The Effectiveness of Pojok Cerita (Po'rita) Counseling in Maintaining Mental Health of Adolescent

Adolescent mental health including anxiety, depression, bipolar disorder, and psychosis is a serious public health challenge because it can affect fundamental aspects of human life. One effort that can be made to maintain mental health is through Counseling as an intervention to solve mental problems. This research aimed to see the effectiveness of Counseling Pojok Cerita (Po'rita) in maintaining the mental health of teenagers. The research used a pre and post-test research design with a population of class X and XI students. Before the Counseling session, mental health screening was conducted using the Self-Reporting Questionnaire (SRQ). Out of 93 respondents, 43 students exhibited symptoms of mental health problems. The sampling technique employed was purposive sampling, targeting only students with identified mental health issues. The data were analyzed using the Paired T-test. Before the Counseling, all 43 students (100%) showed symptoms of neurosis (psychological issues), 37 (86%) exhibited psychotic symptoms, and all 43 students (100%) displayed symptoms of Post-Traumatic Stress Disorder (PTSD). After the Counseling, 19 (44%) still showed symptoms of neurosis, 17 (39%) exhibited psychotic symptoms, and 18 (42%) continued to display PTSD symptoms. There was a significant reduction in the number of students experiencing mental health problems post-counseling, with a p-value of 0.00<0.05


