The Dual Role of Nurses in Adolescent Mental Health: A Systematic Review of Stigma, Policy Barriers, and Digital Health Challenges in Indonesia
TL;DR
A critical socio-technical gap is revealed in the scope of digital mental health resources for adolescents in Indonesia and nurses currently lack the competencies, guidelines, and systemic support needed to use them safely to bridge this gap.
Abstract
Background: Nurses in Indonesia are uniquely positioned to address adolescent mental health through digital tools while mitigating associated risks, yet no systematic review has synthesized evidence on this dual role. Objectives: This review aimed to map the scope of digital mental health resources for adolescents in Indonesia and assess digital risks impacting their care to clarify the nursing role. Methods: This systematic review followed the PRISMA framework. Four databases (PubMed, Scopus, Web of Science, and Google Scholar) were used in identifying 2,051 records. Inclusion criteria comprised peer-reviewed studies (2019-2024) focusing on mental health nursing within the Indonesian context. Exclusion criteria involved non-empirical articles, studies with non-Indonesian populations, and publications lacking full-text access or a DOI. After screening, 12 articles were selected. Methodological quality was appraised using CASP/JBI checklists by two independent reviewers, showing substantial agreement (κ = 0.71). Results: The synthesis identified three core themes: 1) pervasive systemic and socio-cultural barriers (e.g., stigma, low mental health literacy) that shape the care context; 2) notable absence of empirical research on nurses' use of digital resources or management of digital risks; and 3) consistent identified need for nursing capacity building and policy support. Quality appraisal revealed a mix of high, moderate, and low methodological rigors among the included studies, with substantial inter-rater agreement (κ = 0.71). Conclusion: This review reveals a critical socio-technical gap. Digital tools hold transformative potential, but nurses currently lack the competencies, guidelines, and systemic support needed to use them safely. To bridge this gap, the urgent development of a digital mental health competency framework for nursing education and the establishment of enabling policies are imperative.