Does major make a difference? Mental health literacy and its relation to college major in a diverse sample of undergraduate students

Examining a large number of specific college majors and their association with mental health literacy (MHL) is an important step towards identifying at-risk groups at the college level. Though prior research has investigated MHL across student demographics such as gender, age, ethnicity, and level of education, the present study was the first to compare the MHL of undergraduate students across 19 different college majors. A total of 617 demographically and ethnically diverse undergraduate students (62.1% female; 69.3% non-white; mean age = 22.2 years; mean year in college = 2.8) reported their demographics, college experience, and college major, and completed an MHL measure that assessed knowledge of more than 20 psychological disorders and the application of that knowledge to real life scenarios. After controlling for gender, data were analyzed using ANOVA and post hoc comparisons to determine if differences in mental health literacy level were related to specific college majors. Results revealed that mental health literacy significantly differed across majors, F(18, 598) = 5.09, p < .001. Specifically, students majoring in accounting, nursing, business, biology, and those in a multidisciplinary category had significantly lower mental health literacy scores compared to the highest scoring major, psychology. We present empirical data about variations in mental health literacy across many different majors in higher education. Our findings provide a rationale for interventions for academic majors with lower MHL, as well as a rationale for training of college faculty and staff, for the purpose of improving psychological well-being in at-risk college students.

Mental health literacy of adolescents in Bermuda, according to age, gender and race

Mental health literacy (MHL) is an important part of the help-seeking process, yet there is a lack of knowledge about the MHL of adolescents in the Caribbean. This region is important to study as it is underrepresented in mental health research globally. The aim of this study is to explore the ability of adolescents in Bermuda to recognize depression and social phobia (social anxiety) and their beliefs about the sources of help for a peer with these mental health problems. This cross-sectional study surveyed middle and high school students aged 10-19 years in Bermuda. Online surveys conducted between November 2022 and June 2023 gathered demographic data including age, gender and race, and assessed the ability to recognize depression and social anxiety from descriptions provided in randomly assigned vignettes, and beliefs about sources of help. Across 15 middle and high schools, 2423 adolescents (out of 3593 eligible participants) completed all demographic and MHL survey questions (1139 males, 1272 females). Recognition rates for depression and social anxiety were 60% and 53%, respectively. Compared to females, males endorsed a greater variety of help sources. Reporting symptoms of depression or anxiety reduced the likelihood of endorsing multiple sources of help. MHL of adolescents in Bermuda is sub-optimal, particularly for social anxiety. Mental health promotion programs may be useful in improving recognition rates.

How has health literacy and digital health literacy scholarship evolved? A global, qualitative study

Health literacy (HL) is a key social determinant of health (SDoH) and is of increasing importance in public health research and intervention for improved health outcomes. Definitions of HL and digital health literacy (DHL) have evolved over time as the field has expanded conceptualization from an individual focus to the broader community and organizational levels. Careful consideration of HL and DHL for a variety of contexts and audiences is critical given increased global adoption of digital technologies and responses to emerging public health challenges. This study aimed to capture researchers' conceptualizations of HL/DHL and their motivations to engage in this research with attention to SDoH and equity principles. We developed a survey comprising 32 open-ended and multiple-choice questions from which we present participant demographics and overall research affiliations (n = 193), and results from two multiple-choice and three open-ended questions. The three open-ended questions were inductively reviewed and coded using thematic analysis and iterative discussions between multiple coders, while the two multiple-choice questions were descriptively analyzed via SPSS. Findings are situated within the context of the coronavirus disease 2019 (COVID-19) pandemic and inform the international field of HL/DHL research by highlighting momentum and opportunities for increased scholarship.

Changes in the ability to correctly identify schizophrenia and depression: results from general population surveys in Germany over 30 years

PURPOSE

This study aims to examine time trends in the ability to correctly identify schizophrenia and major depression within the German general population from 1990 to 2020, as an indicator of changing mental health literacy (MHL). Additionally, we investigated shifts in the use of stigmatizing language.

METHODS

Our analysis is based on four waves of representative population surveys in Germany in 1990/1993 (West Germany: N = 2044, East Germany: N = 1563), 2001 (N = 5025), 2011 (N = 2455), and 2020 (N = 3042) using identical methodology. Respondents were presented with an unlabelled case vignette describing a person who exhibited symptoms of either schizophrenia or major depression. Participants were then asked to name the problem described in the vignette using an open-ended question.

RESULTS

From 1990/1993 to 2020, correct identification of schizophrenia increased from 18% to 34% and from 27% to 46% for major depression. However, derogatory labels remained constant throughout all survey waves, particularly for schizophrenia (19% in 1990/1993 and 18% in 2020). For depression, more trivializing and potentially devaluing statements were recorded.

CONCLUSION

Despite the increasing use of psychiatric terminology among the general population, the persistence of derogatory labels suggests that improved MHL, reflected in higher recognition rates, may not automatically translate into a reduction in stigmatizing language. With depression, a normalization and trivialization of a severe illness could pose new challenges to people with major depression. Dedicated efforts to combat the stigma of severe mental illness are still needed.

A multidimensional tool to measure farm stressors: development and initial validation of the farmer stress assessment tool (FSAT)

BACKGROUND

Farming is a stressful occupation, and a growing body of research shows that farm stressors are associated with poor mental health. To date, there are few methodologically sound surveys that assess farm stressors, and none have been validated for the Canadian context. Our study aimed to: (a) investigate the types of stressors experienced by farmers, (b) develop a farm stress assessment tool and test its factor structure and internal consistency, and (c) assess its criterion-related validity to self-reported levels of anxiety, depression, burnout, and resilience among farmers.

METHODS

We developed a 20-item survey based on a review of the literature, examining existing farm stress surveys, and consulting 10 farmers and agricultural industry experts. Then, a convenience sample of farmers living in Alberta, Canada (Sample 1, N = 354) completed a questionnaire containing the 20-item farm stress survey and four validated measures that assessed depression, anxiety, burnout, and resilience. Sample 1 was used to assess the factor structure using exploratory factor analysis (EFA), internal consistency, and criterion-validity of the survey. Next, a convenience sample of farmers living outside of Alberta (Sample 2, N = 138) was used to evaluate the factor structure of the survey using confirmatory factor analysis (CFA).

RESULTS

The results of the EFA revealed five underlying dimensions of farm stressors: Unexpected work disruptions, Agricultural hazards, Farm and financial planning, Isolation, and Regulations and public pressure. The subscales accounted for 61.6% of the variance, and the internal consistency (Cronbach's alpha) ranged from 0.66 to.75. Subscale correlations were below 0.44, indicating evidence of discriminant validity. Correlations between the five subscales and the four mental health outcome variables supported the criterion-related validity of the survey. The results of the CFA indicated that the data fit the model, and fit was further improved by correlating one pair of error terms.

CONCLUSIONS

Preliminary analysis of our Farmer Stress Assessment Tool (FSAT) suggests it is a reliable and valid instrument for measuring a range of stressors farmers face. Implications for policy and community-based mental health interventions that help farmers manage the enduring stressors of agriculture is discussed.

Investigating the under-recognition of childbirth-related post-traumatic stress disorder among the public and mental health professionals

BACKGROUND

Childbirth posttraumatic stress disorder (PTSD) poses significant challenges, impacting both mothers and infants. This work investigates whether childbirth PTSD is less recognized than PTSD caused by other index events.

METHODS

In two preregistered experimens we investigated the public and professional perception of PTSD resulting from childbirth compared to other traumatic events (i.e., sexual assault, car accident, terror attack, and an earthquake).

FINDINGS

Study 1, conducted among the general population in the U.S. revealed that a woman depicted as experiencing PTSD symptoms due to childbirth, was less likely to be recognized as suffering from PTSD than a woman with the same symptoms resulting from other traumatic events. Study 2 demonstrated that mental health professionals worldwide are also less inclined to diagnose PTSD when childbirth is the index event in comparison to other index events.

DISCUSSION

Due to the importance of social recognition in the treatment of PTSD, the findings underscore the urgent need for heightened awareness and education regarding childbirth PTSD to bridge the recognition gap among the general population and mental health professionals.

Characteristics of mental health literacy measurement in youth: a scoping review of school-based surveys

Mental health literacy (MHL) was introduced 25 years ago as knowledge and beliefs about mental disorders which aid in their recognition, management, or prevention. This scoping review mapped the peer-reviewed literature to assess characteristics of secondary school-based surveys in school-attending youth and explore components of school-based programs for fostering MHL in this population. The search was performed following the method for scoping reviews by the Joanna Briggs Institute (JBI). Searches were conducted in four scientific databases with no time limit, although all sources had to be written in English. Primary studies (N = 44) provided insight into MHL surveys and programs for school-attending youth across 6 continents. Studies reported that most youth experience moderate or low MHL prior to program participation. School-based MHL programs are relatively unified in their definition and measures of MHL, using closed-ended scales, vignettes, or a combination of the two to measure youth MHL. However, before developing additional interventions, steps should be taken to address areas of weakness in current programming, such as the lack of a standardized tool for assessing MHL levels. Future research could assess the feasibility of developing and implementing a standard measurement protocol, with educator perspectives on integrating MHL efforts into the classroom. Identifying the base levels of MHL amongst school-attending youth promotes the development of targeted programs and reviewing the alignment with program components would allow researchers to build on what works, alter what does not, and come away with new ways to approach these complex challenges, ultimately advancing knowledge of MHL and improving levels of MHL.

