Mental health literacy in a diverse sample of undergraduate students: demographic, psychological, and academic correlates

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.

"When one has no REAL illness"-analysis of the knowledge component of mental health literacy in children and adolescents of parents with a mental illness

Introduction and objective

Mental Health Literacy (MHL) is important in promoting youth mental health. One key aspect of MHL is knowledge about mental disorders, which is particularly relevant for populations at risk for developing mental disorders, such as children of parents with a mental illness (COPMI), representing a mechanism within the transgenerational transmission. Currently, COPMI's level of disorder knowledge in general, and about the specific parental disorder has not been comprehensively researched. We, therefore, aimed to assess COPMI's disorder knowledge and clarify its association with COPMI's age and sex exploratively. To assess both general and disorder-specific knowledge, we took a novel approach that makes disorder knowledge comparable across samples and over time.

Methods

A mixed method analysis of N = 181 semi-structured MHL interviews with COPMI (aged 5 to 17 years) was carried out in the COMPARE-family study in Germany. We conducted a DSM-oriented deductive qualitative content analysis to assess COPMI's general and specific disorder knowledge. Chi-square tests served to identify age and sex differences.

Results

Children revealed limited knowledge of mental disorders in general, whereas adolescents displayed more knowledge that was also partly consistent with descriptions of classification systems like the DSM-5. The level of specific knowledge about the parent's disorder depended on the disorder group. More children displayed adequate knowledge of somatic and anxiety disorders compared to trauma and depressive disorders, and more adolescents displayed adequate knowledge of depressive and anxiety disorders. COPMI's age and sex were found to be significantly associated with disorder knowledge: adolescents exhibited higher levels of adequate general and specific disorder knowledge, and males exhibited higher levels of adequate general disorder knowledge.

Conclusion

Assessing COPMI's disorder knowledge and identifying associated age and sex differences yield valuable insights into the knowledge component of the MHL theory. Our findings can help to improve psychoeducational interventions for COPMI by orienting them to their prevailing levels of disorder knowledge. We recommend employing and extending the DSM-oriented deductive approach to assess knowledge within MHL. Analyses involving additional assessments within the COMPARE-family study are in preparation to identify potential knowledge gains over time, and associations to COPMI's own well-being and mental health symptoms.

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 predictors of mental health literacy among adolescents students

AIM

This study aimed to examine levels of mental health literacy (MHL) and associated factors among adolescents.

METHODS

A descriptive, cross-sectional, analytical study was conducted with a total of 650 students aged 11-18 years in three middle and three high schools. Data were collected using the Child and Adolescent Mental Health Literacy Scale and evaluated using descriptive statistics and regression analysis to determine whether age, gender, and grade are predictive factors of MHL.

RESULTS

The mean age of the participants in the study was 16.8 ± 1.35 years, 55 % of the students were girls, and the mean MHL score was 3.96 ± 1.2, indicating moderate MHL. Multiple regression analysis indicated that the variables of age, gender, and grade explained 5.5 % of the variance in MHL score. When these variables were examined individually, gender and grade had no significant effect (p > 0.05), while older age was associated with higher MHL score (p < 0.05).

CONCLUSION

The results of this study showed that MHL improved with age. MHL promotion is important in mental health resilience. Collaboration between school nurses, school counselors, and psychiatric nurses to provide mental health educational interventions may help reduce stigma and increase help-seeking behaviors.

An exploratory cross-sectional study on Mental health literacy of Spanish adolescents

BACKGROUND

Mental health literacy (MHL) is especially important for young people, but comprehensive studies on MHL in adolescents are limited, with no nationwide studies in Spain. This research aims to study MHL among Spanish adolescents and its relationship with sociodemographic factors.

METHODS

An exploratory study is carried out using stratified random sampling in Spanish adolescents (N = 1000), aged 12-16 years and balanced in terms of gender, age and territorial distribution. Data collection took place in October and November 2023 through online surveys using the CAWI methodology. Sociodemographic variables, contact with mental health and the Spanish version of the Mental Health Literacy Questionnaire (MHLq-E), a self-administered instrument of 32 Likert-type items (1-5) that assesses the dimensions of help-seeking skills, knowledge about causes and symptoms, and stigma, were evaluated. Descriptive and multivariate analyses of variance (MANOVA) were conducted.

