Date of Award


Degree Type


Degree Name

Doctor of Philosophy


The present study was an evaluation of the impact of a community-based mental health course offered by the Perwitasari Mental Health Association, Yogyakarta, Indonesia. A positive impact could not be assumed, in part because course participants are predominantly married women, and mental health education, with its Western orientation, can to some extent be in conflict with the traditional role of women in Javanese society.;A modified cross-over design was adopted for the evaluation. Three hundred married women recruited for the study were allocated at random to comparison groups of equal size. One group took the course of nine weekly two and one-half hour sessions of lectures and discussion, while the other group served as controls. The second group then took the course and the first group was followed. Home interviews were carried out prior to randomization and at the end of each course. Data analysis was based on 232 complete sets of interviews. The impact of the course was evaluated principally in terms of mental health status and marital relationships as a postulated intervening variable. An unsuccessful attempt was made to assess changes in knowledge and attitudes, and participants provided their own assessments of relevance and effectiveness.;Mental health status was assessed by the well-established Symptom Checklist-90 (SCL-90), and significant course-related improvements were found for participants whose initial scores were in the range that have been reported for psychiatric outpatients. There was also some evidence of a reduction in marital conflict, but uncertainty remained as to whether this reduction either contributed to, or resulted from, improved mental health. These and related results support the view that steps should be taken to encourage the participation of both husbands and wives in the course, and that there should perhaps, be a greater concentration on marital relationships and parenting. Steps should also be taken to make the course accessible to a broader cross-section of the population. The long-term follow-up of the participants is advocated, and it is suggested that further insight into the results of the present study might be gained by including measures of competence and self-esteem in any subsequent research.



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