Modifiable predictors of mental health literacy in the educational context: a systematic review and meta-analysis

Mental health literacy is vital for well-being in educational settings, extending beyond academics to include social and emotional development. It empowers individuals, allowing them to recognize and address their mental health needs and provide essential support to their peers. Despite the acknowledged importance of modifiable factors, there is a noticeable research gap in those amenable to change through educational interventions. Thus, this systematic review aims to identify potentially modifiable predictors of mental health literacy in the educational context. A systematic search was conducted for quantitative studies published between 2019 and October 2023 using several databases following PRISMA guidelines. Studies needed to focus on potentially modifiable predictors of mental health literacy in the educational context. Study quality was assessed using the Appraisal tool for Cross-Sectional Studies (AXIS tool). In total, 3747 titles and abstracts were screened, 60 articles were assessed in full-text screening, and 21 were included in the review. Significant correlations between mental health literacy and modifiable predictors, including stigma toward professional help, self-efficacy, attitudes toward help-seeking, social support, positive psychological states, receiving mental health training, and psychological distress, were identified. By addressing these factors, educational institutions can cultivate community's adept in mental health, fostering an environment marked by empathy, understanding, and proactive engagement in addressing mental health issues. The implications serve as a foundation for future research, policy development, and implementing of practical strategies to enhance mental health literacy in diverse educational settings.

The relationship between mental health literacy and professional psychological help-seeking behavior among Chinese college students: mediating roles of perceived social support and psychological help-seeking stigma

Introduction

Mental health literacy is viewed as a significant factor that may facilitate an individual's pursuit of professional psychological assistance. However, it is important to explore further influencing factors that might underlie this association. This study, employing the framework of the Theory of Planned Behavior (TPB), aims to examine the relationship between mental health literacy and the behavior of seeking professional psychological help, with a focus on the potential mediating roles of perceived stigma and social support in this context.

Methods

We surveyed 911 college students in seven regions of China (406 males and 505 females, aged between 19 and 25 years old; M age = 19.65, SD = 1.41) utilizing self-report measures, including the Mental Health Literacy Questionnaire, Professional Psychological Help-Seeking Behavior Scale, Professional Psychological Help-Seeking Stigma Scale, and Perceived Social Support Scale. A chain mediation model was developed to analyze the interconnections between mental health literacy, stigma related to seeking psychological help, perceived social support, and professional psychological help-seeking behaviors.

Results

The mediation effect analysis indicates that: (1) mental health literacy significantly positively correlates with professional psychological help-seeking behaviors; (2) both perceived social support and professional psychological help-seeking stigma significantly mediate the relationship between mental health literacy and professional psychological help-seeking behavior; (3) perceived social support and the stigma associated with seeking professional psychological help play a chained mediating effect between mental health literacy and the behavior of seeking professional psychological help.

Discussion

This study found that mental health literacy indirectly facilitates professional psychological help-seeking behaviors by enhancing the perception of social support and reducing the stigma associated with seeking such help. These findings help in understanding how improving mental health literacy and perceived social support while reducing stigma can increase the likelihood of individuals seeking professional psychological assistance. The results are significant for enhancing the utilization of mental health services and implementing mental health education programs in universities.

The effect of appearance and functionality concerns, and weight status, on negative body image mental health literacy in women

Few studies have investigated community knowledge and beliefs about negative body image. Yet, low rates of recognition and help-seeking for body image concerns have been reported. Given the prevalence of body image problems and associated mental health risks in women, the current online study investigated negative body image mental health literacy in 260 women aged 18 to 64 years recruited via Prolific. The mental health literacy paradigm was employed in a 2 × 2 experimental design in which the effect of a target's domain of body image concern (appearance versus body functionality) and weight status ("normal weight" versus "overweight") was assessed on problem recognition, beliefs, and help-seeking recommendations. Overall, low symptom recognition was observed, and ratings for beliefs and help-seeking suggested low levels of stigma. However, significantly greater sympathy and lifestyle support recommendations were observed in the overweight compared to normal weight condition, and a domain × weight interaction suggested significantly fewer negative emotional reactions in the appearance overweight condition compared to appearance normal weight, and functionality overweight, conditions. The findings suggest a need for education about body image independent of weight status in women. Future research would benefit from examining diverse samples, broader functionality concerns, and stigma.

Mental health literacy and associated factors among traditional healers of Jimma town, southwest, Ethiopia 2020: a community based, cross-sectional study

Background

Traditional healers are in the front line to give the mental healthcare service in developing countries like Ethiopia. In Ethiopia, different studies were done focusing on the role of traditional medicine and perception of the community toward traditional medicine. However, there is paucity of studies, which shows the level of mental health literacy among traditional healers. Therefore, this study intended to mental health literacy level of traditional healers in Jimma town, Ethiopia.

Method

A community-based cross-sectional study design was employed among 310 participants. To select the participants from Jimma town, a stratified random sampling method was utilized from August 1 to September 30, 2020. The Mental Health Literacy Questionnaire was used to assess mental health literacy for assessment of mental health literacy among traditional healers. The collected data were coded and entered into EpiData version 4.6 and exported to SPSS version 25.0 for analysis. Bivariate and multivariable linear regression was used for data analysis.

Result

The finding of this study showed that the samples of traditional healers found in Jimma town scored a total mean of 95.91 ± 3.0025 for mental health literacy. Age [β = -0.052 (95% CI: -0.078, -0.026)], year of experience [β = 0.095 (95% CI: 0.067, 0.123)], family history of mental illness [β = 1.709 (95% CI: 0.543, 2.360)], history of professional help seeking on mental illness [β = 0.501 (95% CI: 0.715, 2.288)], history of getting information of mental illness on media [β = 0.941 (95% CI: 0.345, 1.538)], training on mental health [β = 2.213 (995% CI: 1.520, 2.906)], history of treating mental illness [β = 1.676 (95% CI: 0.808, 2.544)], and informal education [β = -1.664 (95% CI: -2.081, -1.247)] were factors significantly associated with MHL.

Conclusion

The mental health literacy of traditional healers mean score is lower than the mean score of other studies. Age, year of experience, training on mental illness, family history, history of professional help seeking, history of treating mental illness, information on mental illness, and informal education are significantly associated with mental health literacy. Therefore, structured training is very important to improve their level of mental health literacy.

The Impact of Video-Based Microinterventions on Attitudes Toward Mental Health and Help Seeking in Youth: Web-Based Randomized Controlled Trial

BACKGROUND

Mental health (MH) problems in youth are prevalent, burdening, and frequently persistent. Despite the existence of effective treatment, the uptake of professional help is low, particularly due to attitudinal barriers.

OBJECTIVE

This study evaluated the effectiveness and acceptability of 2 video-based microinterventions aimed at reducing barriers to MH treatment and increasing the likelihood of seeking professional help in young people.

METHODS

This study was entirely web based and open access. The interventions addressed 5 MH problems: generalized anxiety disorder, depression, bulimia, nonsuicidal self-injury, and problematic alcohol use. Intervention 1 aimed to destigmatize and improve MH literacy, whereas intervention 2 aimed to induce positive outcome expectancies regarding professional help seeking. Of the 2435 participants who commenced the study, a final sample of 1394 (57.25%) participants aged 14 to 29 years with complete data and sufficient durations of stay on the video pages were randomized in a fully automated manner to 1 of the 5 MH problems and 1 of 3 conditions (control, intervention 1, and intervention 2) in a permuted block design. After the presentation of a video vignette, no further videos were shown to the control group, whereas a second, short intervention video was presented to the intervention 1 and 2 groups. Intervention effects on self-reported potential professional help seeking (primary outcome), stigma, and attitudes toward help seeking were examined using analyses of covariance across and within the 5 MH problems. Furthermore, we assessed video acceptability.

RESULTS

No significant group effects on potential professional help seeking were found in the total sample (F2,1385=0.99; P=.37). However, the groups differed significantly with regard to stigma outcomes and the likelihood of seeking informal help (F2,1385=3.75; P=.02). Furthermore, separate analyses indicated substantial differences in intervention effects among the 5 MH problems.

CONCLUSIONS

Interventions to promote help seeking for MH problems may require disorder-specific approaches. The study results can inform future research and public health campaigns addressing adolescents and young adults.

TRIAL REGISTRATION

German Clinical Trials Register DRKS00023110; https://drks.de/search/de/trial/DRKS00023110.