INTRODUCTION
Mental health including anxiety, depression, bipolar disorder, and psychosis is becoming one of the most serious public health challenges of the 21st century (Hickie et al., 2019).This can affect fundamental aspects of human life, namely work, developing quality social relationships, and even the worst case is suicide.Mental health according to Law Number 18 of 2014 is the condition of a person who can develop physically, mentally, spiritually, and socially so that he can overcome pressure, is aware of his abilities, can work productively, and is able to contribute to his community.Mental condition is very important to support a person's productivity and physical health.If an individual has an unhealthy mentality, it will result in various kinds of problems that can lead to mental problems (Rindu et al., 2022).This situation can be experienced by anyone, especially children and teenagers.
Around one in 3 teenagers experiences mental disorders and research results show that this is the main cause of disability and even suicide.Adolescents are people at high risk with 75% experiencing mental disorders before the age of 25 years and 45% at the age of 10-24 years.This is a top health priority to be able to reduce the burden of this disease so that its impact does not last a lifetime (Hickie et al., 2019).Nowadays, teenage students besides spending time in school, also spend a lot of time in the digital world.Conditions in two places.This greatly determines mental health in adolescents.If they can't regulate their emotions and do not get an optimal support system from the surrounding environment, can lead to mental health issues that cause teenagers to experience difficulties in learning (Handayani, 2022).
The (Organization, 2020)World Health Organization defines mental health as the absence of disease, but in a broader sense, as a state of wellbeing in which individuals develop their abilities, cope with the stresses of daily life, do productive and useful work, and contribute to the improvement of their communities.A survey conducted by Global Health Data Exchange in 2017 found that 27.3 million people in Indonesia suffered from mental health problems.In 2018 the prevalence of emotional mental disorders with symptoms of depression and anxiety was experienced by many teenagers aged 15 years and over with a total of 6.1% of the total population of Indonesia or equivalent to 11 million inhabitants.This is of course the main focus considering that children and teenagers are the generation that we need to prepare as the strength of the Indonesian nation.The prevalence of mental health disorders in children and adolescents tends to increase in line with increasingly complex life and social problems, therefore there is a need for adequate mental health services to enable children and adolescents to have opportunities for maximum growth and development (Rindu et al., 2022).The current dynamics of mental health are very clearly visible during puberty or adolescence.Several factors that can influence mental health, especially in adolescents, are physical, psychological, and environmental.According to data from EGSA UGM in 2020, the incidence of depression in adolescents reached 6.2% (Esperansa et al., 2023).
From a public health perspective, schools are ideal settings for identifying children and adolescents with possible mental health problems because they offer the opportunity to reach large numbers of adolescents.School-based mental health services are the most commonly accessed interventions for children and adolescents with mental health problems, making schools the primary providers of mental health services for children and adolescents (Suswati et al., 2023).
Apart from that, it is also hoped that adolescents will be able to control themselves so that they can build good relationships with parents, teachers, siblings, and friends.Teenagers are also expected to be able to face daily life problems independently.Adolescent behavior is very vulnerable to environmental influences.One of the most difficult parts of adolescent development is adjustment to the social environment.Teenagers have to adjust to the opposite sex in interpersonal relationships that previously did not exist, they also have to adjust to adults outside the school and family environment.If teenagers cannot overcome the various stressors that exist, it will cause various negative conditions such as anxiety, depression, and can even trigger the emergence of psychotic disorders.The impact that can occur on teenagers in conditions like the ones above is the emergence of various complex problems, both physical, emotional, and social, including education, for example, it can cause various physical complaints for which there is no clear cause or various problems that have a social impact, such as being lazy about school, skipping class, joining in.fights between students, abusing Narcotics, Psychotropics and Addictive Substances (NAPZA), and so on.If not treated immediately, this condition can continue into adulthood and will develop further in a more negative direction, such as the formation of an antisocial personality or chronic psychotic conditions.Early detection and early intervention are needed for adolescents who experience mental disorders (Rindu et al., 2022).
Research conducted by the Child and Adolescent Psychiatry Division, Faculty of Health at the University of Indonesia tried to map the mental anxiety of teenagers in the transition age period of 16-24 years.As many as 95.4% stated that they had experienced symptoms of anxiety and 88% had experienced symptoms of depression in facing problems during this age.The results of all respondents, as many as 96.4% stated that they did not understand how to deal with stress due to the problems they often experienced.At this age, especially high school (SMA) age, you must prepare yourself to explore a new environment at the university level, a wider circle of friends, increasingly tough educational or career demands, and a cultural environment that can be very different accompanied by various problems and conflicts that often arise from these various changes.This is a consideration for recommending school-based mental health intervention programs to improve mental health levels (Karyani & Subandi, 2015).
The 2021 survey by the Indonesia-National Adolescent Mental Health Survey (I-NAMS) in the last 12 months found that one in three teenagers (34.9%) or 15.5 million teenagers in Indonesia had a mental health problem.Another survey result, one in five teenagers (5.5%) or 2.45 million teenagers in Indonesia has a mental disorder and only 2.6% of teenagers use mental health facilities or counseling to help them overcome their emotional and behavioral problems.Attention and intervention to students' mental health functioning at school can improve learning and prevent negative outcomes associated with untreated mental health problems.This is because many teenagers have unmet mental health needs in society.However, emergency departments are not the optimal place of care for children with mental health needs.This can of course damage physical and mental health and limit opportunities to live a fulfilling life as an adult (Gloriabarus, 2022).
Mental health counseling has been implemented using communication and information technology, such as online counseling, which was widespread during the COVID-19 pandemic.Research conducted by Sahu, explains that student mental health is an important priority and counseling services are one of the right solutions to support student mental health (Sahu, 2020).Other mental health counseling services are provided to adolescents with the aim of helping them live healthy lives (Agoestina, 2023).Counseling needs to be applied, especially to teenagers who are vulnerable to mental problems.Counseling can be used as a form of social support for adolescents to increase resilience in facing problems that occur (Fitrianur et al., 2022).Apart from that, counseling is expected to help strengthen teenagers' coping, so they can avoid mental problems.Teenagers will feel comfortable being able to tell the counselor about the problems they are experiencing (Fitrianur et al., 2023).
One of the efforts to maintain adolescent mental health is the existence of a 'Pojok Cerita (Po'rita)' as a forum for adolescent counseling to overcome mental problems that occur.Pojok Cerita (Po'rita) Counseling will be a health service that handles adolescent mental health problems while still utilizing information technology.Apart from that, Pojok Cerita (Po'rita) Counseling is an intervention to detect early mental health problems in adolescents.It is hoped that the Pojok Cerita (Po'rita) can collaborate with the Counseling Guidance Room and also Counseling Guidance (BK) teachers to be able to provide a forum or place for teenagers to tell stories and detect mental health problems early.

METHODS
This research used a pre-post-test design, with the population being all students in classes X and XI of SMA Negeri 1 Kebomas, Gresik.As a screening for mental health problems, 93 students completed the Self-Reporting Questionnaire (SRQ).Of the 93 students, 43 showed mental health symptoms.The sampling technique in this research was purposive sampling, where only students who showed symptoms of mental health disorders will undergo counseling at Pojok Cerita (Po'rita).The inclusion criteria in this research were students who were detected as showing symptoms of mental health problems through screening results with the SRQ questionnaire.Data collection was carried out by distributing the SRQ questionnaire as a screening for symptoms of mental health problems.Students whose questionnaire results show symptoms of mental health problems will be registered to take part in the Pojok Cerita (Po'rita) Counseling activity, which previously collaborated with the Counseling Guidance.Counseling activities are carried out for 45 minutes for each student in one room.After the counseling activity, another evaluation of the mental health status of the students was carried out using the SRQ questionnaire.Data analysis in this research used the paired T-test to see how effective Pojok Cerita (Po'rita) Counseling was in maintaining adolescent mental health.The time for conducting the research is April 22-May 31, 2024, at SMA Negeri 1 Kebomas, Gresik.This research was done under an ethical review of the Health Research Ethics Committee of Muhammadiyah University of Lamongan on April 2024 with the number 282/EC/KEPK-S1/04/2024.

