Mental health literacy

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A picture showing the variety of mental health illnesses. Mental Disorder Silhouette.png
A picture showing the variety of mental health illnesses.

Mental health literacy has been defined as "knowledge and beliefs about mental disorders which aid their recognition, management and prevention. Mental health literacy includes the ability to recognize specific disorders; knowing how to seek mental health information; knowledge of risk factors and causes, of self-treatments, and of professional help available; and attitudes that promote recognition and appropriate help-seeking". [1] The concept of mental health literacy was derived from health literacy, which aims to increase patient knowledge about physical health, illnesses, and treatments. [2]

Contents

Framework

Mental health literacy has three major components: recognition, knowledge, and attitudes. A conceptual framework of mental health literacy illustrates the connections between components, and each is conceptualized as an area to target for measurement or intervention. [2] [3] [4] While some researchers have focused on a single component, others have focused on multiple and/or the connection between components. For example, a researcher may focus solely on improving recognition of disorders through an education program, whereas another researcher may focus on integrating all three components into one program.[ citation needed ]

Recognition

Recognition can be broken down into symptom or illness recognition. Symptom recognition is the ability to detect beliefs, behaviors, and other physical manifestations of mental illness, without knowing explicitly which disorder they link to. Specific illness recognition is the ability to identify the presentation of a disorder, such as major depressive disorder.[ citation needed ]

It relates to my article because it defines the mental health needs to be taken seriously Mental-health-2313428 640.png
It relates to my article because it defines the mental health needs to be taken seriously

The recognition of difference between knowledge and attitudes is a crucial part of the mental health literacy framework. While some efforts have focused on promoting knowledge, other researchers have argued that changing attitudes by reducing stigma is a more prolific way of creating meaningful change in mental healthcare utilization. Overall, both approaches have benefits for improving outcomes. [5]

Knowledge

Knowledge is the largest component of mental health literacy, and important topics in Mental Health include:

Attitudes

Attitudes are studied in two sub-components: attitudes about mental disorders, or persons with mental disorders, and attitudes about seeking professional help or treatment. Attitudes can vary greatly by individual, and can often be difficult to measure or target with intervention. Nonetheless, a large body of research literature exists on both sub-components, though not always explicitly tied to the mental health literacy. [8]

Recent research recognizes the varying attitudes across mental health professionals towards prognosis, long-term outcomes and likelihood of discrimination as more negative than those of the public. The attitudes of mental health professionals also differ towards interventions, but this variability is usually related to professional orientation. [9]

Public outlook

Surveys of the public have been carried out in a number of countries to investigate mental health literacy. [10] [11] [12] [13] [14] [15] [16] These surveys demonstrate that the recognition of mental disorders is lacking and reveal negative beliefs about some standard psychiatric treatments, particularly medications. On the other hand, psychological, complementary and self-help methods are viewed much more positively. The public tends to prefer self-help and lifestyle interventions, opposed to medical, and psychopharmacological interventions. [9]

Implications surrounding public attitudes towards mental disorders include negative Stereotypes, Prejudice, or Stigma. As a result, this can influence help-seeking behavior or failure to seek treatment. [9] In Canada, a national survey found that young adult males tend to manage their problems individually and are less likely to seek formal help. [17] Media influence plays a huge role in perpetuating negative mindsets towards mental illness, such as prescribing menacing qualities. A recent study highlights how the majority of participants note the media as the primary source of their beliefs about mental illness being associated with violence, and how this attitude is more prevalent towards serious mental illnesses. [9] Fear and perceptions of danger related to mental illness have increased over the past few decades, largely due to serious mental illness such as schizophrenia being associated as potentially violent and harmful to others. [9] These beliefs and attitudes are potential barriers to seeking individual professional help, and being supportive of others.