Conceptual framework of mental health literacy: Results from a scoping review and a Delphi survey

Mental health literacy (MHL) has been identified as a factor influencing early help-seeking for mental health problems (MHPs) and stigmatizing attitudes. However, the lack of consensus on its definition has led to considerable heterogeneity in measurement and, consequently, methodological challenges in comparing data. In this way, the present study was conducted with the following objectives: in Phase I, mapping the existing literature through a scoping review; in Phase 2, 28 experts in the field of mental health participated to develop a consensus statement on the relevance and importance of the findings from Phase 1. A total of 37 articles were included for review. Notable nuances were identified in the conceptualization of MHL, particularly with regard to the fact that it should not be limited to mental disorders but should also encompass mental health. Furthermore, the sociocultural influence was highlighted as shaping MHL, recognizing it as a modifiable competence that adapts to different contexts and life stages, involving both individual and collective levels. The experts deemed the findings pertinent and relevant with a high degree of consensus, except for factors related to MHL. This framework provides a refined definition of MHL and related factors that should be taken into account to guide nursing and other disciplines' studies and interventions on MHL. The evolution of this concept includes dimensions to be considered in future research, especially when developing new measurement instruments or implementing educational programmes. This knowledge and skills cannot be determined globally without considering the context and development of the individual.

Understanding Mental Health Organizations' Instagram Through Visuals: A Content Analysis

This study analyzed the content, visual features, and audience engagement data of Instagram posts from two mental health organizations over one year (N = 725). For content features, mental health literacy and communicative strategies were examined. Posts that promoted knowledge of mental disorders and treatments, used information and community strategy were more likely to receive higher audience engagement. Visual features of demographic segments, visual composition, and visual framing topics were analyzed. Images that covered an unspecific population, used illustrated images, and focused on anti-stigma topical frames obtained more engagement. Theoretical contributions and practical applications regarding visual message design and management on social media to promote mental health are also offered.

Mediating effect of psychological capital on the relationship between mental health literacy and coping styles among newly recruited nurses

BACKGROUND

Newly recruited nurses face multiple sources of stress and their coping styles need to be focused on to ensure good mental health. This study aimed to examine the relationship among mental health literacy, psychological capital and coping styles in newly recruited nurses.

METHODS

A cross-sectional study was conducted in August and September 2022. A total of 315 newly recruited nurses were recruited in a tertiary hospital in Henan Province, central China, employing the convenience sampling method. The self-reported questionnaires were sent through a QR code, including the Mental Health Literacy Scale for Healthcare Students, Psychological Capital Questionnaire, and Simplified Coping Style Questionnaire. Pearson correlation analysis was used to evaluate the relationships among the variables. Mediation analysis was performed to identify the mediating effect of psychological capital on the relationship between mental health literacy and coping styles.

RESULTS

Positive coping showed a positive relationship with psychological capital and mental health literacy, while negative coping showed a negative relationship with psychological capital and mental health literacy. For positive coping, psychological capital was a partial mediator with an effect of 0.140, accounting for 62.8%. For negative coping, a full mediating effect was shown by psychological capital between mental health literacy and negative coping, with an indirect effect of -0.048.

CONCLUSION

Psychological capital plays a partial and complete mediating role between mental health literacy and different coping styles among newly recruited nurses. Diversified training and personalized guidance in improving mental health literacy and increasing psychological capital simultaneously can be provided to newly recruited nurses continuously to adjust their coping styles.

Internet Gaming Disorder and Mental Health Literacy: A Latent Profile Analysis of Korean Adolescents

OBJECTIVE

This study identified latent subtypes of mental health literacy (MHL) for Internet gaming disorder (IGD) and explored their characteristics and differences in various factors in adolescents.

METHODS

This study analyzed secondary data from the 2019 Youth Smart Digital Media Survey and included data from 1,936 middle and high school students (14-18 years old). Thirteen items of the MHL questionnaire were used for latent profile analysis. We compared the characteristics and predictors of the identified types using various statistical analyses, including one-way ANOVA, chi-square test, and multinomial logistic regression.

RESULTS

We identified three subtypes of MHL for IGD in adolescents: "low perception-prefer informal resources," "moderate perception-preferred resources unclear," and "high perception-prefer professional resources." Subtypes showed significant differences in sex, age, family affluence, e-learning time during weekdays, mental health risks, level of problematic smartphone use, and IGD. All variables except IGD predicted one or more latent types.

CONCLUSION

Practical interventions are required to improve IGD MHL, including customized prevention based on the differences between the three types.

Causal beliefs about mental illness: A scoping review

Research on causal beliefs about mental illness-the beliefs people hold about what causes a particular mental illness, or mental illnesses in general-is split across a number of theories and disciplines. Although research on this subject has provided a number of insights and practical applications, the diversity of theories, terminology, and keywords makes it challenging for a new reader to gain a comprehensive understanding. We sought to address this by conducting a systematic scoping review of research on causal beliefs. This review included English-language articles from any year that mentioned causal beliefs for mental illness in their title or abstract. We identified articles in two stages. In the first stage, we used a narrow set of search terms referring specifically to causal beliefs (1227 records identified, 417 included). In the second stage, we used a comprehensive set of terms relevant to research on causal beliefs (10,418 records identified, 3838 included). We analyzed articles qualitatively, organizing them into one of five theories or categories: the common-sense model of self-regulation, explanatory models, mental health literacy, biogenetic causal beliefs, and other research on causal beliefs. We provide a comprehensive summary of these literatures in terms of their history, typical research questions and study design, findings, and practical applications. These theories differ in their theoretical orientation towards causal beliefs, research methods, findings, and applications. However, they broadly share a view of causal beliefs as multifaceted, culturally determined, and relevant for additional psychosocial variables such as mental illness stigma and help-seeking. We conclude by making recommendations for researchers, clinicians, public health messaging, and for individuals with mental illness.

Negative body image mental health literacy in women: Exploring aesthetic and functional concerns and the role of self-objectification

Despite its high prevalence in women, few studies have examined lay knowledge and beliefs about negative body image. Yet, studies applying mental health literacy to body image problems suggest recognition of appearance concerns is poor, which could impede help-seeking. The present study extended previous work by investigating problem recognition, beliefs and help-seeking for aesthetic and functional (physical ability focused) body image concerns in women, and the role of self-objectification in help-seeking. A within-subjects online survey design employing the mental health literacy paradigm was undertaken in a sample of 210 female-identifying adults residing in Australia (Mage = 31.25, SD = 12.76). Overall, results indicated that recognition of body image problems depicted via fictional text vignettes was limited. Moreover, recognition, as well as ratings of perceived prevalence, distress, sympathy, affective reactions, and help-seeking recommendations and intentions, were significantly greater for aesthetic compared to functional body image concerns. Self-objectification displayed significant negative associations with help-seeking recommendations for aesthetic (but not functional) concerns, and was not associated with help-seeking intentions. Findings suggest that negative body image mental health literacy is poor in women, particularly in relation to body functionality. More research is needed to facilitate help-seeking and reduce the impact of body image concerns in women.

Evaluation of an online-based self-help program for patients with generalized anxiety disorder - A randomized controlled trial

Objectives

This study aimed to evaluate the effects of an online self-help intervention for generalized anxiety disorder (GAD). Our primary outcomes were generalized anxiety symptoms, measured using the Generalized Anxiety Disorder - 7 (GAD-7; Spitzer et al., 2006), and wellbeing based on the World Health Organization Wellbeing Index - 5 (WHO-5; Topp et al., 2015).

Methods

A total of 156 German-speaking patients aged 18 to 65 with a diagnosis of GAD and internet access were included in this randomized controlled trial. The intervention group (N = 78) received access to a 12-week online self-help program, while the waitlist control group (N = 78) received access after the 12-week waiting period.

Results

The intervention group showed a significant improvement in generalized anxiety symptoms compared to the control group (t(df = 123.73) = 4.52, p < .001) with a large effect size (d = 0.88, 95 %-CI: 0.50; 1.26). Additionally, the intervention group demonstrated a significant increase in wellbeing compared to the control group (t(df = 87,86) = 3.48, p < .001), with a moderate effect size (d = 0.62, 95 % CI: 0.27; 0.98). However, no significant effects were observed for secondary outcomes of functional impairments, work productivity, mental health literacy, and healthcare demands. For exploratory outcomes, improvement was found for anxiety and worry symptoms.

Conclusions

These findings suggest that an online-based self-help intervention effectively reduces GAD symptoms and improves overall wellbeing. Future research should explore the long-term effects of this intervention and investigate potential mechanisms underlying its efficacy.

Public health implications

Online-based self-help programs provide a promising treatment option for individuals with GAD who face barriers to traditional face-to-face therapy.

