Mental Health of Couples in Early Adulthood

Background: Mental health is a crucial aspect in the well-being of married couples, especially in early adulthood. The transition from single life to marriage, living together with economic and social challenges, and new roles have a significant impact on couples' mental health. Objectives: This study aims to assess the mental health of married couples in early adulthood. Methods: This quantitative study used a cross-sectional design with a sample of 80 married couples selected by purposive sampling. Using the Self Reporting Questionnaire 20 (SRQ 20) instrument to measure couples' mental health. Data were analyzed using descriptive statistical methods. Results: The majority of husbands in this study worked (96.25%) and 78.68% of couples were in the lower middle economic category. The average mental health of husbands was 5.24 (SD = 1.865) which means mentally healthy (normal), while the mental health of wives averaged 6.38 (SD = 1.604) which means indicated to have psychological disorders. Conclusion: In couples in early adulthood, it was found that the average wife had mental health problems in the form of psychological disorders while the husband had normal or mentally healthy mental health.


INTRODUCTION
Mental health is an integral component of general health that encompasses emotional, psychological, and social well-being (1).In early adult married couples, mental health is a key factor in determining the quality of marital relationships and the stability of family life (2).The early adulthood phase, which generally lasts between the ages of 20 and 40, is a critical period during which individuals undergo a variety of significant transitions, including the transition from single life to marriage, family formation, and career development (3).Amidst these dynamics, married couples often face pressures that can significantly affect their mental state (4).Globally, many studies have shown that married couples in the early adult phase are vulnerable to various mental health problems, such as depression, anxiety, and stress, which can be caused by a combination of internal and external factors (5).Internal factors include individual characteristics such as personality, coping skills, and perceptions of roles and responsibilities in marriage (6).Meanwhile, external factors include the social and economic environment, such as employment status, income, and living conditions that can put additional pressure on couples.In Indonesia, where social and economic structures are still undergoing significant development, early adult married couples often face unique challenges related to culture, social norms and economic disparities (7).Economic stress is one of the main determinants of mental health of early adult married couples in Indonesia.With many societies still relying on the husband as the main breadwinner, heavy economic burdens can increase the risk of mental disorders, especially among men (8).Economic pressures not only increase individual stress but can also affect marital relationship dynamics by increasing conflict and decreasing marital satisfaction.Furthermore, strong norms of masculinity in Indonesian culture may inhibit husbands from seeking support or help when experiencing emotional distress, ultimately worsening their mental health conditions (9).In addition, the length of the marriage also plays an important role in determining the mental well-being of the spouses (10).The early years of marriage are often the most difficult period of adaptation, where couples must navigate different expectations and develop strategies to manage conflict and life stresses.In the first years of marriage, couples tend to be more vulnerable to stress because they have not had sufficient experience in managing the marital relationship.They may also not yet have a strong social support network, which can serve as a buffer against psychological distress (11).On the other hand, couples who have been married longer tend to have better coping skills and more established social support, which can help them cope more effectively with the stresses of life (12).

OBJECTIVE
This study aims to determine the mental health picture of early adult married couples.

METHODS
This type of research is quantitative research with a cross-sectional design.The research was conducted in April-July 2024.The study population was all married couples who were early adults and married from 2017 to 2022 and were in the Gunung Bungsu Health Center working area.The sample amounted to 80 married couples with purposive sampling technique.The instrument used to measure the mental health of married couples is the Self Reporting Quetionnaire 20 (SRQ 20) which has been valid and reliable.Ethical approval has been obtained from the Ethics Committee of the Faculty of Nursing, Andalas University.Data were analyzed using SPSS software.Data analysis using descriptive statistical tests.

RESULTS
Table 1 This study describes the demographic characteristics of early adult married couples.Table 1 shows that the majority of husbands (96.25%) were employed, and only 3.75% were unemployed.This reflects the significant involvement of husbands in economic activities in the study area.In addition, the economic status of the couples showed that more than half (78.68%) of the respondents had an income below 3.3 million rupiah per year, or below the Regional Minimum Wage (UMR), and 10.97% of the couples earned above 3.3 million rupiah per year.This data confirms that the majority of couples in this study are in the middle to lower economic category.The distribution of marriage age is also shown in this table, with more than half (62.5%) of the couples having been married for 3 to 5 years, and 37.5% with a marriage age of 1 to 2 years.This distribution illustrates the length of marriage among respondents, many of whom have been married for more than 3 years, reflecting the different relationship dynamics in the context of their marriage and the adaptation process that each couple has undergone.

DISCUSSION
This study revealed various dimensions that influence the mental health of early adult married couples, including aspects of employment, economic status, marriage duration, and gender roles.The following discussion expands the analysis of these findings.