Additionally, the negative stigma against mental health may impede the ability of some to get help. When a caregiver avoids seeking mental health treatment due to fear of the stigma surrounding the label of a mental illness, it is seen as affiliate stigma. [18] This phenomenon is exacerbated in scenarios where children who present with signs of mental illness have parents who hold negative beliefs about mental illness. Studies found that individuals that have a negative impression of mental health labels might refuse seeking treatment for themselves or their children in order to avoid mental illness label. [19] A study in 2015 found that affiliate stigma decreases a parent's willingness to pursue mental health treatment for their children, which can lead to decreases in overall well-being for children. [20] This same study found that some parents fear that general practitioners will judge them as bad parents if their children are diagnosed with ADHD. A case study from a supplement to the 2001 US Surgeon General’s report on mental health in America shows an example of low mental health literacy and/or fear of the stigma of mental illness: "An was a 30-year-old bilingual, Vietnamese male who was placed in involuntary psychiatric hold for psychotic disorganization. After neighbors found him screaming and smelling of urine and feces, they called the police, who escorted him to a psychiatric emergency room… His parents had a poor understanding of schizophrenia and were extremely distrustful of mental health providers. They thought that his psychosis was caused by mental weakness and poor tolerance of the recent heat wave…These misconceptions and differences in beliefs caused the parents to avoid the use of mental health services" [21] Affiliate stigma and lack of mental health literacy can cause harm in those suffering from mental illness.

Military

Along with schizophrenia, PTSD is also a highly stigmatized mental disorder that is often misunderstood, especially among the military community. Studies have found that there are various barriers to treatment that prevent many veterans from seeking treatment for PTSD and other mental disorders [22] [23] such as concerns that others will see them as "crazy", beliefs that treatment is ineffective or is simply not worth it, and beliefs that those with mental health problems cannot be relied upon. [24] These beliefs about mental health and mental health treatment is more prevalent in the military community due to the culture of the military that places a strong emphasis on emotional toughness, self-control and stoicism. [25] Though these values are useful in combat scenarios, they can serve as barriers to seeking treatment and treatment adherence. [26]

Measures

Researchers have measured aspects of mental health literacy in several ways. [4] [27] Popular methodologies include vignette studies and achievement tests. Vignette studies measure mental health literacy by providing a brief, detailed story of an individual (or individuals) with a mental health problem, and ask participants questions to identify what problem the individual is experiencing, and at times, additional questions about how the individual can help themselves. [2]

Achievement tests measure mental health literacy on a continuum, such that higher scores on a test indicate greater overall knowledge or understanding of a concept. Achievement tests can be formatted using multiple-choice, true/false, or other quantitative scales.[ citation needed ]

Various scales have been created to measure the various components of mental health literacy, though not all are validated. [4] [27] Mental health literacy has been measured across several populations, varying in age range, culture, and profession. Most studies have focused on adult and young adult populations, though improving literacy in children has been a focus of prevention efforts.

Parental label avoidance can be measured by the Self-Stigma of Seeking Help Scale (SSOSH). [28]

Family empowerment is measured by the Family Empowerment Scale (FES). [29]

Limitations

A statue of a man deep in thought. P psychology.png
A statue of a man deep in thought.

Low literacy within a population is a relevant concern, since at the most basic level, mental health literacy is linked to general literacy. Without this foundation, the beneficial effects of mental health literacy are challenging for those who face difficulties with reading and writing. [9] Increased measures to increase literacy rates must be employed to empower and encourage the self-help components of mental health literacy.[ citation needed ]

Populations can be diverse, which means barriers, such as cultural and social contexts, must be addressed. Within and across cultures, social, economic and political factors profoundly influence mental health. [30] There are numerous environmental and socioeconomic determinants of mental health and mental illness, just as there are for physical health and physical illness. [9] Social determinants of physical health including poverty, education and social support also serve as influencers. [9] In order to encompass mental health literacy and diverse perspectives, further research in these areas are needed.

Recognizing uncommon mental disorders is another hurdle that can disrupt mental health literacy within the public. Recent research shows that most studies are limited to identifying depression, generalized anxiety, and schizophrenia. In a recent Canadian study, most participants demonstrated good mental health literacy in regards to most mental health disorders, but a poor understanding of panic disorder. [31] An increased awareness surrounding underrepresented or more uncommon mental disorders is needed to widen public knowledge.[ citation needed ]

A concluding limitation is the lack of research on child mental health literacy, as the majority of studies focus on adults and adolescents. If caregivers are not educated on recognizing and supporting mental disorders, this could create confusion and result in delayed treatment or wrongful prognosis for dependents. A child mental health literacy (CMHL) initiative could be implemented to target all adults in the general population, as well as parents, teachers, health professionals and/or children themselves. [32]

Improvement approaches

A number of approaches have been tried and suggested to improve mental health literacy, many of which have evidence of effectiveness. These include:

  1. Whole of community campaigns. Examples are beyondblue [33] and the Compass Strategy [34] in Australia, the Defeat Depression Campaign [35] in the United Kingdom, and the Nuremberg Alliance Against Depression [36] in Germany.
  2. School-based interventions. These include MindMatters [37] and Mental Illness Education [38] in Australia, and the Mental Health & High School Curriculum Guide in Canada [39]
  3. Individual training programs. These include mental health first aid training [40] and training in suicide prevention skills. [41] Initiatives that encourage empowerment and choice would also be beneficial, such as web-based self-directed therapy. [9]
  4. Websites and books aimed at the public. There is evidence that both websites and books can improve mental health literacy. [42] [43] However, the quality of information on websites can sometimes be low. [44]
  5. Rapport between mental health professionals and clients. By creating a partnership, professionals can promote competence, informed choice, and comprehensible knowledge for all levels of understanding, such as translating research findings into simpler language. [9]

Family empowerment

Children often must rely on their families in order to access mental health services leading to parents receiving an increasing amount of attention from mental health professionals in order to educate them on mental health. The status of family empowerment (FE) is composed of two dimensions: (a) levels of empowerment (family, knowledge, system and community) and (b) the manor that empowerment is expressed (such as attitudes, knowledge and behaviors). [45] [29] Studies have shown that FE is positively associated with healthy child functioning. [46] [47] FE also deals with an individual's belief in their ability to execute behaviors necessary to produce specific performance attainments, also called self-efficacy, [48] specifically regarding attaining knowledge of mental health. A study conducted in 2022 found that increased parent self-efficacy regarding mental health is positively correlated with child well-being outcomes. [49]

Sports

Mental health literacy has also found its uses in the realm of sports. Sports social workers are promoting mental health literacy of athletes through various means. Social workers are engaging in research, education, policy development, advocating for individuals, organizing communities, and through direct practice. [50]

See also

Related Research Articles

A mental disorder, also referred to as a mental illness, a mental health condition, or a psychiatric disorder, is a behavioral or mental pattern that causes significant distress or impairment of personal functioning. A mental disorder is also characterized by a clinically significant disturbance in an individual's cognition, emotional regulation, or behavior, often in a social context. Such disturbances may occur as single episodes, may be persistent, or may be relapsing–remitting. There are many different types of mental disorders, with signs and symptoms that vary widely between specific disorders. A mental disorder is one aspect of mental health.

<span class="mw-page-title-main">Postpartum depression</span> Mood disorder experienced after childbirth

Postpartum depression (PPD), also called postnatal depression, is a type of mood disorder experienced after childbirth, which can affect both sexes. Symptoms may include extreme sadness, low energy, anxiety, crying episodes, irritability, and changes in sleeping or eating patterns. PPD can also negatively affect the newborn child.

<span class="mw-page-title-main">Mental health</span> Level of human psychological well-being

Mental health encompasses emotional, psychological, and social well-being, influencing cognition, perception, and behavior. According to World Health Organization (WHO), it is a "state of well-being in which the individual realizes his or her abilities, can cope with the normal stresses of life, can work productively and fruitfully, and can contribute to his or her community". It likewise determines how an individual handles stress, interpersonal relationships, and decision-making. Mental health includes subjective well-being, perceived self-efficacy, autonomy, competence, intergenerational dependence, and self-actualization of one's intellectual and emotional potential, among others. From the perspectives of positive psychology or holism, mental health may include an individual's ability to enjoy life and to create a balance between life activities and efforts to achieve psychological resilience. Cultural differences, personal philosophy, subjective assessments, and competing professional theories all affect how one defines "mental health". Some early signs related to mental health difficulties are sleep irritation, lack of energy, lack of appetite, thinking of harming oneself or others, self-isolating, and frequently zoning out.

<span class="mw-page-title-main">Beyond Blue</span> Australian mental health and wellbeing support organisation

Beyond Blue is an Australian mental health and wellbeing support organisation. They provide support programs to address issues related to depression, suicide, anxiety disorders and other related mental illnesses.