Influence of health literacy on health-related quality of life after total hip arthroplasty

INTRODUCTION

Personal knowledge about the own disease, a key component of health literacy (HL), may have a considerable impact on treatment outcomes. The purpose of this study was to investigate whether the patients' knowledge about the surgical procedure, risks, and aftercare, as well as the satisfaction with the preoperative level of information, has an influence on the health-related quality of life (HRQoL) after primary total hip arthroplasty (THA).

MATERIALS AND METHODS

A total of 176 patients (68.3 ± 10.3 years, 60.8% female) were evaluated. HRQoL was assessed prior to surgery as well as one and twelve months after THA using the 12-item Short Form Questionnaire. Following standardized surgical informed consent, HL was assessed preoperatively using a self-constructed quiz score, while information satisfaction was measured with a single-item rating scale. Sociodemographic and clinical characteristics, including pain (VAS), functionality (WOMAC), and psychological distress (PHQ-4), were also assessed at baseline. Multiple linear regression analyses were performed to examine whether HL, satisfaction with information, age, social class, WOMAC, VAS, and PHQ-4 predict HRQoL at one and twelve months post-surgery.

RESULTS

The average HL quiz score was 23 ± 5.1 out of a possible 33 points. Social class index significantly influenced HL (p < 0.001). A weak correlation between HL and age (r = 0.23, p = 0.01) and no correlation between HL and psychological distress (p = 0.868) were observed. One month after THA, physical HRQoL was significantly predicted by the WOMAC index (p = 0.031) and subjective satisfaction with information (p = 0.022), but not by HL. After twelve months, only the WOMAC was a significant predictor (p < 0.001) of physical HRQoL.

CONCLUSION

Although subjective satisfaction with the patient's preoperative level of information had a significant effect on the physical HRQoL at one month after THA, the influence of osteoarthritis severity outweighed this effect after twelve months. HL had no direct influence on HRQoL. These results suggest that patient satisfaction, rather than knowledge, predicts HRQoL.

The Effect of Digital Mental Health Literacy Interventions on Mental Health: Systematic Review and Meta-Analysis

BACKGROUND

Accelerated by technological advancements and the recent global pandemic, there is burgeoning interest in digital mental health literacy (DMHL) interventions that can positively affect mental health. However, existing work remains inconclusive regarding the effectiveness of DMHL interventions.

OBJECTIVE

This systematic review and meta-analysis investigated the components and modes of DMHL interventions, their moderating factors, and their long-term impacts on mental health literacy and mental health.

METHODS

We used a random-effects model to conduct meta-analyses and meta-regressions on moderating effects of DMHL interventions on mental health.

RESULTS

Using 144 interventions with 206 effect sizes, we found a moderate effect of DMHL interventions in enhancing distal mental health outcomes (standardized mean difference=0.42, 95% CI -0.10 to 0.73; P<.001) and a large effect in increasing proximal mental health literacy outcomes (standardized mean difference=0.65, 95% CI 0.59-0.74; P<.001). Uptake of DMHL interventions was comparable with that of control conditions, and uptake of DMHL interventions did not moderate the effects on both proximal mental health literacy outcomes and distal mental health outcomes. DMHL interventions were as effective as face-to-face interventions and did not differ by platform type or dosage. DMHL plus interventions (DMHL psychoeducation coupled with other active treatment) produced large effects in bolstering mental health, were more effective than DMHL only interventions (self-help DMHL psychoeducation), and were comparable with non-DMHL interventions (treatment as usual). DMHL interventions demonstrated positive effects on mental health that were sustained over follow-up assessments and were most effective in enhancing the mental health of emerging and older adults.

CONCLUSIONS

For theory building, our review and meta-analysis found that DMHL interventions are as effective as face-to-face interventions. DMHL interventions confer optimal effects on mental health when DMHL psychoeducation is combined with informal, nonprofessional active treatment components such as skills training and peer support, which demonstrate comparable effectiveness with that of treatment as usual (client-professional interactions and therapies). These effects, which did not differ by platform type or dosage, were sustained over time. Additionally, most DMHL interventions are found in Western cultural contexts, especially in high-income countries (Global North) such as Australia, the United States, and the United Kingdom, and limited research is conducted in low-income countries in Asia and in South American and African countries. Most of the DMHL studies did not report information on the racial or ethnic makeup of the samples. Future work on DMHL interventions that target racial or ethnic minority groups, particularly the design, adoption, and evaluation of the effects of culturally adaptive DMHL interventions on uptake and mental health functioning, is needed. Such evidence can drive the adoption and implementation of DMHL interventions at scale, which represents a key foundation for practice-changing impact in the provision of mental health resources for individuals and the community.

TRIAL REGISTRATION

PROSPERO International Prospective Register of Systematic Reviews CRD42023363995; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023363995.

'C'mon, let's talk: a pilot study of mental health literacy program for Filipino migrant domestic workers in the United Kingdom

PURPOSE

This pilot study of a culturally adapted online mental health literacy (MHL) program called 'Tara, Usap Tayo!' (C'mon, Let's Talk) aims to assess the acceptability, appropriateness, feasibility, and potential effectiveness in improving the help-seeking behavior of Filipino migrant domestic workers in the United Kingdom (UK).

METHODS

Using mixed methods, we conducted a non-randomized single-group study of the online MHL program with 21 participants. The development of this intervention was guided by the Medical Research Council Framework for developing complex interventions and utilized Heim & Kohrt's (2019) framework for cultural adaptation. Content materials from the WHO Mental Health Gap Action Program (mhGAP), WHO Problem Management Plus (PM +) and Adult Improving Access to Psychological Therapies (IAPT) were modified and translated into the Filipino language. The MHL program was delivered online in three sessions for two hours each session. Data were collected at three time points: (T1) pretest; (T2) posttest; and (3) follow-up test. Quantitative data on participants' attitudes towards help-seeking and level of mental health literacy as outcome measures of potential intervention effectiveness were collected at T1, T2 and T3, while focus group discussions (FGDs) to assess participants' feedback on the acceptability, feasibility, and appropriateness of the online MHL program were conducted immediately at T2. Data analysis was done using a thematic approach for qualitative data from the FGDs and descriptive statistics and repeated-measures ANOVA were used to assess the difference in the T1, T2, and T3 tests. Both quantitative and qualitative results were then integrated and triangulated to answer the research questions.

RESULTS

The online MHL program is generally acceptable, appropriate, and feasible for use among Filipino migrant domestic workers. Preliminary findings lend support for its possible effectiveness in improving mental health literacy and help-seeking propensity. The cultural adaptation made in the content, form, and delivery methods of the intervention was acceptable and feasible for this target subcultural group.

CONCLUSION

By improving their mental health literacy and help-seeking propensity, this online MHL program has the potential to provide support to the mental health and well-being of Filipino migrant domestic workers in the UK. Further feasibility study or large-scale randomized controlled trial is needed to confirm the preliminary findings of this study.

How gender and low mental health literacy are related to unmet need for mental healthcare: a cross-sectional population-based study in Sweden

BACKGROUND

Men are more likely to have unmet need for mental healthcare than women. However, an under-investigated aspect of the gender difference is the role of mental health literacy. This study investigated how combinations of gender and mental health literacy were related to two indicators of unmet need: not perceiving a need for mental healthcare despite poor mental health, and refraining from seeking mental healthcare.

METHODS

This cross-sectional study was based on a questionnaire sent to a general population sample, aged 16-84 years, in Stockholm County, Sweden, in 2019. Of the 1863 respondents (38%), 1563 were included (≥18 years). The sample was stratified into four groups, men and women with low or high mental health literacy, using the third quartile of the Mental Health Knowledge Schedule. The likelihood of not perceiving a need for mental healthcare and refraining from seeking mental healthcare, at any time in life, were investigated by calculating odds ratios with 95% confidence intervals.

RESULTS

Men with low mental health literacy were most likely to not perceive a need for mental healthcare, also when adjusting for age, education, and poor mental health (OR 5.3, 95% CI 3.6-7.7), and to refrain from seeking mental healthcare, also when adjusting for age and education (OR 3.3, 95% CI 1.7-6.4), followed by men with high mental health literacy (OR 1.9, 95% CI 1.5-2.4, and OR 1.5, 95% CI 1.0-2.2) and women with low mental health literacy (OR 1.9, 95% CI 1.2-2.9, and OR 2.1, 95% CI 1.1-3.9). Women with high mental health literacy were least likely (reference group).

CONCLUSION

The results show differences in the likelihood of unmet need for mental healthcare based on combinations of gender and mental health literacy level, with men having low mental health literacy being most at risk, and women with high mental health literacy being least at risk. This challenges generalisations of a gender difference in unmet need by showing heterogeneity among men and women based on mental health literacy. Men with low mental health literacy may be particularly in need of targeted interventions to reduce potential individual and societal consequences of their unmet need.

