Mental Health Literacy in Healthcare Students: An Expansion of the Mental Health Literacy Scale

The Effectiveness of Interventions on Improving the Mental Health Literacy of Health Care Professionals in General Hospitals: A Systematic Review of Randomized Controlled Trials

BACKGROUND

Suboptimal mental health literacy levels among general hospital health care professionals negatively impact the care coordination of patients with physical-mental comorbidity.

AIMS

This review is to examine the evidence on the effectiveness of interventions to improve the mental health literacy of general hospital health care professionals.

METHODS

A systematic search of literature was conducted in 13 electronic databases with manual searching of reference lists from 1980 to 2021. Studies were screened by pre-set eligibility criteria, that is, participants who were general hospital health care professionals taking care of adult patients, the interventions aimed at improving any components of participants' mental health literacy, comparisons were alternative active intervention or no intervention, and the primary outcomes were any aspects of mental health literacy.

RESULTS

Eight randomized controlled trials (N = 1,732 participants) were included in this review. Evidence indicated that mental health literacy interventions with educational components can improve components of the health care professionals' mental health literacy, in terms of mental health knowledge and mental illness-related attitudes/stigma. In addition, few studies evaluated all components of participants' mental health literacy.

CONCLUSIONS

Based on the available evidence, educational interventions had a positive effect on components of general hospital health care professionals' mental health literacy. Health care organizations should provide educational programs to enhance general hospital health care professionals' mental health literacy. Further studies are needed to explore interventions that target all components of general hospital staff's mental health literacy and to evaluate its impact on the psychiatric consultation-liaison service utilization in general hospitals, as well as patient outcomes.

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.

What works for whom, how and why in mental health education for undergraduate health profession students? A realist synthesis protocol

INTRODUCTION

It has been shown that mental health education can support positive attitudes of health profession students towards people with mental health challenges, which supports them to provide optimal healthcare to this group. There are many different approaches to designing and delivering mental health education to health profession students. Each has their own advantages and disadvantages, and often mental health education programmes incorporate a multimodal approach in order to reap the benefits of a variety of teaching and learning approaches. The aim of this study is to understand the current landscape of teaching and learning approaches to mental health education for undergraduate health profession students. We will examine the features of successful outcomes for health profession students for:Learning environment.Knowledge development and retention.Confidence.

MOTIVATION

Preparedness for professional practice.

METHODS

For this, a realist synthesis has been chosen in order to review the literature. Realist synthesis lends itself to the review of complex interventions such as mental health education for undergraduate health profession curricula because it seeks to uncover the range of different mechanisms and context configurations that produce different outcomes. Health profession education and education practice, in general, is complex. A patient and public involvement (PPI) group is involved throughout this study and includes undergraduate health profession students, and members of the St John of Gods Hospital Consumers and Carers Council who are involved at every stage of the research. This study will engage with a stakeholder group who will support the refining of the programme theory.

ETHICS AND DISSEMINATION

Ethical approval has been sought and approved by Royal College of Surgeons, Ireland Ethical Committee (REC number: 212622783). We will aim to write up and publish the full synthesis as a journal article. We will also discuss ways of dissemination outside of academia with our PPI group.

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.

Predictors of Mental Health Literacy in a Sample of Health Care Major Students: Pilot Evaluation Study

BACKGROUND

The numerous mental health awareness campaigns during the COVID-19 pandemic have shifted our understanding and perception of mental health.

OBJECTIVE

The purpose of this study is to evaluate predictors of mental health literacy (MHL), that is, one's knowledge and beliefs about mental disorders. We evaluate whether digital health literacy, empathy, and mentalizing contribute to MHL.

METHODS

Our sample consisted of 89 health care major students, aged between 17 and 32 years, studying at a university in Lebanon. The Mental Health Literacy Scale for Healthcare Students (MHLS-HS), the eHealth Literacy Questionnaire (eHLQ), the Basic Empathy Scale (BES), and the Reflective Functioning Questionnaire-8 (RFQ-8) were used.

RESULTS

Multiple regression analyses revealed that the Engagement in Own Health subscale of digital health literacy constituted a predictor of MHL. While empathy and mentalizing did not directly predict MHL, they were found to predict components of MHL.

CONCLUSIONS

This is the first study to evaluate digital health literacy, empathy, and mentalizing as predictors of MHL in Lebanon, a country where mental health is still considered taboo. Moreover, this pilot study is the first to provide some support for the predictive role of some digital health literacy subscales on MHL in light of the rise of the digital era following the COVID-19 pandemic.

