Effectiveness of Video and Leaflet Educational Media in Increasing Adolescent Mental Health Literacy

Mental health determines the well-being of adolescents, because adolescence is a time when major changes occur in the body, psychology and society. Mental health literacy is important to increase the capacity of adolescents to face unexpected challenges, for this reason education is needed to increase literacy. Delivering education requires interesting media so that information can be conveyed well, video media and leaflets can be used as educational media. The aim of this research is to determine the difference influence of video and leaflet-based on education of adolescent mental health literacy at Bintang Harapan Vocational School Bekasi. This research design uses a two-group pretest-posttest design without control. The sample for this research was taken using proportionate stratified random sampling with a total of 210 adolescents who were divided into105 adolescents ach in the video and leaflet education groups. Mental health literacy was measured using the MHL-q (Mental Health Literacy-Questionnaire) questionnaire. Data analysis used the independent t-test. The results of the research show that there is no difference in the effect of video and leaflet interventions on adolescent mental health literacy with p value = 0.253 (p> 0.005), so it can be concluded that video and leaflet-based education are equally influential in increasing adolescent mental health literacy. Confounding factors that influence adolescent mental health literacy are gender and access to information. It is recommended that video and leaflet educational media can be used as health education media, especially to increase mental health literacy in adolescents.


INTRODUCTION
Mental health is defined as the ability a person has to be able to identify, overcome life stress, be productive, and have an impact on their environment (WHO, 2022).
Good mental health is important for adolescents, because adolescents must be able to build a broader self-identity and autonomy due to the need for new skills, responsibilities and social relationships (O'Reilly, M and Whiteman, 2018).
World Health Organization (2022) states that there are around 450 million people with mental disorders, 10 -20% of whom are adolescents globally.Riskesdas (2018) shows a significant increase in the prevalence of mental disorders in Indonesia, namely from 1.7% to 7% in 2018.The prevalence rate of emotional mental disorders in West Java among those aged over 15 years increased from 6.5% to 12.1% in 2018 (Wahdi, 2023).The Central Statistics Agency (2023) shows that the population of adolescents aged 15 -19 years in Bekasi is 317,809 adolescents, which is the second largest population of adolescents in West Java province.Bekasi District Health Profile (2022) shows an increasing visitation to mental health services at all age levels, namely from 62.49% in 2021 and increasing in 2022 to 66.14%.The data above shows that this situation is due to a lack of promotional outreach related to mental health (Bekasi District Health Office, 2022).
Research by Sapta Aryantiningsih et al., (2023) states that 96.4% of nearly 400 adolescents do not know how to deal with mental disorders.One of the impacts that possibly occur with mental disorders is the risk of self-injury (Alini and Meisyalla, 2022).The increase in mental disorders in adolescents and a lack of understanding about mental health indicate that there is a need to promote healthy mental health education, and ignorance about mental health can also indicate an inability to develop mental health literacy (Rudianto, 2022).Adolescent mental health disorders are not detected from the beginning.It is caused by the reluctance of parents and adolescents to get mental health treatment from professionals.Cost factors, stigma, lack of understanding about mental health, lack of information, and difficulty in getting services are some of the causes of this reluctance (Ridout & Campbell, 2018).

Mental health literacy (MHL) is an
individual's knowledge and beliefs about mental disorders that help the recognition, management and prevention of mental disorders (Lee, H.Y, et al. 2020).Promotion of mental health literacy through health education helps adolescents achieve and maintain positive psychosocial conditions, which helps adolescents overcome daily life challenges (Ahorsu et al., 2021).
Educational media is important in the process of conveying information.The effectiveness of using health education media is largely determined by the number of senses of reception involved.The more senses are used, the easier it is to understand the delivery of the extension message (Jatmika et al., 2019).The data collection technique was carried out using a pretest and posttest questionnaire via Google Form.The instrument used was the MHL-q (Mental Health Literacy-questionnaire) questionnaire for young adults which was adopted from research by Dias et al (2018) and Kristina & Farrukh (2023).
The stages of research implementation were education in groups using leaflets in the

RESULTS AND DISCUSSION
The results of the univariate research can be seen in the following Table 2 shows that the gender variable in the leaflet group was mostly female, namely 66 people (62.9%), in the video group the majority were female with 61 respondents (58.1%).The ethnic variable shows that in the leaflet group the majority were Sundanese with 42 respondents (40%) and in the video group there were Javanese with 42 people (40%).The monthly parental income variable in the leaflet group was mostly 61 respondents (58.1%) with parental income above the minimum wage, in the video group the majority was 64 respondents (61%) with parental income above the minimum wage.
Table 2 shows the access to mental health information received by respondents in the leaflet group, most of whom used 1 to 3 access information, totaling 72 respondents (68.6%).The type of information access that is frequently accessed is social media using cellphones with 58 respondents (55.2%).Similarly, in the video group, the number of accesses to mental health information sources received mostly used 1 to 3 accesses with 69 respondents (65.7%).The type of information access that is frequently accessed is social media using cellphones as many as 49 respondents (46.7%).
The variable access to mental health services available in the nearest area in the leaflet group shows that the majority stated that there was no access to mental health services nearby in their area, the total of 69 respondents (65.7%), and in the video group, 56 respondents (53.3%) stated that there was no access to services.nearest mental health center in the area.Sex is the biological difference between male and female known as gender (Kutcher, 2016) (Wong et al., 2020).
Access to health information becomes a liaison that connects information sources, so that the information needed by each individual can be fulfilled (Handayani, 2020).The current situation, where easy access to information through various images and sound so that it can attract the attention and interest of the target so that it is easier for the target to understand and can be repeated at any time if necessary (Jatmika et al., 2019).