RESULTS

In general, adequate levels of literacy were observed, although some aspects related to help-seeking towards teachers, stigmatising attitudes towards people of low economic status and knowledge of severe mental health problems could be improved. The results show contact with previous mental health problems as a key variable for stigma and knowledge about symptomatology together with age. Likewise, gender and family educational level were found to be related to the ability to seek professional help.

CONCLUSION

This study provides information on levels of MHL among Spanish adolescents and highlights significant socio-demographic variables. These findings pave the way for interventions aimed at improving adolescents' understanding, attitudes and skills to manage mental health problems, making possible to adapt content and focus on specific groups, thus increasing its effectiveness.

Evaluating mental health literacy amongst US college students: a cross sectional study

Objective: This study examined levels of mental health literacy amongst US university students, as well as relationships between mental health literacy, help-seeking behaviors, and mental health outcomes. Participants: Three hundred and twenty-six (326) US university students participated in this study online. Methods: Participants filled out questionnaires that assessed their mental health literacy, intentions to seek support, psychological distress, wellbeing, and self-compassion. Results: The mean mental health literacy score was 123.96 (SD = 16.01). Women scored significantly higher than men (p < .01) on mental health literacy. Individuals who had a previous mental disorder diagnosis had significantly higher scores than those with no previous diagnosis (p < .01). A significant positive relationship was found between mental health literacy and self-compassion (p < .01). Conclusions: Our research highlights significant differences between women and men in relation to mental health literacy, psychological distress, and help-seeking behavior. There is a need to design culturally competent interventions that involve diverse students.

Mental health literacy of undergraduate radiography students in Zimbabwe

INTRODUCTION

Assessing the Mental Health Literacy (MHL) of students is crucial in having an understanding of mental health knowledge gaps, stigma, wrong beliefs, risk factors, and treatment-seeking behaviour. The aim of this study was to use a validated scale to examine the MHL of radiography students at a tertiary institution in Harare, Zimbabwe.

METHODS

A cross-sectional descriptive survey was conducted to assess the MHL of radiography students at a tertiary institution in Harare, Zimbabwe, using a validated MHL scale. Individual t-tests and analysis of variance (ANOVA) tests were conducted for each variable to examine the differences between groups expected to differ in their MHL.

RESULTS

A total of 89 students were enrolled into the study. The overall mean MHL score was 96.62 (SD-9.55), with students less knowledgeable on environmental, social, familial, or biological factors that increase the risk of developing a mental illness. Gender had no statistically significant effect on the overall score, t(83) = -0.81, p = 0.42 [Males had mean score = 95.64, SD = 10.14; and Females had mean score = 97.35, SD = 9.12]]. However, there was a significant difference in recognition of disorders by gender, t(83) = -2.42, p = 0.02, with female students (M = 26.24, SD =2.68) scoring higher than male students (M =24.69, SD =3.21). In addition, students with a previous history of mental health disorders scored higher (M =26.86, SD = 2.19) than those with no previous history (M =25.47, SD =3.04), however the difference was not statistically significant.

CONCLUSION

The students in the current study demonstrated lower MHL compared to most studies in the literature. Students were less knowledgeable about environmental, social, familial, or biological factors that increase the risk of developing a mental illness. Furthermore, a correlation between MHL and mental health experience was demonstrated. The implication of these findings is that the curriculum ought to be developed to help undergraduate radiography students become more knowledgeable about mental health and comfortable seeking appropriate support.

Mental health literacy and relational health literacy among college students

Objective: The aim of the present study was to examine MHL and RHL in a sample of college students in the United States, and to explore linkages among literacies and related constructs. Participants: Participants were 169 (N = 169) participants who were adult college students at a state university in the southern United States. Participants were recruited through an online recruitment management system that allows college students to participate in research studies for participation credit. Method: We analyzed online survey data using descriptive analysis. In effort to develop a measurement tool to measure relational mental health literacy, we conducted an exploratory factor analysis on the Relational Health Literacy Scale (RHLS) that was developed for the present study. Results: Results suggest that college students would be willing to seek mental health resources from some professional sources. Participants were able to more easily identify symptoms of anxiety and depression, and struggled to accurately identify symptoms of mania, bipolar disorder and schizophrenia. Respondents also demonstrated some awareness of relationship health issues. Conclusions: Implications for further research, practice and policy making are presented and discussed.