Augmenting mental health literacy of troops in a large military station: A novel approach

Background

Mental health literacy (MHL) helps in acknowledging the symptoms at an early stage, thus promoting prompt management of negative stress behaviors. Despite the central thrust towards augmentation of MHL of troops, there is a paucity of available literature on the subject matter, especially in the Indian context. Current research explores the efficacy of a standardized Information Education and Communication (IEC) module for the promotion of MHL among troops.

Materials and Methods

1200 soldiers posted in a large military station underwent a psycho-educational module about stress and related mental health conditions in an open-label experimental study. Data was collected using a simple demographic tool and a specially constructed Armed Forces Medical College (AFMC) mental health awareness questionnaire. The same sample was studied before the IEC activity, immediately after the IEC activity, and again after six months.

Results

Community-based psycho-educational module helped in improvement in MHL and the gains were stable at six months.

Conclusions

Well-standardized and structured module was found to be an effective strategy for improving MHL. The authors consider this study as seminal for bringing objectivity to mental health promotional programs in the Armed Forces.

An Assessment of the Training Program on Mental Health for Community Health Workers in Kashmir, India

In recent years mental health has emerged as a major health threat in low income countries like India. In response, mental health care has been integrated into primary health care, in turn creating a rising demand for trained and skillful mental health professionals. This study was conducted in district Budgam (J&K), India with the aim of providing training to community health workers (CHWs) and measuring the change using pre- and post-training evaluations. The pre and post tests were undertaken, assessing changes in mental health literacy at three different points of time: pre-training, post-training, and three month follow-up. Mental health literacy was assessed using the interviewer-administered Mental Health Literacy Survey. The training intervention was a five-day course based on a facilitator's manual developed specifically for community health workers in India. A total of 25 community health workers from rural areas of Budgam District (mostly Integrated Child Development Service supervisors), Health Educators and Anganwadi Workers, were engaged for the study. Findings demonstrate that the training course improved participants' ability to recognize any mental health disorders. There was a clear distinction between the level of awareness pre- and post- training. The results were statistically significant on various domains Ability to recognize disorders (Pre-post P= 0.001), Knowledge of the professional help available (Pre-post p= 0.000), Attitudes that promote the recognition or appropriate help-seeking behavior (Pre-post p= 0.000) (p<0.05). Further follow up after three months was done. The mixed findings from this study, suggesting the training course has potential to improve some aspects of mental health literacy among the CHWs, including their understanding of various mental health problems.

Sağlık Öğrencileri İçin Ruh Sağlığı Okuryazarlık Ölçeğinin Türkçeye Uyarlanması: Geçerlik ve Güvenirlik Çalışması

Amaç: Bu çalışmada, Sağlık Öğrencileri için Ruh Sağlığı Okuryazarlık Ölçeğinin (RSOÖ-SÖ) Türkçe uyarlaması için geçerlilik ve güvenilirlik yapılması amaçlanmıştır. Method: Çalışma örneklemi 18-27 yaş arasında İstanbul Tıp Fakültesinde öğrenim gören 275 kişiden oluşmaktadır. RSOÖ-SÖ ölçeği, Ruhsal Hastalıklara Yönelik İnanç Ölçeği (RHYİÖ) ve Pozitif Mental Sağlık Ölçeğini (PMSÖ) veri toplamada kullanılmıştır. Dil uyarlaması için çeviri, geri çeviri, uzman görüşleri ve pilot uygulama yapılmıştır. Geçerlik için kapsam geçerlilik indeksi, doğrulayıcı faktör analizi ve güvenilirliği test etmek için Cronbach alfa analizi, test-tekrar test yöntemi kullanılmıştır. Bulgular: Ölçeğin kapsam geçerlilik indeksi 0.99 ve doğrulayıcı faktör analizine göre madde yükleri 0.38-0.94 olduğu bulunmuştur. Cronbach alfa katsayısı tüm ölçek için 0.79, beş alt boyutu için ise 0.60-0.89 arasında olduğu belirlenmiştir. Eşdeğer ölçüt geçerliliğinde RHYİÖ ile negatif yönlü zayıf korelasyon (r=-0.391, p

Perinatal mental health literacy: knowledge, attitudes, and help-seeking among perinatal women and the public - a systematic review

Background

The perinatal period is a time of increased vulnerability to mental health problems, however, only a small proportion of women seek help. Poor mental health literacy (MHL) is a major barrier to seeking help for mental health problems. This study aimed to collect the existing evidence of MHL associated with perinatal mental health problems (PMHP) among perinatal women and the public. This review analysed which tools were used to assess perinatal MHL as well as the findings concerning individual components of perinatal MHL.

