Psychosocial Support During and Post Covid-19 Pandemic1 August 2022 Key Messages ▪ The COVID-19 pandemic has affected the ▪ Existing regulations could be wellbeing of Indonesian students, including strengthened to include specific both physical and mental health. guidance on practical yet systematic framework for psychosocial support. ▪ It is important to provide psychosocial This would enable policy actions to support especially for those whose families focus on a whole-child approach, have been most affected by financial building the resilience of children in pressures and the loss of family members. their families, schools and communities. Objective of this Note This technical note briefly summarizes the current situation regarding psychosocial support for children and their teachers and counsellors, their needs and the existing support system, and synthesizes the findings from a discussion on the subject during Australia-World Bank Indonesia Partnership (ABIP) workshop: ‘ The Importance of Student Psychosocial Support during the COVID-19 Pandemic.’ The workshop was held together with Ministry of Religious Affairs (MoRA) and other relevant education stakeholders, on November 25, 2021 - and aimed to: • Understand how the pandemic has affected children’s wellbeing in Indonesia, and • Provide policy options and practical recommendations on how to provide psychosocial support for students, especially those most affected by the pandemic. 1 This technical note has been written by Petra Wiyakti Bodrogini. It summarizes the discussions from a series of technical workshops. Noviandri Nurlaili Khairina, Shinsaku Nomura, and Indah Shafira Zata Dini provided inputs to this technical note and Sheila Town provided editorial support. The note is designed by Nuriza Saputra. The authors appreciate funding for this study provided by the Australia World Bank Indonesia Partnership (ABIP) through the Government of Australia’s Department of Foreign Affairs and Trade. 1 Introduction The long school closures over the course of the COVID-19 pandemic has hampered the global education system, resulting in substantial learning losses and widened inequalities in learning. The World Bank’s Hify Survey revealed that disadvantaged children in the bottom 40% in rural areas and outside Java faced bigger learning gaps than their peers in wealthier families and in urban areas (The World Bank, 2020). Learning from home was a challenge for many who missed out on social interaction with peers and struggled to keep up with online classes, with the additional challenge of reduced family incomes for many. Many children lost family members to the virus and other related causes during this time. All of these factors will have affected children’s mental health, and children with disabilities and other marginalized groups will have been even more deeply affected. In Indonesia, the Ministry of Social Affairs (MoSA) revealed that as of July 20, 2021, a total of 11,045 Indonesian children had lost one or both parents to the coronavirus (MoSA, 2021). By September 2021, this number had increased to 25,430 children (UNICEF, 2021a). Severe disruptions in daily life, social isolation from peers, and pressure to learn from home with limited guidance have impacted children’s mental health (UNICEF, 2021b). Forty-five percent of children have been experiencing difficulties in concentrating, 13 per cent have become angrier and 6.5 per cent have experienced sleep difficulties. The Government of Indonesia (GoI), through its relevant ministries (the Ministry of Health, MOH, the Ministry of Education, Culture, Research and Technology, MoECRT, the Ministry of Social Affairs, MoSA and the Ministry of Religious Affairs, MoRA), acknowledges the importance of psychosocial support for students and teachers in schools and madrasahs, particularly for those most affected by the pandemic, issuing joint regulations to provide guidance for teachers and educational staff to implement psychosocial support. MoSA implements the Social Rehabilitation Assistance Program (ATENSI) to fulfil children's basic needs (i.e medical assistance, vitamins, swab/PCR tests, vaccinations) and offer counseling to orphaned children and their extended families, as the loss of from parents can cause further mental health disruption. This program also offers foster care services (MoSA, 2021). Covid-19 Pandemic Effects on Children’s Wellbeing • Child health was affected. COVID-19 affected children’s growth and development and led to behavioral change and sleep disorders in Indonesia (Sekartini, 2021). Cases of malnutrition, obesity, vitamin D deficit, lack of physical activities and more screen time are also reported. According to this report, children’s nutrition needs to be appropriate to their development and body endurance should be supported with vitamins and enough sleep. • Reduced psychological wellbeing. A recent study by UNICEF (2021c) revealed that by September 2021, most children in