RESULTS
The research was conducted at SMA Negeri 1 Kebomas, Gresik on 22 April 31 May 2024.A total of 93 Class X and Self-Reporting Questionnaire (SRQ) as a screening for adolescent mental health problems and 43 Students are detected to have mental health problems.Here are the results research that has been carried out: Table 1 shows the distribution of students based on gender, age, class, children, and current residence.Almost all of the students are female, 86% (37), and a small portion are male, 14% (6).Most students aged 15-16 years are 65% (28) and almost half are 35% (15).Most of the students in this research were class X at 70% (30) and almost half were class XI at 30% (13).Almost half of the students are 1st and 2nd children amounting to 37% (16), a small portion of 3rd children amounting to 14% (6), 4th children amounting to 9% (4), and 5th children, etc. amounting to 2% (1).Almost all students today 88% (38) live with their parents and 12% (5) live with their families.(43).Almost all of them experienced psychotic symptoms, 86% (37), and a small number had no psychotic symptoms, 14% (6).All students had symptoms of Post Traumatic Syndrome Disorder (PTSD) of 100% (43).The majority of students after being given the Pojok Cerita (Po'rita) Counseling did not show any symptoms of neurosis (psychological) amounting to 56% (24) and almost half of them still showed symptoms of neurosis (psychological) amounting to 44% (19).All students did not use psychoactive substances by 100% (43).The majority of students also did not show psychotic symptoms after being given the Pojok Cerita (Po'rita) Counseling, 60% (26), and almost half of them still had psychotic symptoms, 40% (17).The majority of students did not have PTSD symptoms after being given the Pojok Cerita (Po'rita) Counseling, 58% (25), and almost half still had PTSD symptoms, 42% (18).

Bivariate Analysis
Bivariate analysis in this research used the Paired T-Test to see whether Pojok Cerita (Po'rita) Counseling was effective in dealing with mental problems experienced by students at SMA Negeri 1 Kebomas which were detected in the screening results using the Self-Reporting Questionnaire.The results of the analysis using the paired Ttest showed a p-value of 0.00<0.05for the categories of neurosis symptoms, psychotic symptoms, and Post Traumatic Syndrome Disorder (PTSD) symptoms, meaning that Pojok Cerita (Po'rita) Counseling was effective in maintaining adolescent mental health ρvalue 0,0001.