Methods

Four electronic databases (PubMed, PsycINFO, Web of Science, and CINAHL) were analysed from their inception until September 1, 2020. Not only quantitative studies reporting on components of MHL (knowledge, attitudes, and help-seeking), but also studies reporting overall levels of MHL relating to PMHP were taken into account. Two independent reviewers were involved in the screening and extraction process and data were analysed descriptively.

Results

Thirty-eight of the 13,676 retrieved articles satisfied the inclusion criteria. The majority of selected studies examined MHL related to PMHP in perinatal women (N = 28). The most frequently examined component of MHL in the selected data set was help-seeking. A lack of uniformity in assessing MHL components was found. The most common focus of these studies was postpartum depression. It was found that the ability to recognize PMHP and to identify relevant symptoms was lacking among both perinatal women and the public. Perinatal women had low intentions of seeking help for PMHP and preferred seeking help from informal sources while reporting a variety of structural and personal barriers to seeking help. Stigmatizing attitudes associated with PMHP were found among the public.

Conclusions

There is a need for educational campaigns and interventions to improve perinatal MHL in perinatal women and the public as a whole.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12884-022-04865-y.

Measuring health literacy: A systematic review and bibliometric analysis of instruments from 1993 to 2021

BACKGROUND

It has been about 30 years since the first health literacy instrument was developed. This study aimed to review all existing instruments to summarize the current knowledge on the development of existing measurement instruments and their possible translation and validation in other languages different from the original languages.

METHODS

The review was conducted using PubMed, Web of Science, Scopus, and Google Scholar on all published papers on health literacy instrument development and psychometric properties in English biomedical journals from 1993 to the end of 2021.

RESULTS

The findings were summarized and synthesized on several headings, including general instruments, condition specific health literacy instruments (disease & content), population- specific instruments, and electronic health. Overall, 4848 citations were retrieved. After removing duplicates (n = 2336) and non-related papers (n = 2175), 361 studies (162 papers introducing an instrument and 199 papers reporting translation and psychometric properties of an original instrument) were selected for the final review. The original instruments included 39 general health literacy instruments, 90 condition specific (disease or content) health literacy instruments, 22 population- specific instruments, and 11 electronic health literacy instruments. Almost all papers reported reliability and validity, and the findings indicated that most existing health literacy instruments benefit from some relatively good psychometric properties.

CONCLUSION

This review highlighted that there were more than enough instruments for measuring health literacy. In addition, we found that a number of instruments did not report psychometric properties sufficiently. However, evidence suggest that well developed instruments and those reported adequate measures of validation could be helpful if appropriately selected based on objectives of a given study. Perhaps an authorized institution such as World Health Organization should take responsibility and provide a clear guideline for measuring health literacy as appropriate.

Adolescent Mental Health Literacy Questionnaire: Investigating Psychometric Properties in Iranian Female Students

Objectives

Mental Health Literacy (MHL) is an important factor in promoting mental health. Assessing this structure is required for early recognition and intervention in mental health problems. To date, there was no tool to assess it among Iranian adolescents, so this study was aimed at examining the psychometric properties of the Persian version of the Adolescent Mental Health Literacy Questionnaire (AMHLQ) among Iranian female students.

Method

The study instrument was a Persian version of the AMHLQ prepared through a translation and back-translation process. In this cross-sectional study, 275 female students completed the AMHLQ, and the Adolescent Strengths, and Difficulties Questionnaire (SDQ).

Results

Findings of content, construct validity tests, Cronbach's alpha, and split-half coefficient demonstrated that the AMHLQ had satisfactory validity and suitable reliability. The exploratory factor analysis showed four dimensions of the AMHLQ: (1) knowledge of mental health problems (α = 0.89); (2) erroneous beliefs/stereotypes (α = 0.89); (3) help-seeking and first aid skills (α = 0.86); and (4) self-help strategies (α = 0.74).

Conclusion

The findings showed that the tool was confirmed by questions and subscales, and this questionnaire was a valid and reliable tool in assessing level differences of MHL and in determining the impact of programs designed to improve MHL in Iranian female adolescents.

The Effectiveness of Mental Health Literacy Curriculum among Undergraduate Public Health Students

Mental health literacy (MHL) plays an important role in public health. Improving MHL can promote mental health at the individual and public levels. To date, no published studies have assessed the effectiveness of MHL curriculum interventions among undergraduate public health students. The participants in this study were undergraduate public health students (n = 48) who were enrolled in an 18-week MHL curriculum for 100 min per week. MHL was assessed using the Mental Health Literacy Scale for Healthcare Students. A paired sample t-test was performed to examine the immediate and delayed effects of the MHL curriculum. The total MHL score significantly improved, and a moderate effect size was found directly after the intervention and six weeks later. There were significant differences in the recognition of mental illness (p < 0.01), help-seeking efficacy (p < 0.05), and help-seeking attitude (p < 0.05) in the five components of MHL between pre- and post-test. Furthermore, significant improvements were obtained for the maintenance of positive mental health (p < 0.05) and reduction of mental illness stigma (p < 0.001) between the pre-test and follow-up. Our findings provide evidence for the development and implementation of an MHL curriculum for public health education.

