Information Search Patterns of Depression Sufferers in Fulfilling Mental Health Information Needs

This study aims to find out the model of information search process are carried out by depression sufferers at Cahaya Bunda Cirebon Mother & Children Hospital to obtain information, especially regarding mental health by using the information seeking behavior model by Kuhlthau known as ISP (Information Search Process). The research method used in this study is a qualitative research method with a case study approach. Data collection techniques were carried out through observation, interviews, and literature studies. The results of the study show that the construction that depression sufferers go through from the stage of uncertainty to understanding and in this search for information there are 6 (six) stages, namely The initial stage, aware of the need for information so that the search for information is motivated by motivation in searching for information; Topic Selection Stage; Information Search Stage; Crosscheck and validation stages to expert individuals including psychologists/psychiatrists; Collection Stage, collecting information that has been sorted; and Final Stage, characterized by storing information for oneself and the emergence of feelings of satisfaction and relief. The conclusion from the results of this study is that it is known that the depressed sufferers studied have a model of information search process according to the characteristics of the depressed sufferers and is sufficient to help them to obtain and use mental health information.


INTRODUCTION
It is a true fact that mental health is one of the most crucial aspects of someone's wellbeing.The World Health Organization explains that mental health means the condition of an individual who is in a condition that is able to develop mentally, spiritually, physically and even socially so that the individual is aware of his own abilities, can cope with all the stresses of life that occur normally, and can also work.productive and able to contribute to the surrounding community (WHO 2018).Febriyanti and Susilawati (2022) said that mental health itself related to several important aspects of a person' life.It includes how someone think, feel, and live their life, how they perceive themselves and others, lastly, how they evaluate and make decision towards certain issues.Therefore, having a stable mental health information to solve their problems, just like other individuals who have a need to develop themselves in fulfilling information needs.This situation increases the risk of depression sufferers themselves experiencing this condition for longer.Lack of awareness about depression will make it too late for individuals to seek help from mental health professionals and will make depression more difficult to treat (Wahyuni & Nabila, 2021).Moreover, understanding mental health is also said to be knowledge about mental disorders that can help someone to recognize, manage and prevent mental disorders themselves, including depression (Nazira, Mawarpury, Afriani, & Kumala, 2022).Thus, people who suffers depression have to be aware about their information needs regarding to the mental health.
According to Permana, Ifroh, and Wiranto (2021), information is a primary need in society and life.Supported by developments in technology and the internet, providing information to the public is becoming easier and faster.In terms of searching an information, Kuhlthau (2004) stated that there are six processes in information search, namely initiation, selection, exploration, formulation, collection, and presentation.There are various ways and steps taken by the public to access information about mental health.Starting from the stages of searching, and managing when finding appropriate information, as well as further action (decision making) when finding information that is in accordance with the activities carried out by the community in an effort to find appropriate information.Information is the most important thing in today's era in carrying out every activity.There are many ways to fulfill information needs, every person needs information every day, especially the latest information, therefore information is easily disseminated through various media, especially on the internet where the search process is easy and fast.
The pattern of information seeking begins when individuals feel they lack knowledge about information, so they need to dig up the information they want.To fulfill their information needs, people seek information from various sources.The act of searching for information using literature is a behavior that in fact reflects various goals.The process of information seeking behavior begins with ignorance or a gap in information, so researchers developed a model of information seeking behavior by Kuhlthau (2004) known as ISP (Information Search Process) which states that information search patterns are tiered, starting from something that is not clear.until the stage of clarity of the information sought.In these 6 (six) stages, Kuhlthau then highlights the search process into three aspects, namely, knowledge, feelings and action.Based on these three aspects, six stages are produced, namely initiation, selection, exploration, formulation, collection and presentation.
Based on the explanation above, fulfilling information needs and information seeking patterns are two interrelated things, including for people suffering from mental health disorders such as depression.In this case, of course depression sufferers need increased mental health information.In facing a mental health crisis, the first step that can be taken is to search for information either online or via social media or directly asking experts about it (Alkautsar et al., 2023).Regarding the information, mental health information needs to include knowledge to prevent mental disorders and recognize when a disorder develops, available treatment or help options, effective self-help strategies for dealing with mild to moderate problems; as well as first aid skills to help others who have mental disorders or are in a mental health crisis (Fatahya & Abidin, 2022).Moreover, Idham et al (2019) revealed that individuals with high mental health literacy are more likely to recognize mental illness and identify appropriate treatment sources than individuals with low mental health literacy who tend to use inappropriate coping strategies such as the use of alcohol and other drugs.
The results of pre-research by interviewing patients suffering from depression at Cahaya Bunda Mother & Child Hospital, found that when initiation took place, they had the motivation to seek information based on what they were experiencing.At the selection stage, they select the right information topics.The next stage, namely exploration, they start to look for the information they really need, then filter the information they get, this stage is called the formulation stage.At the collection stage, they have sorted the information that has been filtered and then verified it with individuals who are experts in their field.Then at the final stage, namely the presentation stage, they found a bright spot and then a feeling of satisfaction and relief emerged.Based on these problems, researchers were interested in studying the pattern of seeking mental health needs of depression sufferers at Cahaya Bunda Mother & Child Hospital in Cirebon City.