Validity and reliability of the Arabic version of the population postpartum depression literacy scale (PoDLiS): a web-based survey in Saudi Arabia

BACKGROUND

Proper knowledge about postpartum depression (PPD) will help recognize symptoms and encourage women to seek the needed professional help. Until now, there has been a scarcity of research on the literacy level of PPD among the Saudi population and the factors affecting it. This study translated the Postpartum Depression Literacy Scale (PoDLiS) into Arabic and evaluated its psychometric properties. Furthermore, the Saudi population's mental health literacy for PPD and the factors associated with it were examined as a secondary objective.

METHODS

This cross-sectional study involved 2,336 participants selected via convenience sampling from all over Saudi Arabia, all of whom willingly agreed to participate. Data collection was done through an online questionnaire using Google Forms, covering sociodemographic characteristics and the Arabic PoDLiS.

RESULTS

The Arabic version of PoDLiS showed acceptable goodness-of-fit between the observed data and the resulting six-factor solution, RMSEA = 0.049, 90% confidence interval RMSEA (0.010-0.050), pCLOSE = 0.742, CFI = 0.962, TLI = 0.940, χ2(270) = 1576.12, p-value = 0.742. The total Cronbach's alpha (α) of the PoDLiS showed acceptable internal consistency, measuring at 0.742. High literacy was seen in married and young participants with a postgraduate degree and sufficient household income who have known someone with PPD. Significantly lower literacy was seen in male, non-Saudi participants and those residing in the central and northern regions of Saudi Arabia.

CONCLUSIONS

The Arabic version of the PoDLiS showed good psychometric properties, and it can be used to assess PPD literacy among perinatal women and to examine the impact of PPD awareness programs. Despite reporting relatively good PPD literacy in the Saudi population, there is a persistent gap in participants' beliefs about available professional help and the attitudes that facilitate recognizing PPD. Our findings highlight the importance of implementing public education campaigns to improve overall knowledge about PPD and promote prevention, early recognition, and treatment of PPD.

Adolescents' beliefs about what symptoms constitute depression: Are more expansive definitions helpful or harmful?

Purpose

What symptoms do people think constitute "depression"? In a mental health literacy framework, knowing more of depression's nine core symptoms (per formal psychiatric diagnostic criteria) is thought to help people identify and seek help for depression. However, the common-sense model of self-regulation suggests that more expansive beliefs about what symptoms constitute an illness may be maladaptive, whereby viewing more symptoms as characterizing a disorder predicts greater functional impairment.

Methods

We collected data from N = 281 U.S. adolescents experiencing elevated depression symptoms, recruited via social media. Symptom beliefs were assessed descriptively and with a latent profile analysis to test associations with other variables.

Results

Adolescents' beliefs about what symptoms constitute depression varied widely, and only 49% endorsed all DSM-5 depression symptoms as characterizing the disorder. Adolescents who identified more symptoms as belonging to depression had more severe depression symptoms (p = .004), reported more hopelessness (p = .021), and were more pessimistic about the permanence of depression (p = .007); they were also more likely to rate medication as potentially helpful (p = .001).

Conclusion

These findings simultaneously support and challenge elements of both the common-sense model and the mental health literacy framework. Future research on mental health literacy may examine why adolescents with more psychiatrically-accurate understandings of depression experience worse clinical outcomes. Likewise, future research on the common sense model should explore whether more expansive depression symptom beliefs may be adaptive as well as maladaptive.

[How good are teachers at recognising mental health issues and assistance needs in adolescents? A vignette-based study]

INTRODUCTION

Teachers can help identify mental health issues in adolescents and act as gateway-providers by referring adolescents at risk to a mental health professional. Studies have so far investigated awareness concerning mental health issues among primary school teachers in the USA. The present study uses case vignettes to examine whether secondary school teachers in Germany can detect and assess the presence and severity of mental disorders in adolescents, and which factors predict referral to professional support services.

METHODS

N=136 secondary school teachers completed an online questionnaire with case vignettes depicting students with moderate or severe internalizing and externalizing disorders. We assessed the ability to recognize mental health issues and evaluate the level of severity, worry and perceived prevalence of the problem as well as the helping behaviour among teachers.

RESULTS

66 and 75% of the teachers were able to identify mental health issues in case vignettes of externalizing and internalizing disorders, respectively. 60% and 61%, respectively, designated the mental disorder correctly as externalizing or internalizing, and the true positive rates did not differ between externalizing vs. internalizing disorders. However, moderate and externalizing disorders were identified with less precision, and recommendations to seek professional mental help were more seldom made for these disorders.

DISCUSSION

The results indicate that teachers can validly and probably intuitively identify (at least severe cases of) mental disorders in their students. Given the uncertainty expressed and the substantial interest of teachers, further education and training on mental health conditions disorders in adolescents is recommended.

A scoping review of studies examining mental health literacy among Arabs worldwide

BACKGROUND

There is growing interest in Mental health literacy (MHL) worldwide, given its important role in overcoming barriers to service use and reducing mental health disparities. However, little is known about MHL among Arabs.

AIM

We conducted a scoping review to examine MHL levels and correlates among Arabs in both Arab and non-Arab countries, based on Jorm's MHL framework.

METHODS

We conducted a scoping review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, using six electronic databases: PubMed, PsycINFO, CINAHL, Soc Index, Web of Science, and Scopus. Data were summarized and synthesized.

RESULTS

Nine studies examining MHL among Arabs met our inclusion criteria. Seven of them used a quantitative cross-sectional design. Four studies were conducted in Arab, and five were in non-Arab countries. Five studies were conducted among university students. The studies included indicate moderate to high levels of MHL. Higher MHL was associated with female gender, personal experience of mental health illness, and with help-seeking behaviours.

CONCLUSIONS

Our review shows a significant lack of empirical studies on Arabs' MHL. These findings should be considered as a call for action for public health researchers, mental health workers, and policymakers to prioritize research in this field.

The impact of mental health literacy intervention on in-service teachers' knowledge attitude and self-efficacy

Mental health literacy (MHL) is an essential component in the process of de-stigmatization, promoting mental health, and supporting people struggling with mental illness. Today, as the number of people suffering from mental illnesses is nearly 450 million people worldwide, the importance of having a teacher-training program that incorporates MHL in its curriculum has become paramount. This study is a quasi-experimental pre-post research that uses the MHL program as an intervention. The sample included 36 (n = 36) high school in-service teachers from 11 schools. The participants took an online training program for 6 weeks. The evaluations were used before and after the training to assess their mental health knowledge, attitude, and self-efficacy. The data were analyzed using the paired sample t-test. The findings revealed a significant level of improvement in relation to the teachers' MHL knowledge, attitude, and self-efficacy after the training. The study findings reveal the effectiveness of MHL training in improving in-service teachers' knowledge, attitude, and self-efficacy in relation to mental health. The study's limitations and future study recommendations are discussed.

Mental illness stigmatisation among Malaysian adults: a systematic review

BACKGROUND

Stigmatisation is considered a 'second illness' for people with a mental illness and is highly prevalent in Malaysia. Stigmatisation negatively impacts wellbeing, recovery and productivity. Addressing stigmatisation is integral towards people attaining a higher quality of life.

AIM

To explore mental illness stigmatisation in Malaysian adults.

METHOD

A systematic literature review was conducted using thematic analysis to synthesise and categorise evidence. Five key themes emerged, providing insight into mental health stigmatisation.

FINDINGS

Cultural beliefs, limited knowledge of mental health and lack of education on mental health were factors influencing stigmatisation. Stigmatisation significantly affected the wellbeing and functioning of people with a mental illness. Interventions such as contact-based education effectively reduce stigmatising attitudes manifested by healthcare providers.

CONCLUSION

Establishing mental health literacy, encouraging patient contact, promoting mental health awareness and strengthening mental health policies could reduce mental illness stigmatisation and its impact in Malaysia. Future research is warranted to investigate the impact on physical wellbeing and anti-stigmatising strategies targeting the general public.

Multiple Mental Health Literacies in a Traditional Temple Site in Kerala: The Intersection Between Beliefs, Spiritual and Healing Regimes

The notion of 'mental health literacy' has been proposed as a way of improving mental health problem recognition, service utilisation and reducing stigma. Yet, the idea embodies a number of medical-model assumptions which are often at odds with diverse communities' spiritual traditions and local belief systems. Twenty participants were recruited to this study consisting of mental health service users (N = 7), family carers (N = 8) and community members (N = 5) in a temple town in Kerala, South India participated in semi-structured interviews exploring the variety of beliefs and practices relating to mental health. Our findings indicate that the issue may be better understood in terms of multiple mental health literacies which people deploy in different circumstances. Even those sceptical of traditional and spiritual approaches are knowledgeable about them, and the traditional practices themselves often involve detailed regimes of activities aimed at effecting an improvement in the person's mood or condition. Therefore, we argue it is appropriate to consider mental health literacy not as a unitary universal phenomenon but instead as a mosaic of different literacies which may be deployed in different settings and in line with different experiences and which may operate in synergy with each other to enable treatment but also facilitate a sense of meaning and purpose in life.