Indonesia who lost their primary care givers are being raised by sole female caregivers or by their extended families. Out of 25,430 children who lost their parents due to COVID-19, 114 were living without adult caregivers. Twenty percent of 15-24 year-olds stated that they were depressed or had low 2 interest in doing any activities. They perceived the current situation as unpredictable and stressful (UNICEF, 2021; UNICEF, 2022). Furthermore, violence against children also reached 3,314 cases in 2021 (MoECRT, 2021a). Furthermore, in respect to how students react to social distancing, the UNICEF U-Report poll results show that reduced social interactions during the pandemic hav e affected students’ mental health. Globally, the risk of mental illness, anxiety and depression among children and teenage students has increased considerably during COVID-19 as a likely consequence of lacking socialization (Racine et.al, 2021). In parallel, a survey conducted by UNICEF and Gallup in 21 countries in the first half of 2021 showed that almost one in three young people in Indonesia reported often depressed feeling or having little interest in doing things (UNICEF, 2021c). Consistent results also emerged from MoECRT survey which showed that 16.6 per cent of students experienced emotional struggles during the pandemic. Girls tended to show higher stress rates than boys, with average scores of 13.98 and 12.81 respectively (MoECRT, 2021). A case was presented from Sekolah Cikal that students have been facing a number of issues since the pandemic began, including losing interest in learning, socialization, communication problems with parents, dependency issues, grief, financial challenges, and future uncertainty (Savitri, 2021). • Teachers also experienced challenges. Mental health issues also affected teachers (Hestiyanti, 2021). They experienced increasing workloads due to demand for online interactions using digital devices, difficulty limiting work time and time to rest. Some also reported that they lacked support to help them adapt and provide optimal services and this led to confusion, anxiety and stress. Teachers also reported experiencing anxiety, mental fatigue, and procrastination (Saripah in Hestiyanti, 2021). Contract teachers also suffered from loss of income (Indasari et. Al in Hestiyanti, 2021). Rethinking What Needs to Be Done • More concrete policy guidance on psychosocial support can strengthen psychological services. Revised Joint Regulations on Teaching and Learning Guideline During the COVID-19 Pandemic were issued in November 2021, by MoECRT, MoRA, MoH, and MoHA. Relevant key regulations have been issued even prior to the pandemic and can be further enhanced to support psychosocial services for students based on the needs identified above. ▪ Revised Joint Ministerial Decrees on Teaching and Learning Guideline During the COVID-19 Pandemic 2 emphasize the role of educators and COVID-19 task forces to provide psychosocial support to students. However, more elaboration is needed to provide options for support and how to implement it. • MoECRT Regulation No. 111/2014 on Guidance and Counseling and Guidelines in Primary and Secondary Education. This regulation explains the principles, objectives, mechanisms, and strategies and procedures for the implementation of Guidance and Counseling Services in educational units which aims to achieve students’ optimal development. This regulation needs to be updated to accommodate specific guidance on psychosocial services for students affected by COVID-19 2 Revised Joint Ministerial Decrees of Four Ministers of Minister of Education, Culture, Research and Technology, Minister of Religious Affairs, Minister of Health, and Minister of Home Affairs No. 03/KB/2021; No. 384 Year 2021; MoH No. HK.01.08/Menkes/4242/2021; and No. 443-5847/2021 on Teaching and Learning Guideline during the COVID-19 Pandemic. A Circular No. 2/2022 on Discretion of Teaching and Learning during COVID-19 Pandemic was further issued for adjustments 3 circumstances. Reference can also be made to MoECRT’s book on Preliminary Psychological Support Mode Development for Children and Teenage Education, which was issued in 2018. • The MoECRT Regulation No. 15/2018 on Teachers, Principals, and School Supervisors Workload. The regulation elaborates the main and additional workload of teachers, principals, and school supervisors at the base administration unit. This determines a 1:160 school counselor-student ratio. However, even in well-established private school such as CIKAL, one counselor is responsible for around 200 students and involves classroom teachers to provide direct support to their students. Regular meetings are held and chaired by the school psychologist and counselors to provide mentorship to the teachers so that they can play this role (Savitri, 2021). • Mapping of student well-being to aptly address their psychosocial support needs. During the pandemic, MoECRT (2021) developed a Policy Brief