METHODS Types and Objects of Research
This research is a qualitative study that seeks to intensely observe and examine participants who experience depression in fulfilling their mental health information needs.Researchers use a case study approach to explain the existence of casuistic social phenomena in Cirebon City.There were 4 people suffering from depression who were the subjects of this research, namely Fuji, Endang, Refah and Fian.Depression sufferers in this study took the Beck's Depression Inventory -II test (a psychometric measuring tool to measure a person's level of depression) with the results of experiencing moderate depression and severe depression.

Sources and Data Analysis Techniques
The main data sources in this research are words and actions obtained through observation and interviews.The data analysis technique carried out in this research based on Sugiyono in 2015 consists of data reduction, data presentation or display, and data verification (conclusions drawing/verifying) as well as testing the validity of the data using source triangulation, data collection and time techniques.

Focus Formulation Stage
What is the process of formulating information for depression sufferers to meet their mental health information needs?
1. How do you convince yourself that the information you get is correct information?

Collection Stage
What is the process of collecting information for depression sufferers to meet their mental health information needs?
1. How do you gather the information you have focused on previously?
2. How do you feel when gathering information?3. What obstacles did you experience while searching for information?4. What action to take when no information is found?

Presentation Stage
What is the process of presenting information to depression sufferers to meet their mental health information needs?
1. How do depression sufferers use the information they have obtained?2. How do you feel after searching for information?

RESULTS AND DISCUSSION
Information is an aspect that continues to flow without stopping over time and individuals need this aspect to support their lives.The information that we currently see, read and hear does not all contain valid facts and data, for example information presented through communication media or social media, so information literacy skills are needed for each individual to filter the information obtained so that this information can be used.
Likewise, depression sufferers can find a lot of information either through print media such as books, newspapers, magazines, journals, research reports, dissertations, theses, or information through online media such as e-journals, e-books., online newspapers, or social media such as Facebook, Instagram, Twitter and so on.The function of information has a different nature.According to Yusup (2010), viewed from a distance, the function of information can develop according to the field it touches.But at least the main thing is as data and facts that can prove the existence of a truth, as an explanation of things that were previously still doubtful, as a prediction for events that may occur in the future, so in this case depression sufferers look for information to make it a truth and provide explanations for things that previously had doubts, and express predictions about whether they really have mental health problems or not.
In research conducted and analyzed using Kuhlthau's (2004) information seeking behavior model theory, it can be explained from the results of the research conducted that there are six processes or stages in seeking information that are carried out by depression sufferers, including:

