiovisual intervention produced a statistically significant reduction in negative perceptions across all 35 participants ($Z = -5.167$, $p < 0.001$).

  • Pre-Intervention Stigma: Before viewing the educational video, 57.1% of participants (20 individuals) exhibited high stigma levels, while 42.9% (15 individuals) showed moderate stigma. Zero participants displayed low stigma levels.
  • Post-Intervention Stigma: After the intervention, high stigma was entirely eliminated. Moderate stigma became the predominant category at 66.7% (23 individuals), while 34.3% of participants (12 individuals) shifted into the low stigma category.
  • Universal Improvement: Every single participant demonstrated a measurable decrease in stigma scores following the session, with no participants showing increased or unchanged stigma levels.

Implications and Real-World Impact

The study demonstrates that public stigma is not permanent and can be altered through targeted, engaging educational tools. By combining visual illustration with auditory explanations, audiovisual media simplifies complex psychiatric concepts, making them accessible to populations with varying educational backgrounds.

These findings offer clear practical benefits for healthcare providers, non-governmental organizations, and government policymakers:

  • Public Health Strategy: Integrating short audiovisual modules into routine community health programs (Puskesmas) can serve as a cost-effective method to dismantle social barriers.
  • Improved Recovery Outcomes: Reducing public prejudice directly encourages individuals with mental health conditions and their families to seek early medical intervention without fear of social ostracization.
  • Policy Integration: Education authorities and health ministries can deploy standardized digital content across rural regions to promote human rights and social inclusion.

Expert Perspective

Emphasizing the core insight of the research, the study's primary authors highlighted the transformative power of engaging media in community healthcare settings:

"Health education through audiovisual media constitutes an effective approach to reducing public stigma toward Persons with Mental Disorders, as it conveys information in an engaging, concrete, and easily understood manner, thereby encouraging the community to become more open, foster closeness, and accept them as an integral part of society." — Ellen Lombonaung & Fany Sabban, STIKes Maluku Husada

Researcher Profiles

  • Ellen Lombonaung, B.S., M.N. (or equivalent nursing/health degree), is a researcher at STIKes Maluku Husada, specializing in psychiatric nursing, community health education, and public mental health promotion.
  • Fany Sabban, M.Kep., is a nurse educator and researcher affiliated with STIKes Maluku Husada, focusing on mental health nursing, community-based interventions, and stigma reduction strategies.

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