An interactive video increasing French students' mental health literacy: a mixed-methods randomized controlled pilot study

Mental health literacy (MHL) is a determinant of psychological well-being in young people. A randomized controlled design was used to evaluate the appreciation and effectiveness of an interactive video on French University students' MHL (knowledge about depression and suicidal behavior, mental health help-seeking behaviors, stigma and misconceptions about mental health). At the baseline, all participants (n = 101) completed a questionnaire including several scales on MHL. One month after, participants were randomly assigned to two homogeneous groups (intervention, n = 50 or control, n = 51) and again completed the questionnaire on MHL. Through a mixed-methods approach, semi-structured interviews were also conducted with the intervention group to collect information on the appreciation of the interactive video. Quantitative data indicated that MHL scores increased or remained stable in the intervention group. Comparison with the control group and multivariate logistic regression models did not show statistically significant differences, due to the small sample of the study. According to qualitative data, users appreciated the content and the format of the intervention. It was suggested that the video could be disseminated in other University campuses in France and internationally to promote MHL among students.

Old Age Psychiatry

OBJECTIVE

Older Chinese people in New Zealand underutilise mental health services. Lack of recognition of mental health issues and awareness of available treatment is a potential barrier to accessing care. This study investigated depression literacy in older Chinese people.

METHOD

A convenience sample of 67 older Chinese people were presented a depression vignette and completed a depression literacy questionnaire.

RESULTS

There was a good rate (71.6%) of depression recognition, but no participant chose taking medication as the best method of help. There was a notable level of stigma among participants.

CONCLUSION

Older Chinese people would benefit from information regarding mental health conditions and their interventions. Strategies to deliver this information and de-stigmatise mental illness in the Chinese community which incorporate cultural values may be beneficial.

Mental Health Literacy for Supporting Children: A Systematic Review of Teacher and Parent/Carer Knowledge and Recognition of Mental Health Problems in Childhood

The level of mental health literacy (MHL) in adults who work with or care for children is likely to influence the timeliness and adequacy of support that children receive for mental health problems. The aim of this study was to systematically review the literature on mental health literacy for supporting children (MHLSC, recognition/knowledge) among parents and teachers of school aged children (5 to 12 years old). A systematic search was conducted for quantitative studies published between 2000 and June 2021 using three databases (MEDLINE, PsycINFO and ERIC) and relevant citations reviewed in Scopus. To be included, studies needed to measure at least either 'mental health knowledge' or 'recognition'. Synthesis proceeded according to study design, adult population, child MHP, then MHL outcome. Study quality was assessed using AXIS. 3322 documents were screened, 39 studies met inclusion criteria. 49% of studies examined teachers' knowledge or recognition of ADHD; only five studies reported on parent samples. Synthesis found a nascent field that was disparate in definitions, methods and measures. Little research focussed on knowledge and recognition for internalizing problems, or on parents. Methods used for measuring knowledge/recognition (vignette vs screening) were associated with different outcomes and the quality of studies was most often low to moderate. Adults appear to have good recognition of childhood ADHD but their knowledge of internalizing disorders is less clear. Further research is required to develop standard definitions and validated measures so gaps in MHLSC can be better identified across populations who have a role in supporting children with their mental health.

The well-being of Iranian adult citizens; is it related to mental health literacy?

Background

Subjective well-being (SWB) is a fundamental concept in the definition of mental health and is a significant health indicator for individuals and societies. Mental health literacy (MHL) is a modifiable variable with known effects on mental health, but its relationship with SWB is not recognized. In this study, the SWB is measured, and its relationship to MHL is investigated.

Methods

In this cross-sectional study conducted in Iran in 2019, 1,682 individuals participated using a convenient sampling method. Participants with a basic ability to use internet were included. A simple online form was used to collect data. SWB and MHL were measured with three questionnaires: WHO-5 Well-Being Index, Mental Health Literacy Scale, and Mental Health Positive Knowledge.

Results

Most of the participants were young (mean age 25.99, SD 9.14), female (71.9%), and had a university degree (78.5%). The mean SWB was 50.19 out of 100 (SD 20.92). More than half of the participants (50.4%) were screen-positive for clinical depression regarding their low well-being. Significant but very small correlations were detected between SWB and both MHL measures.

Conclusion

The well-being of half of the educated Iranian citizens who participated in this study was poor and lower than previous measurements. No strong correlation is detected between SWB and MHL measures in this study. This suggests that people's well-being cannot be improved by merely implementing mental health educational programs.

The prevalence and factors associated with mental disorders in a community setting in central Uganda

BACKGROUND

Mental disorders are known to predict poverty, morbidity and mortality. In resource limited settings, low levels of mental health literacy (MHL) and high mental illness stigma (MIS) have been sighted as possible factors that may impede access to mental health care. However, little has been done to examine the association between mental disorders and these factors (MHL and MIS) in sub-Saharan Africa.

METHODS

We assessed for the prevalence of major depressive disorders (MDD), substance use disorders (SUD), post-traumatic stress disorder (PTSD), generalized anxiety disorder (GAD), documented MHL and MIS among 814 participants from 24 villages in central Uganda. We conducted regression analyses to examine the association between the prevalence of mental disorders, demographic factors as well as MIS and MHL.

RESULTS

Over two thirds of the participants 581 (70%) were female. The mean age of the participants was 38 years (SD± 13.5). The prevalence of mental disorders ranged from 6.8-32%. Participants who were older were less likely to screen positive for GAD (OR 0.98; 0.96-0.99), female gender was protective against SUD (OR 0.46; 0.3-0.68) and those with MDD had lower education level (OR 0.23; 0.1-0.53). The mean MIS score was 11.3 (SD± 5.4) with a range of 6-30 and the mean MHL score was 21.7 (SD ±3.0) with a range of 10-30. MIS was negatively associated with GAD [β = -1.211 (-2.382 to -0.040)]. There no statistically significant association between MHL and a mental disorder.

CONCLUSION

There was a high prevalence of mental disorders in the community that we studied. Adequate resources should be allocated to address this burden.

Depression literacy and misconceptions scale (DepSter): a new two-factorial tool for measuring beliefs about depression

BACKGROUND

Depression literacy has received extensive attention within mental health research. It has been studied by different social groups and professions in Western and non-Western cultures. The importance of this topic stems from the fact that depression literacy is strongly related to attitudes toward people who are diagnosed with depression, the tendency to stigmatize this mental disorder, and to the propensity to undertake help-seeking behaviors. Therefore, understanding and promoting depression literacy is crucial in contemporary mental health prevention and promotion. We propose a new two-factorial tool measuring beliefs about depression. This 14-item self-report measure captures how people vary across two dimensions of beliefs about depression-depression literacy and misconceptions about depression.

METHODS

In ten studies with a total sample of over 4,600 participants from three countries, we demonstrated the two-factorial structure of the Depression Literacy and Misconceptions Scale (DepSter) in Polish (Studies 1 and 2), American (Study 4), and British (Study 5) samples. We showed measurement equivalence for the Polish and English versions of the scale (Study 3). Furthermore, we tested the discriminant meaning of the two dimensions of beliefs about depression analyzing its association with health literacy, mental health literacy, and prejudice toward people with mental illness (Study 4), depression literacy and depression stigma (Study 5), empathetic concerns (Study 7), social dominance orientation (Study 8), and the Big Five personality traits (Study 9). We also investigated whether individuals with formal education in psychology and direct or indirect experience with depression demonstrate a higher level of depression literacy and a lower level of misconceptions about depression (Study 6). Our measure showed high stability for two dimensions of beliefs about depression (Study 10), in both its Polish and English versions, with the measurement conducted after three weeks and three months.

DISCUSSION

We conclude that the proposed approach to beliefs about depression capturing both depression literacy and misconceptions about depression measured with the DepSter scale can easily be applied in clinical and social settings, especially in studies concerning the perception of those diagnosed with depression.

Reducing psychiatric illness in the perinatal period: A review and commentary

This brief overview highlights the global crisis of perinatal psychiatric illness (PPI). PPI is a major contributor to many adverse pregnancy, childbirth, and childhood development outcomes. It contributes to billions of dollars in spending worldwide each year and has a significant impact on the individual, their family, and their community. It is also highly preventable. Current recommendations for intervention and management of PPI are limited and vary considerably from country to country. Furthermore, there are several significant challenges asso-ciated with implementation of these recommendations. These challenges are magnified in number and consequence among women of color and/or minority populations, who experience persistent and negative health disparities during pregnancy and the postpartum period. This paper aims to provide a broad overview of the current state of recommendations and implementation challenges for PPI and layout a framework for overcoming these challenges. An equity-informed model of care that provides universal intervention for pregnant women may be one solution to address the preventable consequences of PPI on child and maternal health. Uniquely, this model emphasizes the importance of managing and eliminating known barriers to traditional health care models. Culturally and contextually specific challenges must be overcome to fully realize the impact of improved management of PPI.