Initiation Stage
In the Information Search Process (ISP) theory, Kuhlthau explains that this initial stage is called the initiation stage.At this stage, a person's awareness of the need for information is the same as depression sufferers who have an awareness of the need for mental health information that they experience in everyday life.It is said to be the initial stage by researchers because this is the first stage before depression sufferers will continue a more complex search regarding mental health.
At this stage, Kulhtau also explained that usually someone is still unsure about the essence of a problem and feels that the knowledge they have is still less than what is needed, because there is a lack of knowledge about the information needed by depression sufferers so that the search for information is motivated by the motivation to carry out the search.The triangulator said that when a depressed sufferer has symptoms, the depressed sufferer will start searching via search engines or Google about what he feels, what problems make the depressed sufferer feel down or under pressure.
At this early stage, depression sufferers such as Endang and Fuji really have symptoms, while Refah does have an interest in the field of psychology and reads a lot about this topic and Fian's motivation is curiosity and wanting to know how to overcome this.It is these backgrounds or reasons that ultimately make them search for mental health information on an ongoing basis.Triangulator provides further information that everyone's motivation for information is to fulfill needs, answer problems, for solutions, to survive, to be competitive, for entertainment, to defeat opponents, to earn income.In the context of mental health, it means getting out of the problems you are experiencing and looking for alternative answers that will make you make the right decision.
In line with what the triangulator said, Fian and Endang searched for mental health information to fulfill their information needs because Fian wanted to know whether he actually had depression or not.If the answer was yes, Fian wanted to know ways to overcome this, while Endang wanted to find out this information before asking an expert in that field.In contrast to Fuji, who carried out the search to answer the problems he was experiencing and to survive, Fuji said that he had no motivation, he only took the initiative to look for information about his health, which really interfered with his daily activities.In contrast to Refah's answer, Refah carried out this search for recreational or entertainment aspects only because she had been interested in mental health since she was at school.
It can be concluded that at this initial stage the motivation that arises comes from oneself (internal factors) and from outside oneself (external factors).For the information function at the initial stage, it has not yet reached the stage of adding knowledge, only at the stage of knowing the need for information and knowing the motivation for carrying out a search.The motivation for carrying out this search is an action so that the search can be focused on getting out of the problems experienced and looking for alternative answers for decision making.

Topic Selection Stage
At the selection stage, Kuhlthau explains that a person feels optimistic after choosing a topic and feels ready to start searching.However, from the results obtained, the second stage is to explain how depression sufferers choose topics from searching for information.Search topics regarding general information to determine the right information topic and the source of information needed.Sometimes choosing this topic makes depression sufferers confused, blank because there are too many problems that need to be solved for as explained by the triangulator because there are too many stories so it is too complicated to determine which problem will be solved first because the problems are related to each other.Triangulator also added that before determining a topic before conducting a search, this can be done by discussing or doing self-talk / asking yourself questions or asking yourself questions (5W+1H).Fuji said that the choice of topic was based on what he experienced in everyday life which interfered with his activities in the sense that Fuji asked himself questions regarding determining the topic of information needed.As for Endang, who chooses topics randomly because the technology will filter them itself, this is confirmed by the triangulator because there are several posts related to the stigma of stress, the stigma of depression on several social media, including Refah who searches for topics based on the algorithm of posts that appear on social media because they have filtered by social media itself.The feelings of depression sufferers when determining the topic of searching for information vary, such as Fuji who feels worried/worried, Endang only feels normal because he is just curious and most importantly, he is not allowed to self-diagnose.Fian stated that today's technology is so sophisticated that he is very optimistic that he will get the relevant information he is looking for.
In conclusion, at the topic selection stage, you can start by collecting what information needs are needed, based on what the depression sufferer is experiencing or doing self-talk, namely asking yourself questions, making search goals and making a 5W+1H formula so that Depression sufferers feel optimistic after choosing a topic to search for and feel ready to start searching.Apart from this, topic selection can be done by looking at the algorithm of posts that appear on the social media homepage and carrying out continuous searches.