The influence of education using leaflets on adolescent mental health literacy
In this research, education using leaflets had an effect on adolescents' mental health literacy because in the research process, after health education was carried out, leaflets were distributed to each student and could be taken home so that respondents could read them repeatedly and it didn't take a long time.Here it can be seen that providing specific, valid and targeted knowledge and education can increase adolescents' mental health literacy.
This research is parallel with Ramdaniati to record the information conveyed (Jatmika et al., 2019).

The Differences between video-based education and using leaflets on adolescent mental health literacy
The research results showed that there was Media that have been developed to increase mental health literacy include the book Promoting Alternative Thinking Strategies (PATHS) developed by Kusche & Greenberg (2018) which explains mental health literacy by including games, crafts and stories based on pictures specifically for pre-school and primary school.Furthermore, the poster media created by Jafar & NR (2023) regarding the effectiveness of online psychoeducation in late adolescents shows an increase in participants' knowledge of literacy interventions in improving mental health.Different from previously developed media, the video and leaflet-based educational media created by researchers has newness, namely that the education provided not only contains knowledge about mental health literacy but also provides education about first aid skills, help-seeking behavior and self-help strategies.overcoming mental disorders in teenagers.Where education is carried out directly to adolescents by looking at the differences in effectiveness between the video media and leaflets used.Based on the description above, the researcher aims to explain the differences in the influence of video and leaflet-based education on mental health literacy in adolescents at Bintang Harapan Vocational School Bekasi.METHOD This research is an experimental design research.The design of this research is a two-group pretest-posttest design without control.This experimental research was carried out in two intervention groups, namely the video-based education group and the education group using Leaflets.The population in this study was all students at Bintang Harapan Vocational School from 736 students consisting of class X with 248 students, class XI with 260 students and class XII with 228 students.The sample size calculation in this study used the G-power statistics application.The total sample in this study was 210 respondents, namely 105 respondents for the video-based educational intervention group and 105 respondents for education using leaflets.The sampling technique in this research used a probability sampling technique with proportionate stratified random sampling.The inclusion criteria in this study are students who officially registered at the school, students are in good health and cooperative and participated in the research process from the beginning to the end.The exclusion criteria in this study were students who had previously received mental health education and students who were under the supervision of a counseling guidance teacher.
media sources has the opportunity to increase knowledge about mental health literacy.Continuous exposure to positive information forms positive views and habits in adolescents' lives, that adolescents are very curious about new things which can be an opportunity to increase their health literacy.This research was conducted in the Bekasi Regency area, where the area has been exposed to modernization but has limited access to mental health in the area, the community health center in the local area does not yet provide mental health services that should be able to run in accordance with the government program so they have to be referred to a regional hospital which is far away from residence.Private hospitals in the surrounding area have not yet opened psychiatric clinics, so access to mental health services can be a factor inhibiting help-seeking behavior.The effect of video-based education on adolescent mental health literacy In this research, video education has an effect on increasing adolescent mental health literacy because videos can integrate the senses of sight and hearing where information is better absorbed.The video media that the researchers created presents interactive information to increase adolescents' interest, thereby increasing adolescents' mental health literacy in managing their mental health in the hope of helping teenagers to detect mental disorders, increasing help-seeking behavior, and reduce the stigma of mental disorders.Tito's research (2023) in Surakarta found that there was an influence of animated videos on increasing adolescents' mental health literacy in Muhammadiyah Middle Schools.Animated video content that pays attention to several things such as image selection, color and animation effects in the video can have a positive impact on someone.Adjusting the theme or content and duration of the animated video is also a component to achieve the goals of the animated video (Efendi et al., 2022).The advantage of video media is that it produces

( 2022 )
that there is an influence of leaflet media on increasing knowledge and attitudes towards preventing Covid-19 at Islamic State Senior High School 1 Pandeglang.The advantage of leaflet media can provide more detailed knowledge about knowledge and with the existence of leaflets for outreach targets there is no need

table : Table 1 .
Distribution of respondents based on adolescent age at Bintang Harapan Vocational School, October 2023 (n=210) Source: Primary Data, 2023Table 1 shows that the average age of children in the leaflet group is 16.81 years with a standard deviation of 0.722 years.Meanwhile, the average age of children in the video group was 16.67 years with a standard deviation of 0.780 years.Respondent characteristics data can be seen in the table below:

Table 2 .
Distribution of respondents based on gender, ethnicity, parental income, access to information, access to mental health services for adolescents in video-based educational groups and using leaflets, October 2023 Source: Primary Data, 2023

Table 3 .
Average of mental health literacy before and after video and leaflet-based education for adolescents at Bintang Harapan Vocational School, October 2023 (n=210)

Table 5 .
The difference in average of mental health literacy between video and leaflet-based education groups for adolescents at Bintang Harapan Vocational School, October 2023 (n=210) Source: PrimaryData, 2023