Validation and Psychometric Testing of the Chinese Version of the Mental Health Literacy Scale Among Nurses

The Mental Health Literacy Scale (MHLS) is the most widely used and strong theory-based measurement tool to gain an understanding of mental health knowledge and ability. This study aimed to test the psychometric properties of the Chinese version of the Mental Health Literacy Scale (MHLS-C) and to document the norm and its influential factors of mental health literacy among nurses. The MHLS was translated following Brislin's translation model and tested with a sample of 872 clinical registered nurses. The Jefferson Scale of Empathy-Health Professionals (JSE-HP), Patient Health Questionnaire-2 (PHQ-2), and Generalized Anxiety Disorder-2 (GAD-2) were administered to assess convergent validity. The minimum average partial test, parallel analysis and confirmatory factor analysis supported 4 first-order 2 second-order structure. The 4 factors were named "knowledge of mental disorder," "ability to seek information and help," "recognition of mental disorder," and "acceptance of patients with mental illness," with factor 1-3 were summarized into MHLS-Core (Core literacy subscale) and factor 4 as MHLS-SA (Social acceptance subscale). The MHLS-C was moderately negatively correlated with the PHQ-2 and GAD-2 (-0.111, -0.081) and highly positively correlated with JSE-HP (0.492). The Cronbach's α was 0.85 for the overall scale and 0.89 and 0.93 for two subscales. The test-retest reliability was good, with intraclass correlation coefficients (ICCs) of 0.80 for the whole scale, and 0.79 and 0.94 for two subscales. As an approximately normal distribution, the 50 th percentile for the MHLS-C was 99, with 50 th percentiles of 74 and 20 for MHLS-Core and MHLS-SA. Higher position, higher professional credentials, higher hospital hierarchy, other specialist hospital, psychiatric hospital and unmarried status were positive predictors. The 29-item MHLS-C, with two subscales of MHLS-Core and MHLE-SA, is a stable and validated tool to measure mental health literacy. MHLS-Core could be used independently to measure the core content of mental health literacy. It may be applicable for Chinese health professionals, but need further validation among the general public. MHL curriculum and a targeted culturally appropriate program for acceptance for health professionals, especially for those in general hospitals and with less working tenure, may be recommended.

A Structural Equation Modeling of Mental Health Literacy in Healthcare Students

Background: There is a high prevalence of mental illness among healthcare students, and most students with mental health problems are reluctant to seek help from mental health professionals. Help-seeking is a component of mental health literacy (MHL). Although MHL is conceptualized as multi-dimensional, a theory-based multi-construct of MHL is still lacking. We aimed to build a theory-based multi-construct of MHL to explore the pathways of help-seeking. Methods: The data were obtained from a survey on MHL among healthcare students in 2018 (n = 1294). The Mental Health Literacy Scale for Healthcare Students was used to measure the maintenance of positive mental health, recognition of mental illness, mental illness stigma attitudes, help-seeking efficacy, and help-seeking attitudes. Descriptive analysis and structural equation modeling (SEM) were conducted. Results: The findings of the SEM model indicated recognition of mental illness had a positive direct effect on both help-seeking efficacy and maintenance of positive mental health. Additionally, help-seeking efficacy fully mediated the relationship between recognition of mental illness and help-seeking attitudes. Conclusions: Help-seeking efficacy plays a significant role in healthcare students' willingness to seek professional help when mental health care is needed. Accordingly, improving help-seeking efficacy strategies would increase the use of mental health services and contribute to the prevention of mental health problems.

Psychological distress and mental health literacy in university students

PURPOSE

This study aimed to assess university students' levels of psychological distress and mental health literacy.

DESIGN AND METHODS

This descriptive and cross-sectional study using self-assessment instruments with 417 volunteer university students was conducted in the fall semester of the 2019-2020 academic year.

FINDINGS

More than half of the participants had diagnosable psychological distress in terms of mental illness. The participants had a low level of mental health literacy, females and people with a mental illness had higher mental health literacy scores.

PRACTICE IMPLICATIONS

The results indicated that the scales could be used to develop interventions to assist Turkish students' transition to healthy adulthood. Determining individuals' psychological distress allows early detection of mental problems.