on Improving Psychological Wellbeing of Students. This brief discussed students’ mental health mapping based on Str ength and Difficulties Questionnaires and Psychological Well Being inventories. Similarly, this approach could provide model for MoRA to undertake the mapping of current madrasah students’ psychological wellbeing and use this information to inform specific guidelines for madrasahs students and teachers. • Making the curriculum work. Drawing from the workshop discussion, the attempt to deliver all content in the curriculum was seen to have added to student stress during the learning from home period. Some students also experienced quite limited parental guidance or mentorship. Hestiyanti recommended using the Curriculum in Special Conditions developed by MoECRT and continuing to use a student-centered learning approach. These efforts combined could benefit student mental health. MoECRT’s simplified curriculum offers flexibility in learning and schools can determine what works for their context3. However, the definition of the student-centered approach during remote learning needs to be adjusted to include providing space to students for them to voice their concerns and connect them with psychological services if needed (O’Hara, 2021). In the Indonesian context, the student-centered approach means that curriculum is being delivered according to student needs and in support of their wellbeing (KSI, 2020; MoECRT in Supriyadi, 2020) • Take a systematic approach by: ▪ Building psychosocial support based on more systematic framework. This can be done by optimizing internal resources (individual’s own resources) and external resources (those own by the community and social environment). The main goal of psychosocial support is to obtain psychosocial recovery, to restore individuals, families, groups or community to be able to function normally, to be empowered and to be more resilient in facing challenges. This can be achieved through three-fold efforts: i) strengthening of psychosocial protection; ii) removing psychosocial stressors; and iii) reducing post-traumatic risks (Hestiyanti, 2021). ▪ Focusing on student resilience. Resilience is the key to minimizing risks and increasing protection against traumatic events or stress. This needs a systemic effort and a model of Biological and Resilience Framework as used by the Center for Family Resilience and Development or Pusat Ketangguhan dan Pembangunan Keluarga (PKPK) Atma Jaya. The strength of such a model is that individuals will be understood and supported within their life context and systems. According to this 3 During the pandemic, MoECRT issued Minister Decree No. 719/P/2020 on Curriculum Implementation Guideline for Educational Units during Special Conditions. 4 model, interventions are aligned with the severity of the students’ psychological problems, ranging from mild disturbances to more serious psychological disorders. Family members, schools and communities (e.g.: volunteers and social workers) can play a greater role in addressing stress and mild psychological issues through psychological first aid. A Guideline for Mental Health and Psychosocial Support has also been developed for use by health professionals in Community Health Centers or Pusat Kesehatan Masyarakat at sub-district level (MoH, 2020). However, referral to mental health professionals is needed for moderate and more severe cases. Figure 1. Bioecological and Resilience Framework (Sourcer: Hestiyanti, 2021) • Develop a practical guideline on psychosocial support for students, presenting required knowledge, and options which can be taken by schools, counselors, and teachers. This could include although not limited to the following: ▪ Understanding of nature of the crises that caused psychological discomforts or traumatic events (Hestiyanti, 2021). This can inform how school counselors or teachers and other educational staff help the impacted students to develop coping mechanisms and re-establish healthy relationships with themselves, families, friends, and environment. ▪ Understanding and make explicit the roles and responsibilities of educators in psychosocial support. Principals, school counselors, and classroom teachers have different roles and may take different approaches in supporting their students to cope with their problems. For example, while school 5 counselors can provide counseling sessions for students and train classroom teachers on how to support students and liaise with parents, principals or vice principals can map students’ problems and give strategic guidance to counselors (Savitri, 2021). ▪ Whole-child Remedy. Parental training is needed to be able to provide parents with knowledge and know-how in educational play, encouraging a balance diet, promoting physical activities, appropriate screen time and content, more family time to create a deeper bond between parent and child, and early detection of traumatic children and immediate support (Sekartini, 