Mental Health Implications throughout Quarantine and

Isolation during Pandemic Covid-19 in Indonesia:

Survey & findings

Firda Nurul Sulaini

120310203004

Supporting Lecturer:
Prof. Mokhamad Anwar, M.Si., PhD,

MARCH 2022
MANAGEMENT STUDY PROGRAM
FACULTY OF ECONOMICS AND BUSINESS
UNIVERSITY OF PADJADJARAN
Abstract:
Pandemics have occurred throughout the decades. The last pandemic was the Spanish flu pandemic in
1918, which infected 500 million people and caused death to as many as 100 million people
worldwide.(Elvira et al., 2021). At the end of January 2020, similar symptoms is occurring as coronavirus
disease 2019 has infected millions of people worldwide, and WHO has announced COVID-19 as a public
health emergency. The pandemic outbreaks enforced government to apply quarantine regulations. There
are several mental health response in pandemic outbreaks. People’s experienced process, behavior, and
emotional response to an outbreak is vary according to their own backgrounds and the environment where
they lived in.

Introduction:
For some people, the misinformation, uncertainty, and fear of contagion may increase stress and anxiety,
which can induce mass panic. Mental health education and psychological support from all stakeholders,
such as the government, health professionals, and the community, may be valuable during a
pandemic.(Elvira et al., 2021). Public health measures for managing the current situation sistem from
SARS and MERS pandemics. At an individual level, either isolation or quarantine will prevent the disease
from spreading. Due to this physical distancing policy, people turn to the Internet to perform their daily
routines, from studying, meeting, performing a religious activities, and socializing. Utilization of the
Internet also offered ease in disseminating public advice, delivering specific treatment, and sharing of data
between countries.(Siste et al., 2020)

The psychological impact of quarantine:

The COVID-19 can be stressful for people. Overwhelmed of fear and anxiety during the disease causes
strong emotions to emerge out of adults even in children of all ages. Some populations may respond more
strongly to the stress of a pandemic, which includes old people, especially those with chronic diseases who
are at higher risk for covid-19, children and teens, healthcare providers, and people who already have
mental health symptoms. Pre-symptoms mental health issues may be getting worse with the stress of the
pandemic. Moreover, the elderly, particulary those with reduced cognitive function, might become
irritated under isolation conditions. In addition, children could feel fear and sadness because they cannot
socialize and have to adjust to a new routine at home. (Williams, 2020). The stress that people may
experience throughout the pandemic can manifest as fear and worry about their health condition, changes
in mood, sleep and eating patterns, trouble in concentrating, smoking and other symptoms. Though stress
is a normal response during
a crisis, stress is known to lower the host immune system and leads to immune dysregulation, which can
decrease or worsen the host condition.(Morey et al., 2015). Currently, WHO and other public services
authorities around the world are employing substantial efforts to slow down the covid-19 outbreak and the
stress caused by it. Along with the Inter-Agency Standing committee, a briefing note that summarizes key
mental health and psychosocial support considerations in the relation to the covid-19 pandemic has been
provided by WHO. One key point that they said it is common for individuals to feel pressured and
worried. Therefore, it is essential to have good consultations and mental support throughout this situation.
Moreover, professional health workers have been tasked to prepare guidelines for dealing with mental
health problems that would arise during the pandemic(Pangestika, 2020).
It is also essential to highlight that not only external community but also frontline workers such as doctors,
nurses, and ambulance drivers, are exposed to additional stress during the covid-19 pandemic. They have
experienced higher demands of patients, fear of contaminating Covid-19, aware of spreading covid to their
surroundings. Amid the COVID-19 pandemic, the Indonesian government announced a policy of large
scale social restriction and urged people to work, study, pray, and basically, stay at home (Cahya, 2020).

Theoretical basis:
According to the five studies comparing psychological outcomes. For people quarantined with those not
quarantined. A study of hospital staff who might have had contact with SARS found that immediately after
the quarantine period ended, having been quarantined was the most predictive factor related to the stress
disorder. In the same study, quarantined staff was more likely to declare exhaustion, fear when dealing
with contagious patients, insomnia, poor concentration, and a decrease in work performance. In another
study, the effect of being quarantined was a predictor of post-traumatic stress symptoms in hospital
employees even in three years later.(Brooks et al., 2020). A study comparing post-traumatic stress
indicators in parents and children quarantined with those not quarantined found that the mean post
traumatic stress scores were four times higher in children who had been quarantined than in those who
were not quarantined. 28% (27 of 98) of parents quarantined in this study reported great enough
symptoms to proven a diagnosis of a trauma-related mental health disorder, compared with 6% (17 of
299) of parents who were not quarantined. Another study of hospital staff examined symptoms of
depression 3 years after quarantine and found that 9% (48 of 549) of the whole sample reported high
depressive symptoms. In the group with high depressive symptoms, nearly 60% (29 of 48) had been
quarantined but only 15% (63 of 424) of the group with low depressive symptoms had been
quarantined.(Brooks et al., 2020). All other quantitative investigations, which generally found a
significant prevalence of psychological discomfort and disorder symptoms, only included those who had
been quarantined. Studies have examined post-traumatic stress disorder symptoms, general psychological
symptoms, emotional disturbance, depression, stress, poor mood, irritability, and stress symptoms. In one
study, post-quarantine symptoms of post-traumatic stress disorder and general mental health issues were
not significantly different between undergraduates who had been quarantined and those who had not. It's
probable that these findings cannot be applied to a larger population because the entire study sample
consisted of undergraduate students, who are often young and may have fewer obligations than adults
who are employed full-time.

Research Methods:
In spite of the Covid-19 pandemic affecting more people worldwide continuously, not only physique
health but also mental health support is required for those affected by it. It is also really essential to
maintain good mental health during Covid-19 as it may also prevent the relationship to physique health
((PDSKJI), 2020) conducted a survey on May 14, 2020, using the General Anxiety Disorder-7, Patient
Health Questionnaire 9, and Posttraumatic Stress Disorder Check List-Civilian version-17 questionnaires.
The survey included 214.988 people from 34 provinces, mostly from Jakarta (18,4%), Banten (7,4%),
West Java (22,7%), Central Java(10,8%), and East Java (12,4%). 75,8% of them are women and 24,2%
are men, the data shown in table 1. The most common symptoms of anxiety reported by the respondents
included feeling anxious that something bad will happen, worrying too much, getting angry or irritated
easily, and having difficulty relaxing. Sleep problems, lack of confidence, fatigue, and loss of interest
were the most prevalent complaints reported by those with depressive symptoms((PDSKJI), 2020).
Table 1. Psychological problems during COVID-19 in Indonesia as of Dec 26, 2022
Conclusion:
The current study identified out of the population (214.988 respondents), most of them have the highest
psychological issues due to quarantine and isolation, especially for those who already have psychological
problems that might getting worse due to the several restrictions which enforce to stay at home, social
distancing, work from home and etc. Despite of these issues, During the COVID-19 pandemic, the
Indonesian Psychiatric Association published recommendations for the general public on maintaining
mental health. The recommendations were initially based on WHO recommendations, which emphasize
four key aspects in battling stress and widespread anxiety brought on by the COVID-19 epidemic.
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