Information Search Stage
The theory put forward by Kuhlthau in this third stage is the exploration stage, but the researchers changed it to the information search stage because it is in accordance with the stages carried out previously and it is also at this stage that depression sufferers begin to focus on searching for the mental health information they need. .Kuhlthau explained that the exploration stage is the most difficult stage, because usually a person will experience confusion, uncertainty and doubt due to the discovery of inaccurate information.Meanwhile, the research results show that the search for information is carried out individually or by looking for it yourself (self-help/self-learner).According to triangulator Susanti Agustina, M.I.Kom (Lecturer at Perpusinfo FIP UPI and Founder of @bibliotherapy.id)the indicator of good information is credible information, meaning that the information can be accounted for, shows clear facts and data, the information is trustworthy, clear references, sources information that comes from individuals who have a scientific background in that field.
In accordance with what was stated by the triangulator, several informants chose the internet as the main material for searching for mental health information.But Fian looked for this information on the alodokter/halodoc health platform where it was clear who the article researchers were, namely doctors, so the information was reliable and the references were clear.Meanwhile, Refah conducted a search on the Quora platform because the author has a scientific background in that field, the author's profile is known.Apart from looking for information on the internet, Fuji tried to have discussions with his friends who DOI: https://doi.org/10.17509/edulib.v13i2.56547p-ISSN 2528-1410 e-ISSN 2527-8045 were studying in the guidance and counseling study program.When depression sufferers gain new cognitive knowledge (knowledge), it means they have succeeded in gaining new meaning/insight that was previously sought.But if not, depression sufferers will continue to be haunted by the stigma of depression, when they are actually the ones who actualize themselves.When depression sufferers are in that phase, they just need someone they can share with and discuss with (for example, a friend who is studying in the field of counseling).
Triangulator provides tips when searching, use websites that have the domain dot com (.com), dot org (.org), dot id (.id) and so on to avoid hoax information.Triangulator also added that sometimes depression sufferers have a tendency to have unique patterns of information seeking and knowledge sharing as seen from their biological information.Biological information is a set of data and facts contained in human biological factors.The triangulator also explains in detail about the genetics in question, namely that there is something called blood group strata, even though blood group is a spontaneous or momentary response (not for decision making) but after researching it turns out the pattern is the same tendency between one blood group and another blood group.different.But those in the same blood type have the same tendencies.

Crosscheck/Validation Stage
At this stage, the depression sufferer's feelings of uncertainty begin to recede, selfconfidence begins to increase, thinking patterns become more clearly focused on the problem and they begin to cross-check the focus of the information they already have.It is also at this stage that depression sufferers can convince themselves that the information previously obtained is credible information obtained, by filtering the information that has been selected which is mentally healthy and which makes the situation or condition worse.So depression sufferers start the crosscheck or validation stage by asking experts directly such as psychologists or psychiatrists to validate the information.
It is called the crosscheck or validation stage, because all informants or depression sufferers will carry out a crosscheck or validation regarding the correctness of the information they have previously obtained, such as Endang who stated that he validated the information with the doctor.

Information Collection Stage
This stage is where depression sufferers collect all the information that has been obtained or sorted in the previous stage.The interaction between depression sufferers and the information system increases to become more effective and efficient so that information gathering is focused on the problems they face.Depression sufferers do not experience obstacles when searching for information.