Pedagogy of death within the framework of health education: The need and why teachers and students should be trained in primary education

The objective of the present study is to analyze the perceptions of in-service teachers about Pedagogy of Death within the framework of Health Education (HE), with respect to the training received and their teaching experience. A quantitative method was utilized, with the design of an ad hoc questionnaire with a Likert-type response scale and dichotomous questions. The results showed that while the teachers were aware of the need to educationally address death and health, they lacked or did not have initial or continuous training for doing so, and had not thought about it as a normalized aspect throughout their teaching career. We believe it is necessary to offer more training on Pedagogy of Death in the area of HE at universities and continuous education centers, so that it can ultimately be implemented in Primary Education classrooms.

Farmers Supporting Farmers: Livestock Auctions as Spaces to Reconstruct Occupational Community and Counter Mental Health Issues

Social isolation within agricultural communities is prevalent within the United Kingdom (UK). Along with other social and economic determinants, social isolation is considered to be a contributing factor towards the high rates of mental health issues experienced among people working in agriculture. The livestock auction mart is one of the remaining spaces upon which many livestock farmers rely for consistent social interaction and to experience community, both determinants proven to improve physical and mental health. However, the importance of the social contribution of livestock auction marts to farmer wellbeing appears rarely in associated literature. The aims of this study, therefore, were i) to determine levels of isolation experienced by livestock farmers who attend auction marts and ii) to identify the role of the mart as a system of social support, with an emphasis on the informal support system attendees provide for one another. Findings from 90 qualitative interviews demonstrate that the auction mart is an important social site where occupational community and identity can be produced and reproduced for all attending stakeholders, positively impacting upon mental health and wellbeing. The strength of the occupational community among livestock farmers should be considered as a key element among a basket of options approach in the development of support interventions, and as a pathway to negotiating barriers to both help-seeking behaviors and reaching the hard-to-reach.

Facilitators and barriers in the development and implementation of depression prevention and treatment policies in China: a qualitative study

BACKGROUND

Depression is one of the leading causes of avoidable suffering and premature death worldwide, leading to the disease burden among mental disorders. Depression-related deaths can be prevented by developing and implementing good depression prevention and treatment policies. The goal of this study is to provide theoretical direction and useful references for examining the outstanding service work of depression prevention and treatment. It also aims to describe how depression prevention and treatment policies were developed and put into practice in China, along with the associated facilitators and barriers.

METHODS

We integrated two data sources using a case study approach: a document review of relevant policy documents, published articles and reports between 2004 and 2022 (N = 12 papers) and in-depth interviews (N = 41). Participants were drawn from pertinent sectors to managing depression: research and academia, relevant government departments, health care providers, people with depression and their families, and community organisations. Thematic analysis was used to analyse all data.

RESULTS

A comprehensive programme of work exploring specific services for depression prevention and treatment was developed in China in 2020. Facilitators of policy development and implementation include (1) political commitment and strong leadership, (2) coordination mechanisms, (3) stakeholder enthusiasm and commitment, (4) resources, and (5) the use of digital technologies. The main barriers leading to delays in policy development and implementation include (1) insufficient awareness and lack of depression literacy, (2) lack of resources and (3) stigma and social discrimination (4) lack of united action.

CONCLUSION

Although the process of implementing a distinctive service programme for depression prevention and treatment in China has been long, the current policy is in line with current global efforts. Strategies to reduce Stigma and increase knowledge about depression are part of a national and international approach to reducing the burden of depression. Political commitment and the involvement of all stakeholders remain necessary. An adequate response to depression will require the involvement of society as a whole, with joint action to reduce the risk of exposure to adversity and enhance protective factors.

Designing interventions to ameliorate mental health conditions in resource-constrained contexts: some considerations

Health interventions, including those directed at ameliorating symptoms of mental disorders, can contribute significantly to realising the goal of sustainable development. The Strategic Development Goal of ensuring healthy lives and well-being for all, at all ages, pertains all health conditions, including those affecting mental health. Considering the low ratio of researchers to the population of many low- and middle-income countries, there is a specific need to build capacity for research so as to ensure good quality data so that social policies can be data-informed. This article outlines four considerations for trial investigators assessing the effectiveness of mental health interventions in low- and middle-income countries, namely, task sharing, scaling up, structural barriers, and the transformation imperative. Task sharing is an arrangement in which non-specialist health workers receive training and supervision to screen for and diagnose mental disorders and intervene with persons affected by them. Scaling up a proof of concept is appropriate when trials yield positive results showing effectiveness of the intervention. Structural barriers such as transport difficulties, long waiting times in clinics, food insecurity, competing demands on people’s time, childcare concerns, and poor health literacy play an important role in driving health behaviours and should be considered in intervention design. Transformation of the cadre of researchers to include those from oppressed and marginalised groups will yield investigators who are able to frame research questions and develop methodologies that reflect the lived realities of these communities.

Prevalence and correlates of subjective cognitive concerns in Australian university students during the COVID-19 pandemic

Introduction

Coronavirus (COVID-19) instigated unprecedented global effects on healthcare systems, economies, employment, education, travel, and social lives. In addition to increased mental health challenges, pandemic restrictions have triggered emerging cognitive concerns. University students are at particularly high risk of adverse lockdown-related effects, yet despite the substantial adaptions to learning necessitated by COVID-19, limited research has so far focused on the cognitive consequences of the pandemic among university students. This study aimed to comprehensively examine the nature, prevalence, and correlates of subjective cognitive concerns among 972 students (Median age = 22 years, 70% female) enrolled at Monash University, Australia, in December 2020.

Methods

Students completed the online THRIVE@Monash survey, 5 weeks following prolonged lockdown in Melbourne. Using group comparisons and hierarchical binary logistic regression analyses, we examined associations between demographic and enrolment characteristics, COVID-19-related experiences and impacts (author-developed questions), self-reported anxiety and depression symptoms (PROMIS Anxiety and Depression scales), and students' perceived changes in everyday cognitive functions (author-developed questions).

Results

Over 60% of students reported subjective cognitive concerns (SCCs). After controlling for anxiety and depression symptoms, students reporting more SCCs were more likely to be younger, from White/European ethnic backgrounds, and in their first year of undergraduate study. No differences in SCCs were found between male and female students. Greater worry, anxiety, or stress related to COVID-19 (e.g., infection, leaving the house, hygiene and exposure prevention, impact on physical and mental health), and time spent reading or talking about COVID-19, were generally not associated with SCCs after controlling for anxiety and depression symptoms.

Discussion

These findings highlight vulnerable subgroups of students who might benefit from regular monitoring, education, and interventions to support their cognitive health during the pandemic and beyond. In addition, cognitive concerns may provide additional insight into mental health problems among students, and emphasize the importance of understanding factors that impact students' long-term academic and career success.

Effectiveness of Augmented and Virtual Reality-Based Interventions in Improving Knowledge, Attitudes, Empathy and Stigma Regarding People with Mental Illnesses-A Scoping Review

Interventions adopting augmented and virtual reality (AR/VR) modalities allow participants to explore and experience realistic scenarios, making them useful psycho-educational tools for mental illnesses. This scoping review aims to evaluate the effectiveness of AR/VR interventions in improving (1) knowledge, (2) attitudes, (3) empathy and (4) stigma regarding people with mental illnesses. Literature on published studies in English up till April 2022 was searched within several databases. Sixteen articles were included. The majority of studies were conducted in the West (93.8%), within undergraduates (68.8%) but also amongst high school students, patients, caregivers, public including online community, and covered conditions including psychotic illnesses, dementia, anxiety and depression. A preponderance of these included studies which employed AR/VR based interventions observed improvements in knowledge (66.7%), attitudes (62.5%), empathy (100%) and reduction of stigma (71.4%) pertaining to people with mental illnesses. In the context of relatively limited studies, extant AR/VR based interventions could potentially improve knowledge, attitudes, empathy and decrease stigma regarding people with mental illness. Further research needs to be conducted in larger and more diverse samples to investigate the relatively beneficial effects of different AR/VR modalities and the durability of observed improvements of relevant outcomes of interests over time for different mental conditions.

Health Literacy and Serious or Persistent Mental Illness: A Mixed Methods Study

BACKGROUND

Health literacy is increasingly recognized as a major determinant of health; however, our insights into the health literacy strengths and needs of adults living with serious or persistent mental illness remain limited by a notable lack of research in this area. Improving our understanding is important because people in this group are especially vulnerable to numerous negative health outcomes, many preventable.

OBJECTIVE

To assess the health literacy strengths and needs of people living with serious or persistent mental illness in terms of their ability to acquire, understand, and use information about their illness and the health services they require.