2021). ▪ Access to counseling services, including online counseling. Schools and madrasahs are to partner with counseling services. These services are available both online and offline, and information on how to access them could be made available for these schools and madrasahs. Online services were mainly triggered during the pandemic restrictions and responding to the need for the service. The Indonesian Psychologists Association or Himpunan Psikolog Indonesia (HIMPSI) and other similar associations or communities offer free online counseling for the public (Yuliana, 2021). Schools/madrasahs or Education Offices can establish partnerships with these service units to mitigate the need for more school counselors. ▪ Use data obtained from student well-being profiling to serve as guidelines for psychosocial support. Student profiling can identify factors such as living condition, family financial situation, parental and peer support that influence student s’ socioemotional state. Data should also consist available services on child protection, healthcare, family support, and other related assistance that offer psychosocial support and offer evidence to address challenges and support for student well-being. ▪ Consider international experience to strengthen the existing programs in Indonesia. Indonesia can also learn from other countries Mental Health and Psychosocial Support (MHPSS) programs. Some examples are: Dominican Republic with support from UNICEF, provide a remote psychosocial support for children, adolescents, and their families via landline, WhatsApp calls, WhatsApp chats, web chat, and videocalls; Trinidad and Tobago rolled out a psychosocial plan for students which later mandate that each student of each class level must benefit from at least one interactive session with the guidance officer/counsellor within every eight-day cycle; and Mozambique conduct training for teachers using MHPSS training manual and recently has been scaled up to reach 83,000 primary school teachers. Lessons learned can add insights for policy making. References Hestiyanti, Y. R. (2021) Pendekatan Sistemik: Kerangka Kerja dan Pedoman. Pusat Ketangguhan dan Pembangunan Keluarga Fakultas Psikologi Unika Atma Jaya. ABIP Workshop 3: Psychological Support for Students During and Post-Pandemic Covid-19. Jakarta, 25 November 2021. Joint Ministerial Decrees of Four Ministers on Teaching and Learning Guidelines during the COVID-19 Pandemic: MoECRT Stipulation No. 03/KB/2021; MoRA Stipulation No. 384 Year 2021; MoH Stipulation No. HK.01.08/Menkes/4242/2021; MoHA Stipulation No. 443-5847 (2021). Knowledge Sector Initiative (KSI) (2020, August 28) Layanan Pendidikan Harus Disesuaikan dengan Kondisi Siswa. Retrieved from: https://www.ksi-indonesia.org/en/wawasan/detail/2135-layanan- pendidikan-harus-disesuaikan-dengan-kondisi-siswa MoEC Regulation Number 111/2014 on Guidance and Counseling and Guideline in Primary and Secondary Education (2014). MoEC (2018) Development of Early Psychological Support Model for Children and Teenage Education. Jakarta: MoEC MoECRT Regulation Number 15/2015 on Teachers, Principals, and School Supervisors Workload. (2015). 6 MoECRT (2021) Risalah Kebijakan: Mendorong Peningkatan Kesejahteraan Psikologis Siswa Selama Pandemi COVID-19. June 2021. Jakarta: MoECRT. MoH (2020) Pedoman Dukungan Kesehatan Jiwa dan Psikolosial Pada Pandemi COVID-19. Retrieved from: https://infeksiemerging.kemkes.go.id/download/Pedoman_Dukungan_Kesehatan_Jiwa_dan_Psik ososial_pada_Pandemi_COVID19.pdf MoSA (2021, August 6) Perlindungan Anak yang Kehilangan Orangtua Akibat Covid-19. [Press release]. https://kemensos.go.id/perlindungan-anak-yang-kehilangan-orangtua-akibat-covid-19 O’Hara, R. (2021, February 8) Redefining Student-Centered Education During a Pandemic. Retrieved from: https://evolllution.com/programming/personal-development/redefining-student-centered- education-during-a-pandemic/ Savitri, I. (2021) Peran Sekolah dalam Menangani Murid-Murid yang Terimbas Pagebluk Covid-19. ABIP Workshop 3: Psychological Support for Students During and Post-Pandemic Covid-19. Jakarta: 25 November 2021. Sekartini, R. (2021). Anak-anak Menghadapi Covid-19: Perawatan dan Dukungan. ABIP Workshop 3: Psychological Support for Students During and Post-Pandemic Covid-19. Jakarta: 25 November 2021. Supriyadi, E. (2020, August 12) Kemendikbud Terbitkan Kurikulum Darurat pada Satuan Pendidikan dalam Kondisi Khusus. Retrieved from: https://lpmpkaltara.kemdikbud.go.id/2020/08/12/kemendikbud- terbitkan-kurikulum-darurat-pada-satuan-pendidikan-dalam-kondisi-khusus/ The World Bank (2020). Indonesia High-Frequency Monitoring of COVID-19 Impacts. Round 4. Retrieved from: https://pubdocs.worldbank.org/en/699911612171364251/Indonesia-HiFy-COVID-19- November-2020.pdf UNESCO, UNICEF, the World Bank, OECD (2021). Survey on National Education Responses to COVID- 19 School Closures, Round 3. Paris, New York, Washington D.C.: UNESCO, UNICEF, World Bank, OECD 7