Final Stage
In the theory by Kuhlthau, this is the presentation stage, but the researchers replaced it with the final stage because this stage is the final stage which is marked by the emergence of feelings of satisfaction or disappointment felt by depression sufferers after carrying out all the stages in the previous stages.If the search goes well and according to your wishes, you will be disappointed if the opposite happens.At this stage, the informant uses information that has been obtained from independent searches or after validating the information with experts in their field, psychologists/psychiatrists.The feeling that arises and is felt by depression sufferers is relief because they know the root of the problem as expressed by Fuji.Meanwhile, Fian does mood tracking every day after going through the crosscheck and validation stages and Refah follows the tips and directions given by her psychologist or psychiatrist.
According to the triangulator, using the information that has been obtained can be stored and attached to its meaning, so that if we search again, it will be easy.This was done by Refah who recorded all the important information that was needed to be understood again from the start.Triangulator also added that the information obtained could also be utilized by disseminating it, but this was not done by depression sufferers so they kept the information only to themselves.The feelings that emerged after going through the process of searching for information and getting the information were feeling relieved, feeling better, the mood rarely fluctuated as said by Endang, and Fuji who followed all the tips given by the psychologist/psychiatrist.
Based on the discussion above, the researcher created a flow chart explaining the information search patterns of depression sufferers in fulfilling mental health information at each stage, as follows: friends who are studying psychology; (iv) The crosscheck/validation stage is carried out when the depression sufferer has collected a lot of information obtained and sought the truth by crosschecking or validating it with an expert individual, in this case a psychologist or psychiatrist; (v) Information Collection Stage, depression sufferers will collect all the information obtained and sort it; AndThe final stage is the stage where depression sufferers feel satisfied or relieved with the results of the search for information and keep mental health information to themselves.Apart from creating a flow for the stages of searching for information for depression sufferers obtained from direct research results, researchers also created a flow for searching for mental health information in collaboration with a triangulator.continues at the topic selection stage which can be done by identifying information needs through the 5W+1H information search objectives.At the information search stage, depression sufferers can search via the internet, social media or conventional media.If the search is successful, the information will be filtered to carry out the next stage, namely the crosscheck/validation stage with a psychiatrist/psychologist.After carrying out crosscheck/validation, depression sufferers will carry out the stages of collecting credible information and will follow all the tips or directions given by expert individuals, so that in the final stage the triangulator reveals that the information can be disseminated.
In this research, researchers also developed Kuhlthau's model of information search behavior, known as ISP (Information Search Process), where Kuhlthau (2004) stated that information search patterns are tiered, starting from something that is not clear to the stage of clarity of the information sought.This model combines three areas, namely affective (feelings), cognitive (thoughts), and physical (actions).
Kuhlthau describes the search for information as a construction that a person goes through from the stage of uncertainty to understanding, and in this search for information there are 6 (six) stages, namely: In these 6 (six) stages, Kuhlthau then highlights the search process into three aspects, namely, knowledge (Thoughts/Cognitive), feelings (Feelings/Affective) and action (Action/Physical).Starting from the feeling aspect (Feelings/Affective) felt by depression sufferers, namely at the Initiation stage, depression sufferers feel uncertain about what they feel so that there are many doubts about what they are feeling.At the selection stage, feelings felt by depression sufferers begin to emerge as feelings of optimism because they have gotten a little idea of the topic they are looking for regarding mental health.In the exploration stage, the feelings that arise from depression sufferers are confusion, frustration and questions because they start to get a lot of information that is confusing with what depression sufferers want to get.At the formulation stage, the feelings that arise begin to feel relieved because they have found the bright spot in their search.At the collection stage, the feeling that arises in depression sufferers is that they feel confident with the information found so that their minds remain focused on the information that will be searched periodically.In the final stage, namely the presentation stage, the feeling that arises is that someone can feel satisfied with the search process, but also feel disappointed.Meanwhile, in this study, depression sufferers felt satisfied and relieved with the process of searching for the information they received and they applied this in their daily lives.
Furthermore, the knowledge aspect (Thoughts/Cognitive), starting from the initiation stage to the exploration stage, the thoughts of depression sufferers that emerge are still unclear.Meanwhile, at the formulation stage, depression sufferers' thoughts are already trying to focus on the search carried out up to the final stage and there is a focus showing interest in recovery at the presentation stage.
In the action aspect (Action/physical), in the initial stage (initation) depression sufferers are still looking at or searching for relevant information according to the topic they are looking for.At the selection stage, depression sufferers have begun to determine the information that is truly relevant to the information needed.The action they take then at the collection stage is to collect, sort and select documents or information that are related to the information that has been found previously.After that, depression sufferers will store the information for themselves that they got at the presentation stage.Assessment based on the information that has been obtained, a person can feel a sense of accomplishment of the information that he has obtained and the thought of awareness of himself arises, then with the knowledge and confidence that depression sufferers have, they use the information obtained to help the treatment and mental healing process.Below is a chart of the Kuhlthau information search model modified by researchers according to the results of the research conducted, namely:

CONCLUSION
The stages or patterns of information seeking that occur in the field consist of several stages, including (i) The initial stage is where depression sufferers discover gaps in information or symptoms experienced in daily life that interfere with their activities, thus gaining motivation to search for mental health information based on internal factors and external factors to continue a more complex search regarding mental health.(ii) Topic Selection Stage.This stage explains how depression sufferers choose topics from searching for information.Search topics regarding general information to determine the right information topic and the source of information needed.(iii) The information search stage is carried out by depression sufferers via the internet, health platforms such as halodoc, alodoc, and Quora or discussing with friends who are studying psychology.When depression sufferers gain new cognitive knowledge (knowledge), it means they have succeeded in gaining new meaning/insight that was previously sought.(iv) Crosscheck/validation stage.At this stage, the depression sufferer's feelings of uncertainty begin to recede, self-confidence begins to increase, thinking patterns become more clearly focused on the problem and they begin to cross-check the focus of the information they already have.It is also at this stage that depression sufferers can convince themselves that the information previously obtained is credible information obtained, by filtering the information that has been selected which is mentally healthy and which makes the situation or condition worse.(iv) Information Collection Stage.This stage is where depression sufferers collect all the information that has been obtained or sorted in the previous stage.The interaction between depression sufferers and the information system increases to become more effective and efficient so that information gathering is focused on the problems they face.the informant uses information that has been obtained from independent searches or after validating the information with experts in their field, psychologists/psychiatrists.

Suggestion
In accordance with the research results, researchers provide recommendations that can be aimed at information seekers, especially for depression survivors and for previous research.Depression sufferers need to carry out searches by considering aspects of validity, accuracy and newness.Then, depression sufferers also need to always involve professionals in this field, so they can accompany them and provide the right advice.
Through references in this research, subsequent research can be further developed to dig deeper into other necessary aspects.Apart from examining patterns of information-seeking behavior in sufferers, research also needs to be carried out to determine the accessibility and availability of information sources that can support a more optimal search for information about depression.Apart from the right pattern, the main support for searching for information more precisely, it is also necessary to explore supporting sources.

Figure 1 .
Figure 1.Flow of Information Search Stages for Depression Sufferers Based on the chart above, the flow of information search stages for depression sufferers obtained by researchers from this research consists of: (i) Initial stage.The initial stage is where depression sufferers discover gaps in information or symptoms experienced in daily life that interfere with their activities, thus gaining motivation to search for mental health information based on internal and external factors; (ii) Topic Selection Stage, depression sufferers have started to carry out search goals by selecting topics where solutions to their problems will be sought; (iii) Information search stage, carried out by depression sufferers via the internet, health platforms such as halodoc, alodoc, and Quora or discussing with DOI: https://doi.org/10.17509/edulib.v13i2.56547p-ISSN 2528-1410 e-ISSN 2527-8045

Figure 2 .
Figure 2. Flow of Information Search Stages for Depression SufferersIn the flow above, in the initial stage the triangulator explains that depression sufferers begin to see symptoms or information gaps that cannot be resolved by themselves so that there is motivation to search for information from both internal and external factors and (i) Initial Stage (Initiation); (ii) Selection Stage (Selection); (iii) Exploration Stage; (iv) Formulation Stage; (v) Collection Stage (Collection); and (vi) Presentation Stage.

Table 1 .
Research Instruments