Mental Health of Couples
This study found that the average mental health of husbands was 5.24, which is considered to be within normal limits.In contrast, the mean mental health of wives was 6.38, which indicates an indication of psychological impairment.This difference may be related to the double burden often experienced by wives, especially in the household context where wives may be responsible for household chores in addition to working.In addition, social and cultural factors that emphasize the wife's traditional role as the primary caregiver of children and manager of the household may also contribute to increased stress and psychological distress in wives.Husbands' mental health scores ranged from 2 to 12, while wives' ranged from 3 to 11.The higher range for husbands indicates greater variability in their mental health, reflecting the various external factors that affect their well-being, such as work pressures and financial responsibilities.
Husbands in this study tended to have more stable mental health than wives, although they also faced significant economic pressures.The traditional role of husbands as the primary breadwinner can put them in a vulnerable position to stress, especially when cultural expectations and economic realities do not align (13).This is reinforced by Nolen-Hoeksema's (2001) study, which showed that men are often less open to expressing their emotions due to strong masculinity norms, so they may not seek psychological help despite experiencing high stress (14).As a result, this stress can build up and potentially lead to long-term mental health problems if not properly addressed (15).

The Impact of Social Environment on Mental Health
Mental health is not only influenced by internal factors such as personality and coping ability, but also by the social environment in which the couple is located (16).In the Indonesian context, where social and economic norms are still evolving, married couples often have to navigate complex challenges, including pressure from extended family, societal expectations, and limited access to mental health services (17).Social support plays an important role in maintaining one's mental balance, but access to this support can be limited by social and economic factors (18).Therefore, couples who have better social support, such as a strong network of family and friends, tend to be better able to cope with stress and maintain their mental health (19).

Economic Gap and Inequality
Almost all (96.25%) husbands reported working, while only 3.75% were not working.This indicates that the majority of husbands act as the main breadwinners in the family.This data is consistent with findings from various recent studies that highlight the traditional role of men as economic providers in the family, despite the increasing participation of women in the workforce.A total of 78.68% of the couples had an income below the minimum wage (3.3 million rupiah per month), indicating that most families were in the lower-middle economic category.Low economic factors are often associated with increased stress and psychological burden in the family, which can negatively affect the mental well-being of the couple.Only 10.97% earn above the minimum wage, indicating that only a small proportion of couples are in the upper-middle economic category.The economic disparity experienced by the majority of respondents in this study reflects the broader socioeconomic reality in Indonesia, where many married couples live below a decent economic standard.This condition not only affects their material well-being but also has a direct impact on their mental health (20).Low-quality jobs or inadequate wages can worsen psychological well-being, especially if individuals feel they have no control over their economic conditions.In this context, pressure to meet basic needs and economic uncertainty can trigger feelings of anxiety and depression, which in turn worsen mental health (21).

Marital Adaptation and Mental Health Stability
Most couples (62.5%) have been married for 3-5 years, while 37.5% have been married for 1-2 years.
Other studies have shown that the early years of marriage are a critical period where couples often face challenges in adjustment and adaptation to each other.Therefore, a longer duration of marriage may be associated with higher stability in the relationship, although this does not necessarily reduce the potential for conflict.The early phase of marriage is often identified as the most challenging time for couples, where they have to adjust to new roles, responsibilities and expectations of the marriage itself (22).Marital quality is strongly linked to personal well-being, with couples who successfully manage conflict and adjust to married life likely to have better mental well-being.Couples who are able to develop effective coping strategies and build strong social support are more likely to maintain stability in their mental health over time (10).

CONCLUSION
The mental health of early adult married couples is influenced by various factors, including gender roles, economic status, social environment, and marital dynamics.The results show that wives are more vulnerable to mental health disorders than husbands, due to the pressures of traditional gender roles and greater household responsibilities.In contrast, husbands tend to have more stable mental health, although they also face significant economic pressures.This study highlights the importance of understanding demographic characteristics and mental health in the context of marriage.The husband's high level of employment, lower-middle economic status, and differences in marital duration are factors that may influence the relationship dynamics and psychological well-being of couples.In addition, significant differences in mental health between husbands and wives suggest the need for specific interventions to support wives' mental health, especially in the face of double burden and stressful traditional roles through psychosocial support and policies that support economic and social well-being to improve the mental health of early adult married couples in Indonesia.Appropriate and comprehensive interventions are needed to address the vulnerabilities faced by wives in the context of mental health.

Table 2 : Mean Mental Health of Early Adult Married Couples (n=80)
In table 2. it can be seen that the husband's mental health averages 5.24, which means that the husband's mental health is within normal limits with the lowest value of 2 and the highest of 12.Meanwhile, the wife's mental health averages 6.38, which means that the average wife is indicated to have psychological disorders with the lowest value of 3 and the highest of 11.