Social stigma is the disapproval of, or discrimination against, an individual or group based on perceived characteristics that serve to distinguish them from other members of a society. Social stigmas are commonly related to culture, gender, race, socioeconomic class, age, sexual orientation, sexuality, body image, physical disability, intelligence or lack thereof, and health. Some stigma may be obvious, while others are known as concealable stigmas that must be revealed through disclosure. Stigma can also be against oneself, stemming from negatively viewed personal attributes in a way that can result in a "spoiled identity".

Mental health in China is a growing issue. Experts have estimated that about 130 million adults living in China are suffering from a mental disorder. The desire to seek treatment is largely hindered by China's strict social norms, as well as religious and cultural beliefs regarding personal reputation and social harmony.

Mental disorders are classified as a psychological condition marked primarily by sufficient disorganization of personality, mind, and emotions to seriously impair the normal psychological and often social functioning of the individual. Individuals diagnosed with certain mental disorders can be unable to function normally in society. Mental disorders may consist of several affective, behavioral, cognitive and perceptual components. The acknowledgement and understanding of mental health conditions has changed over time and across cultures. There are still variations in the definition, classification, and treatment of mental disorders.

Mental distress or psychological distress encompasses the symptoms and experiences of a person's internal life that are commonly held to be troubling, confusing or out of the ordinary. Mental distress can potentially lead to a change of behavior, affect a person's emotions in a negative way, and affect their relationships with the people around them.

<span class="mw-page-title-main">Mental health first aid</span>

Mental health first aid is an extension of the concept of traditional first aid to cover mental health conditions. Mental health first aid is the first and immediate assistance given to any person experiencing or developing a mental health condition, such as depression or anxiety disorders, or experiencing a mental health crisis situation such as suicidal ideation or panic attack.

The study of mental health in the Middle East is an area of research that continues to grow in its scope and content. As of May 10, 2019, WHO study shows over 70 countries and territories across six regions, including Egypt, Iraq, Jordan, Lebanon, the occupied Palestinian territory, Qatar, Syria, Tunisia, the UAE, and Yemen, have prioritized coverage of mental health conditions.

Mental illnesses, also known as psychiatric disorders, are often inaccurately portrayed in the media. Films, television programs, books, magazines, and news programs often stereotype the mentally ill as being violent, unpredictable, or dangerous, unlike the great majority of those who experience mental illness. As media is often the primary way people are exposed to mental illnesses, when portrayals are inaccurate, they further perpetuate stereotypes, stigma, and discriminatory behavior. When the public stigmatizes the mentally ill, people with mental illnesses become less likely to seek treatment or support for fear of being judged or rejected by the public. However, with proper support, not only are most of those with psychiatric disorders able to function adequately in society, but many are able to work successfully and make substantial contributions to society.

Culture defines how people view the world and certain phenomena. Culture also appears to influence the way people experience depression. An individual's experience with depression can vary from country to country. For example, a qualitative study revealed that some countries did not recognize post-natal depression as an illness; rather, it was viewed as a state of unhappiness that did not require any health interventions.

Mental health inequality refers to the differences in the quality, access, and health care different communities and populations receive for mental health services. Globally, the World Health Organization estimates that 350 million people are affected with depressive disorders. Mental health can be defined as an individual's well-being and/or the absence of clinically defined mental illness. Inequalities that can occur in mental healthcare may include mental health status, access to and quality of care, and mental health outcomes, which may differ across populations of different race, ethnicity, sexual orientation, sex, gender, socioeconomic statuses, education level, and geographic location. Social determinants of health, more specifically the social determinants of mental health, that can influence an individual's susceptibility to developing mental disorders and illnesses include, but are not limited to, economic status, education level, demographics, geographic location and genetics.

In colleges and universities in the United States, suicide is one of the most common causes of death among students. Each year, approximately 24,000 college students attempt suicide while 1,100 students succeed in their attempt, making suicide the second-leading cause of death among U.S. college students. Roughly 12% of college students report the occurrence of suicide ideation during their first four years in college, with 2.6% percent reporting persistent suicide ideation. 65% of college students reported that they knew someone who has either attempted or died by suicide, showing that the majority of students on college campuses are exposed to suicide or suicidal attempts.

<span class="mw-page-title-main">Mental health in South Korea</span>

Mental health issues are prevalent in South Korea, with the highest suicide rate in the OECD and the highest rate of hospitalizations for mental illness among OECD countries. South Korea has state-funded mental health services, the majority of which are inpatient hospital facilities, but they are largely underfunded and underutilized. Despite the prevalence of mental illness, social stigma remains prevalent throughout the South Korean population, which discourages sufferers from seeking treatment. Mental illness, while present across all demographic groups, is most common among the elderly and adolescents in South Korea.