The weaponization of medicine: Early psychosis in the Black community and the need for racially informed mental healthcare

There is a notable disparity between the observed prevalence of schizophrenia-spectrum disorders in racialized persons in the United States and Canada and White individuals in these same countries, with Black people being diagnosed at higher rates than other groups. The consequences thereof bring a progression of lifelong punitive societal implications, including reduced opportunities, substandard care, increased contact with the legal system, and criminalization. Other psychological conditions do not show such a wide racial gap as a schizophrenia-spectrum disorder diagnosis. New data show that the differences are not likely to be genetic, but rather societal in origin. Using real-life examples, we discuss how overdiagnoses are largely rooted in the racial biases of clinicians and compounded by higher rates of traumatizing stressors among Black people due to racism. The forgotten history of psychosis in psychology is highlighted to help explain disparities in light of the relevant historical context. We demonstrate how misunderstanding race confounds attempts to diagnose and treat schizophrenia-spectrum disorders in Black individuals. A lack of culturally informed clinicians exacerbates problems, and implicit biases prevent Black patients from receiving proper treatment from mainly White mental healthcare professionals, which can be observed as a lack of empathy. Finally, we consider the role of law enforcement as stereotypes combined with psychotic symptoms may put these patients in danger of police violence and premature mortality. Improving treatment outcomes requires an understanding of the role of psychology in perpetuating racism in healthcare and pathological stereotypes. Increased awareness and training can improve the plight of Black people with severe mental health disorders. Essential steps necessary at multiple levels to address these issues are discussed.

Development and reliability and validity test of the Fear of Cancer Scale (FOCS)

OBJECTIVE

To develop a Fear of Cancer Scale (FOCS) for non-cancer populations.

METHODS

FOCS was developed by classical measurement theory. A total of 15 college students were invited to conduct semi-structured interviews. Seven experts were invited for expert consultation. A total of 2012 Chinese college students who had completed the electronic questionnaire on WJX.cn platform was included. The reliability and validity of FOCS were verified. Multiple linear regression analysis was adopted to explore the influencing factors of cancer fear among college students and further verify the validity of FOCS.

RESULTS

There were 17 items in the FOCS, including two subscales - direct fear (8 items), and indirect fear (9 items). FOCS had good validity and reliability. Multiple linear regression showed that GAD-7 score, CSDS score, negative coping score, positive coping score, guardian's highest education, gender, life satisfaction, nationality and major were the influencing factors of cancer fear (p < .05).

CONCLUSIONS

The 17-item FOCS was a reliable and valid measure to examine the level of cancer fear in non-cancer populations.

Evaluating mental health literacy in a university hospital: A cross-sectional study

Objective: Mental state and social condition are integrally linked to a person’s physical health. The present study investigates the mental health literacy levels of patients aged 30–50 years who presented to the outpatient clinics of training and research hospital, as well as the relationship between mental health literacy and sociodemographic characteristics. Material and Method: This cross-sectional study included 522 patients aged 30–50 years who presented to the Adult Outpatient Clinics of Karabuk University Training and Research Hospital between October and December 2021. The participants were administered a two-part, 33-item face-to-face questionnaire, in which the first part included 11 items assessing sociodemographic characteristics, and the second part included a 22-item scale comprising three (knowledge, belief, and resource-oriented) subscales for the measurement of the level of Mental Health Literacy (MHL). Results: The mean scores of knowledge, belief and resource-oriented subscales were 8.92±0.98, 1.16±0.92 and 3.37±0.71, respectively, and the mean total MHL scale score was 13.46±1.39. The participants' education level, employment status, financial status, presence of chronic and psychiatric diseases, and psychiatric medication were significantly associated with the MHL scale scores (p=0.013, p=0.023, p=0.024, p=0.000, p=0.000 and p= 0.000, respectively). Conclusion: As the level of MHL increases, so does the person’s awareness of the symptoms of mental health disorders and the correct use of appropriate treatment resources. It is believed that training programs aimed at improving mental health literacy will improve health-related social outcomes, thereby reducing the burden of disease.

