Knowledge/Understanding, Perception and Attitude Towards ADHD in Indonesia
Nandini Jhawar & Kevin Antshel, Ph.D.
Department of Psychology
ADHD Lifespan Treatment, Education and Research (ALTER) program
ADHD prevalence rates in low- and middle- income countries (LAMICs) are approximately 6.1% (Bitta, Kariuki, Abubakar, & Newton, 2018), but the majority of ADHD research takes place in high income countries, like the United States, Western Europe, and China. Murtani and colleagues (2020) surveyed 1,536 Indonesian community members, teachers, general practitioners, medical students, pediatricians, and psychologists about their levels of knowledge regarding ADHD symptoms and treatments, perceptions of ADHD symptoms impact upon daily functioning, and attitudes towards ADHD treatment. Most healthcare professionals had heard of ADHD, but more than half the general practitioners, pediatricians and psychologists were classified as having poor to very poor range of knowledge and understanding of ADHD, perceptions of ADHD, attitudes towards ADHD. The majority of psychologists did not consider ADHD to be a mental disorder. Close to 60% of psychologists in the study endorsed flavoring ingredients as a risk factor for ADHD and only 30-40% of psychologists agreed that Methylphenidate and Atomoxetine should be used in ADHD treatment. Only 32% of the community sample were familiar with ADHD, although most knew the term “hyperactivity.” Community members and medical students obtained most of their information regarding ADHD from online sources, while teachers obtained their information from media sources, and medical practitioners from books.
The results from the Murtani et al. study are important for building understanding of existing knowledge, perceptions and attitudes towards ADHD diagnoses and treatment in LAMICs and Asian countries beyond China. Collectively, these data suggest that ADHD knowledge, perceptions and attitudes in Indonesia are considerably lower than what is reported in other countries, including in other Asian countries. Murtani and colleagues note a circularity to this problem: without any experiences regarding ADHD, Indonesians lack important information regarding the condition, leading to poor attitudes and perceptions surrounding ADHD. In 2016, the Indonesian Psychiatric Association established an ADHD diagnosis and management guideline which was specifically developed for general practitioners and pediatricians. In addition to policy level work such as this, Murtani and colleagues recommended culturally sensitive psychoeducational interventions for community members and healthcare professionals to optimize intervention outcomes.
This line of research has important clinical and public policy implications as countries with more limited resources, such as Indonesia, can greatly benefit from incorporation of evidence-based interventions into existing healthcare structures. Challenges such as difficulty implementing mental health services in primary care settings, difficulty disseminating treatments in rural areas, stigma associated with mental health disorders, and a dearth of knowledge about child development and childhood mental disorders all represent major hurdles for the treatment of child mental health disorders and the conduct of clinical research in all countries yet especially those with more limited resources.
Bitta, M., Kariuki, S.M., Abubakar, A., & Newton, C.R.J.C. (2018). Burden of
neurodevelopmental disorders in low and middle-income countries: A systematic review and meta-analysis. Wellcome Open Research, 2, 121. doi: 10.12688/wellcomeopenres.13540.1.
Murtani, B. J., Wibowo, J. A., Liu, C. A., Goey, M. R., Harsono, K., Mardani, A. A. P., & Wiguna, T. (2020). Knowledge/understanding, perception and attitude towards attention- deficit/hyperactivity disorder (ADHD) among community members and healthcare professionals in Indonesia. Asian Journal of Psychiatry, 48, 101912. doi: 10.1016/j.ajp.2019.101912