DISCUSSION
Before the Pojok Cerita (Po'rita) Counseling was carried out, there were 43 students out of 93 students who filled out the Self-Reporting Questionnaire (SRQ) showed symptoms of neurosis (psychological).Neurosis according to Sigmund Freud in the psychoanalytic tradition is a mild psychological disorder that arises from emotional conflict.Adolescent problems that can cause symptoms of neurosis (psychological) are parental divorce, pressure faced in the home environment, violence, parenting patterns, bullying, loss of parents, unhealthy circle of friends, and academic pressure at school.Qualitative research by Hasanah related to the influence of parental divorce on children's psychology found that children losing their parenting roles from both parents had an impact on children's development (Hasanah, 2020).Research results show that 25% of children whose parents divorce as adults will have serious social, emotional, and psychological problems compared to children whose parents remain together.Children tend to have behavioral problems and get caught up in delinquency.Parental divorce also has an impact on teenagers' reduced self-confidence when expressing opinions and feeling embarrassed about their situation.This makes it difficult for teenagers to get along with other people, they are unable to control their emotions when they vent their anger, making it difficult for them to adapt to their surrounding environment (Syarif, 2023).Several studies have also found that teenagers who come from caring, warm, and harmonious families can socialize and adapt well to their surrounding environment (Azzahra et al., 2022).
The results of the screening of students at SMA Negeri 1 Kebomas showed that the circle of toxic friendships (Toxic friendship) also affects their mental health.Toxic friendship is a toxic, unhealthy friendship relationship that only benefits on one side and harms on the other side.The characteristics of a toxic friendship are criticism, no empathy, stubbornness and always being dependent (Amir et al., 2020).Students who show symptoms of neurosis say that some of their friends create a toxic circle of friends that makes them feel bad or negative.They say that their toxic friends are unsupportive and make them feel inferior and helpless.In contrast to the research conducted by Esperansa et al (2023) stated that there is no significant relationship between toxic friendships and students' mental health.
Another result of the SRQ filled in by students is the presence of psychotic symptoms and Post Traumatic Syndrome Disorder (PTSD).This was shown before the Pojok Cerita (Po'rita) Counseling was carried out, as many as 37 students (86%) showed psychotic symptoms and 43 (100%) showed PTSD symptoms.Psychoticism is a condition that causes sufferers to have difficulty distinguishing between reality and imagination (Sadock et al., 2007).This is indicated by the results of students' answers stating that they felt something was disturbing or unusual in their minds, felt that people were trying to harm them in various ways, and heard sounds without knowing the source.If this problem is not handled quickly, it can change a person's way of thinking, attitudes, and behavior which have an impact on daily life and relationships with other people.Post Traumatic Stress Disorder (PTSD) is a mental disorder/post-traumatic stress that occurs after someone experiences a traumatic event, such as sexual violence, war, accidents, or other events that can threaten a person's life by having symptoms such as nightmares and related memories related to the trauma they experienced (Erlin & Sari, 2020).
Evaluation of the research results showed that after being given Pojok Cerita (Po'rita) Counseling, students who showed symptoms of neurosis (psychological), psychotic symptoms, and PTSD decreased.A total of 24 students (56%) showed no symptoms of neurosis, 26 students (61%) showed no psychotic symptoms and 25 students (58%) showed no symptoms of PTSD.The results of the Paired T-test obtained values P value 0.00 < α 0.05, meaning that Pojok Cerita (Po'rita) Counseling is effective in maintaining adolescent mental health.This is in line with research conducted on UNESA students that online counseling can help improve psychological wellbeing.Online counseling is effective for adolescent psychological problems such as depression, panic disorder, social anxiety, post-traumatic stress disorder, and eating disorders (Mulawarman et al., 2022).
Psychological well-being describes an individual's psychological health with the criteria of fulfilling the criteria for positive psychological functioning which is also known as optimal achievement of the individual's psychological potential.Individuals with a high level of psychological well-being have good selfacceptance, are independent, can establish positive relationships with other people, can control the environment well, have goals in life, and can develop themselves in a better direction (Wahyuningsih et al., 2021).
Other research also shows that counseling results online have considerable effectiveness in improving mental health in adolescents (Sosialita, 2023).According to his research, counseling online become an effective medium that can provide therapeutic effects related to reducing symptoms of complaints as well as improving well-being and mental health.Counseling online becomes a therapeutic experience that allows clients to make peace with the stigma of self and others.
Pojok Cerita (Po'rita) Counseling aims to improve mental health by strengthening adolescents' self-esteem and coping with existing problems.This counseling also applies professional therapeutic services and communication from counselors to be able to interact with teenagers as clients.Pojok Cerita (Po'rita) Counseling can be an effective intervention to overcome adolescent mental health problems, strengthen self-esteem, and cope with problems that arise.High coping in students can help them deal with existing problems, especially mental health problems (Fitrianur et al., 2023).

CONCLUSION
There was a decrease in the number of students experiencing mental health problems after being given Pojok Cerita (Po'rita) Counseling with a p-value of 0.00<α 0.05, meaning that Pojok Cerita (Po'rita) Counseling was effective in maintaining the mental health of adolescent at SMA Negeri 1 Kebomas, Gresik.

SUGGESTION
It is hoped that Pojok Cerita (Po'rita) Counseling can collaborate with counseling guidance in schools to provide therapeutic interventions in overcoming adolescent mental health problems.

ACKNOWLEDGEMENT
Thank you to the University of Muhammadiyah Gresik for the opportunity given to researchers to carry out this research.We also express our appreciation to all students of SMA Negeri 1 Kebomas who are willing to be research respondents involved in this research.

FUNDING
This article received internal funding from the University of Muhammadiyah Gresik with a research recommendation letter No.051/REK/II.3.UMG/DPPM/G/2024.

CONFLICTS OF INTEREST
All the authors have no conflict of interest related to the research.

AUTHOR CONTRIBUTIONS
Widya Lita Fitrianur's role is to manage permits, coordinate data, distribute tasks to research members, intervene (counseling Pojok Cerita), prepare data and processing, supervision, and implementation of data collection.Ervi Suminar and Wiwik Widiyawati are responsible in coordinating every activity in research, collect data, carry out mental health pre-test and post-test, intervention (Counseling Pojok Cerita), carry out data processing, and prepare seminars and publications.Putri Lidiah and Eka Febby Andrea are responsible to carry out mental health pre-tests and post-tests and documentation.