Validation of the Mental Health Literacy Scale in French University Students

Background: Mental health literacy is a determinant of mental health, which can facilitate early detection of psychological problems and endorse timely access to care. Instruments to measure mental health literacy exist, but not in French. Assessment of mental health literacy in young adults is essential to tailor appropriate educational interventions promoting psychological wellbeing and preventing mental health problems in this vulnerable population. The aim of this study was to validate the French version of the Mental Health Literacy Scale (MHLS-FR) in university students. Methods: A total of 482 students from the University of Bordeaux, France, completed the translated version of the scale. Collected data were used to validate the MHLS-FR through psychometric analyses: descriptive statistics, item distribution, test-retest reliability, exploratory structural equation model, confirmatory factor analysis, Cronbach’s alpha and McDonald’s omega coefficients, and hypothesis testing. Results: The final scale included 26 items covering 6 dimensions. Cronbach’s alpha and McDonald’s omega coefficients were 0.744 and 0.961, respectively. With test-retest, about 50% of items had intraclass correlation coefficients superior to 0.5. Conclusions: The MHLS-FR can be considered as a valid and reliable instrument for measuring mental health literacy in French students.

'You're on the waiting list': An interpretive phenomenological analysis of young adults' experiences of waiting lists within mental health services in the UK

Waiting lists in mental health services are currently considered too long. Lengthy waits of up to 18 weeks are commonly reported in the UK. Waiting lists have long been associated with a variety of negative psychological responses, however there is little understanding behind young adults’ personal experiences of such delays within mental health services. The current study aimed to explore young adults’ experiences of waiting lists in mental healthcare in the UK. Seven young adults were interviewed in the current study (aged 19–22). Interpretive phenomenological analysis was utilised to explore participant accounts. Three super-ordinate themes were generated: Reliance on Alternative Methods of Support; Inability to Function Sufficiently; and Emergence of Negative Beliefs, Emotions and Thoughts. Participants primarily reported a variety of negative psychological and behavioural consequences associated with waiting lists in mental health services, as well as exacerbated existing physical and psychological health issues. In accordance with the limited number of previous studies, waiting lists are considered by patients to be barriers to mental health support and intervention. Future direction is advised.

The Determinants of Mental Health Literacy among Young Adolescents in Malaysia

Mental health literacy (MHL) is an established multifaceted concept that comprises mental health knowledge, help-seeking, and stigma. Adequate MHL (i.e., the ability to correctly recognize mental health disorders alongside having the intention to seek help) is able improve mental health outcomes among individuals. This study aims to examine the determinants of MHL among young Malaysian adolescents. A cross-sectional study was conducted among 1400 adolescents between 13 and 14 years old from nine national secondary schools in Selangor state, Malaysia. Sociodemographic determinants assessed included gender, age, ethnicity, smoking status, alcohol consumption, history of being bullied, feeling lonely, parental marital status, and parental income which were assessed using the Global School Based Student Health Survey. MHL was assessed using the Mental Health Literacy and Stigma questionnaire. Several factors were significantly associated with adequate levels of MHL following multivariate analysis, such as being female (AOR = 1.68; 95% CI 1.12, 2.52), older adolescents (AOR = 1.56; 95% CI 1.07, 2.30), not smoking (AOR = 1.99; 95% CI 1.20, 4.26), not consuming alcohol (AOR = 1.23; 95% CI 1.18, 2.41), and not feeling lonely (AOR = 1.25; 95% CI 1.06, 1.85). Addressing these determinants could be key in assisting the development of policies and programs to prevent mental health disorders among adolescents, which are currently on the rise.

Factors Influencing Retention of Transgender and Gender Nonconforming Students in Undergraduate STEM Majors

Despite calls for improved data-collection efforts tracking transgender and gender nonconforming (TGNC) people in science, technology, engineering, and mathematics (STEM) education, there have been no reports of TGNC continuation in STEM majors at the university level. Using national, longitudinal data from the Higher Education Research Institute at the University of California, Los Angeles, we analyzed the experiences of 20,910 students who indicated an initial intent to major in a STEM field and found that TGNC students (n = 117) continue in STEM majors at a rate ∼10% lower than their cisgender peers. This gap persists despite TGNC students' high levels of academic ability and academic self-confidence. Through multilevel regression modeling, we found this difference is not explained by experiences that have predicted the likelihood of cisgender students leaving STEM. The only significant predictor of STEM attrition for TGNC students in our model was whether they sought personal counseling; TGNC students who more frequently sought personal counseling were 21% less likely to remain in STEM majors. Overall, TGNC students leave STEM at rates similar to or higher than other minoritized groups, building the case for a multifaced, intersectional approach to addressing diversity and equity in the preparation of the future STEM workforce.