METHODS

A cross-sectional convergent mixed methods design guided by the Ophelia Access and Equity Framework. People diagnosed with serious or persistent mental illness were offered participation. Quantitative and qualitative data was collected using questionnaires (Health Literacy Questionnaire [HLQ], World Health Organization [WHO-5]) and semi-structured interviews. Hierarchical cluster analysis identified and grouped participants with similar health literacy scores into mutually exclusive groups, for the development of clinical vignettes.

KEY RESULTS

Participants struggled most with the appraisal of health information (HLQ mean 2.72, standard deviation [SD] .63 [scale 1-4]) and navigating what they often perceived to be a confusing health care system (HLQ mean 3.29, SD .79 [scale 1-5]). On the other hand, most participants reported positive experiences with their health care providers (HLQ mean 3.19, SD .62 [scale 1-4]) and generally felt understood and supported. The cluster analysis suggests we should not assume people living with serious or persistent mental illness have homogeneous HL strengths and needs, meaning a one-size-fits-all solution for improving health literacy in this diverse group will likely not be a successful strategy. It will be important to explore solutions that embrace patient-centered care approaches.

CONCLUSIONS

This study is one of only a handful assessing the health literacy strengths and needs of people living with serious or persistent mental illness. By collecting both quantitative and qualitative data, then analyzing the results using sophisticated cluster analysis methods, the authors were able to develop clinical vignettes per the Ophelia Framework that offer results in a practical way that can be readily understood and acted upon by stakeholders. We found that the HLQ is a measure of HL that is acceptable to mental health clients, and our findings provide preliminary data on the use of this instrument in the mental health population. [HLRP: Health Literacy Research and Practice. 2023;7(1):e2-e13.] Plain Language Summary: This study explored the health literacy strengths and needs of people living with serious or persistent mental illness. The results showed a mix of strengths and needs among our participants, though several consistent themes emerged. Most of our participants felt understood and supported by their health care providers, but many often struggle with judging the quality of health information and finding their way through the health care system.

Low depression literacy exacerbates the development and progression of depressive mood in Chinese adult social media users during COVID-19: A 3-month observational online questionnaire-based study with multiple cross-sectional analyses

Background

The main purpose of this study was to explore the relationship between depression literacy (D-Lit) and the development and progression of depressive mood.

Methods

This longitudinal study with multiple cross-sectional analyses used data from a nationwide online questionnaire administered via the Wen Juan Xing survey platform. Eligible participants were 18 years or older and had subjectively experienced mild depressive moods at the time of their initial enrollment in the study. The follow-up time was 3 months. Spearman's rank correlation test was used to analyze the predictive role of D-Lit on the later development of depressive mood.

Results

We included 488 individuals with mild depressive moods. No statistically significant correlation between D-Lit and Zung Self-rating Depression Scale (SDS) at baseline was observed (adjusted rho = 0.001, p = 0.974). However, after 1 month (adjusted rho = -0.449, p < 0.001) and after 3 months (adjusted rho = -0.759, p < 0.001), D-Lit was significantly and negatively correlated with SDS.

Limitations

The targeted subjects were limited to the Chinese adult social media users; meanwhile, China's current management policies for COVID-19 differ from most of the other countries, limiting the generalizability of this study.

Conclusion

Despite the limitations, our study provided novel evidence supporting that low depression literacy may be associated with exacerbated development and progression of depressive mood, which, if not appropriately and promptly controlled, may ultimately lead to depression. In the future, we encourage further research to explore the practical and efficient ways to enhance public depression literacy.

Assessment of health sciences academic advisors' mental health literacy and their experiences with students facing mental health problems

Background

Owing to everyday educational activities, academic advisors often have to deal with mental health problems among students. Therefore, their mental health literacy must be assessed to determine whether they can detect mental health problems when working with the students.

Objective

This study aimed to assess health sciences academic advisors' mental health literacy and their experiences dealing with university students facing mental health challenges.

Methods

A cross-sectional descriptive study was undertaken among a convenience sample of 133 health sciences academic advisors at the medical campus of a public university in Jeddah, Saudi Arabia. An electronic self-administered questionnaire using the Mental Health Literacy Scale (MHLS) was used to appraise participants' recognition, knowledge, and attitudes toward ways to solve mental health difficulties. Data collection was completed from November 2020 to February 2021. Descriptive statistics, Student's t-test for independent samples, One-Way Analysis of Variance (ANOVA), and Tukey's test were selected for data analysis.

Results

Academic advisors were found to be highly literate about matters of mental health. The mean mental health literacy score was statistically significantly higher in those advisors who were lecturers, assistant professors, associate professors, and professors (p <0.001). Additionally, the mean scores were significantly higher among advisors with a teaching role of lecturer rather than those who did not have the teaching role of a clinical supervisor (t = -2.331; p = 0.021).

Conclusions

The academic advisors had an elevated level of mental health literacy, and the highly experienced academic advisors could deal better with students having mental health problems. Hence, it is essential to continue to provide educational programs and training on mental health literacy to academic advisors, as it helps them identify the signs of mental health complications. Furthermore, it improves their skills and confidence when they offer student support in coping with mental health issues.

Knowledge of psychology in Cambodia: Exploring the relationships to demographics, psychopathology, and idioms of distress

Rates of mental health disorders in Cambodia are markedly higher than in other low- or middle-income countries. Despite these high rates, mental healthcare resources remain scarce and mental health stigma is pervasive, particularly for vulnerable populations of young women and individuals of low socioeconomic status. To address this gap, teaching Western mental health treatments and using a mental healthcare framework are recommended within the Cambodian context. However, Western frameworks do not address cultural syndromes or idioms of distress and operate from an individualistic perspective that does not address cultural values and beliefs. The present study employs a mental health literacy framework in an exploratory analysis of rates of psychological knowledge in a nationally representative sample of Cambodian adults (N = 2,690). To address recommendations for increasing mental healthcare, we designed a survey to investigate Cambodians' knowledge about mental health constructs. Results indicated that only 18.9% of Cambodians knew about psychology, and chi-square analyses revealed that women, individuals in rural areas, and individuals with significant distress due to cultural symptoms and syndromes reported knowing about psychology significantly less than their male and non-distressed counterparts. Additionally, those who reported higher income and higher levels of education indicated significantly higher rates of psychological knowledge, as did those with clinically significant rates of PTSD, at a rate of knowledge approaching significance. Implications for this study include the need to tailor interventions and resources to vulnerable populations, to assess the fit of current recommendations for the Cambodian context, and to further emphasize the need for culturally responsive interventions that address all presentations of Cambodian distress and align with understandings of mental health within the nation.

Online HOPE intervention on help-seeking attitudes and intentions among young adults in Singapore: A randomized controlled trial and process evaluation

INTRODUCTION

Despite the high prevalence of mental health disorders, professional help seeking was often unsought, worsening impairments in overall functioning among those who experienced them.

AIM

This study aimed to evaluate the online HOPE intervention on help-seeking attitudes and intentions among young adults 18 to 24 years old in a University in Singapore. The study also described the process evaluation of the online HOPE intervention.

METHOD

The study adopted a parallel two arms RCT. Outcome measurements measured at baseline, post-test and two-month follow-up were (1) recognition of depression, (2) barriers of help-seeking, (3) help-seeking intentions (4) attitudes about interventions, help sources, medications and (5) participants' perceptions about the intervention.

RESULTS

At post-test, intervention group had significantly lower acknowledgement of depression as stress. At two months, control group was significantly more concerned about side effects of medications. There were no significant differences in all barriers of help-seeking between groups, pre and post intervention. The intervention group had greater acknowledgement of antidepressants, tranquilisers and antipsychotics. Thematic analysis revealed four main themes.

DISCUSSION

There was high baseline recognition of depression. Improvements in help-seeking intentions were partially attributed to decreased help-seeking barriers.

IMPLICATION FOR PRACTICE

The online HOPE intervention could be promptly implemented for young adults to enhance the identification of mental health disorders, early help-seeking and recovery. Nurses played an important role in patient education, and online interventions are especially crucial during this Covid period which mandated social distancing. [NCT04266119].

College Students' eMental Health Literacy and Risk of Diagnosis with Mental Health Disorders

BACKGROUND

This study investigated college students' eMental health literacy (eMHL), knowledge of common mental disorders and risk of being diagnosed with a mental health disorder and compared their knowledge of mental disorders and concurrent risk of diagnosis with high and low eMHL; Method: A total of 123 college students completed an online survey through Amazon's Mechanical Turk (MTurk). Data were analyzed using descriptive statistics and chi-square tests; Results: eMental health literacy scores were higher when students had a history of prior mental health problems, were female, and graduate students. College students with high eMHL were more likely to recognize symptoms, recommend professional help, and be at lower risk for common mental health disorders compared to low eMHL students; Conclusions: eMHL was associated with mental health status and demographic variables. Level of eMHL was associated with knowledge of mental disorders and risk of diagnosis.

IMPLICATIONS

The results highlight the need for targeted interventions to enhance eMHL of college students, support mental health resilience and prevent mental health disorders.