Prevention of mental disorders are measures that try to decrease the chances of a mental disorder occurring. A 2004 WHO report stated that "prevention of these disorders is obviously one of the most effective ways to reduce the disease burden." The 2011 European Psychiatric Association (EPA) guidance on prevention of mental disorders states "There is considerable evidence that various psychiatric conditions can be prevented through the implementation of effective evidence-based interventions." A 2011 UK Department of Health report on the economic case for mental health promotion and mental illness prevention found that "many interventions are outstandingly good value for money, low in cost and often become self-financing over time, saving public expenditure". In 2016, the National Institute of Mental Health re-affirmed prevention as a research priority area.

The Attribution Questionnaire (AQ) is a 27-item self-report assessment tool designed to measure public stigma towards people with mental illnesses. It assesses emotional reaction and discriminatory responses based on answers to a hypothetical vignette about a man with schizophrenia named Harry. There are several different versions of the vignette that test multiple forms of attribution. Responses assessing stigma towards Harry are in the form of 27 items rated on a Likert scale ranging from 1 (not at all) to 9 (very much). There are 9 subscales within the AQ that breakdown the responses one could have towards a person with mental illness into different categories. The AQ was created in 2003 by Dr. Patrick Corrigan and colleagues and has since been revised into smaller tests because of the complexity and hypothetical that did not capture children and adolescent's stigmas well. The later scales are the Attribution Questionnaire-9 (AQ-9), the revised Attribution Questionnaire (r-AQ), and the children's Attribution Questionnaire (AQ-8-C).

Obstacles to receiving mental health services among African American youth have been associated with stigma and shame, child-related factors, treatment affordability, availability, and accessibility, clinician and therapeutic factors, the school system, religion/spirituality, and social networks. When examining the prevalence rates of African American youth that have experienced cognitive and behavioral challenges, the underutilization of mental health services is startling. The National Comorbidity Survey-Adolescent Supplement revealed that 46.8% of African Americans under 18-years-old may have a mental health disorder. Additionally, African American children between the ages of five- and twelve-years old commit suicide at approximately double the rate of their White counterparts. Furthermore, the data from the Youth Risk Behavior Surveillance System (YRBSS) showed that Black students commit suicide at higher rates than White students. With all this information in mind, only three-quarters of African American children receive mental health care. 76.5% of African American youth from the ages of six to seventeen have mental health issues that need help, but their needs are not met. 50% to 75% of urban community-dwelling Black children and adolescents do not receive mental health care. A study showed that African American youth experiencing a major depressive episode are more unlikely to seek aid or speak to anyone about how they feel. 13% to 52% of African American child and adolescents who do not receive the mental health care that they need are at higher risk for detrimental health outcomes; hence, the importance of identifying the obstacles that may prevent unaddressed mental health service needs.

Serious mental illness (SMI) is characterized as any mental health condition that impairs seriously or severely from one to several significant life activities, including day to day functioning. Four common examples of SMI include bipolar disorders, psychotic disorders, post-traumatic stress disorders, and major depressive disorders. People having SMI experience symptoms that prevent them from having experiences that contribute to a good quality of life, due to social, physical, and psychological limitations of their illnesses. In 2021, there was a 5.5% prevalence rate of U.S. adults diagnosed with SMI, with the highest percentage being in the 18 to 25 year-old group (11.4%). Also in the study, 65.4% of the 5.5% diagnosed adults with SMI received mental health care services.

The social determinants of mental health (SDOMH) are societal problems that disrupt mental health, increase risk of mental illness among certain groups, and worsen outcomes for individuals with mental illnesses. Much like the social determinants of health (SDOH), SDOMH include the non-medical factors that play a role in the likelihood and severity of health outcomes, such as income levels, education attainment, access to housing, and social inclusion. Disparities in mental health outcomes are a result of a multitude of factors and social determinants, including fixed characteristics on an individual level – such as age, gender, race/ethnicity, and sexual orientation – and environmental factors that stem from social and economic inequalities – such as inadequate access to proper food, housing, and transportation, and exposure to pollution.

References

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