Aspects Of Mental Health Literacy Research Articles

Stigma, Help-seeking and Factors Associated with Mental Health Literacy in Adults: A Literature Review

The article aims to review domestic and foreign research to provide information about the current condition of two of the three aspects of mental health literacy, namely stigma, and help-seeking, and the related factors to understand impact measures to help improve the adults' mental health literacy. This study uses a literature review method with English and Vietnamese keyword searching on PubMed and Vietnamese journals. Results show that stigma happens to be higher in Asian regions than in Australia, Europe, and America. Reducing stigma will improve treatment effectiveness and enhance the mental health literacy of individuals and communities. Regarding help-seeking, it shows that the rate of seeking help ranges from 28.2% to 76.9%. People with low mental health literacy are often less likely to seek help. Age, gender, education level, income, employment position, marital status, medical history, and alcohol use history are factors related to mental health literacy. Previous studies have shown that people with higher knowledge tend to seek help, while those with less stigma have a higher ability to seek help.
 Keywords: Related factors, mental health literacy, adults, stigma, help-seeking.

Seeking professional help for mental health issues in Slovenia: Prevalence and associated factors

Abstract Background The aim of the study was to examine the prevalence of seeking professional help for mental health issues and explore its association with sociodemographic factors, various aspects of mental health literacy, and symptom severity. Methods A cross-sectional survey was conducted from November 2021 to January 2022 using a probability sample of Slovenians aged 18-64 (prepared by The Statistical Office of the Republic of Slovenia). Of the 9000 participants invited, 2677 (52.2% males) completed the survey (30% response rate) either online (78.9%) or in paper format (21.1%). The prevalence of mental health issues and professional help-seeking was assessed using self-developed questions. Logistic regression was used to test the probability of seeking professional help, with predictor variables including sociodemographic, Depression literacy questionnaire (D-lit), Anxiety literacy questionnaire (A-lit), Inventory of Attitudes Toward Seeking Mental Health Services (IASMHS), General Help-Seeking Questionnaire (GHSQ), Patient Health Questionnaire (PHQ-9), Generalised Anxiety Disorder Assessment (GAD-7), General mental health (self-developed question). Results Among those who reported having mental health issues currently or in the past (44% of the sample), 46.6 % had never sought professional help. The logistic regression model was statistically significant (p < 0.001, χ2 (df)= 214,637(16)), revealing that women, older participants, those with higher score on A-lit, GHSQ, and those participants which reported worse general mental health were more likely to seek professional help. The variable D-lit, as well as PHQ-8, GAD-7, and subjective social status, were not significant predictors. For education and the variable IASMHS, only some of the predictors were statistically significant. Conclusions The study highlights the need for systematic approaches and targeted interventions at the national level to promote and enhance seeking professional help for mental health issues. Key messages • The study found a large help-seeking gap for mental health issues, with only specific aspects of mental health literacy (eg anxiety literacy) being significant predictors of seeking professional help.

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

Suboptimal mental health literacy levels among general hospital health care professionals negatively impact the care coordination of patients with physical-mental comorbidity. This review is to examine the evidence on the effectiveness of interventions to improve the mental health literacy of general hospital health care professionals. 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. 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. 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.

A randomised controlled trial evaluating the Guide Cymru mental health literacy intervention programme in year 9 (age 13–14) school pupils in Wales

BackgroundAdolescent mental health has become a public health concern as 10–20% of adolescents have experiences with mental health problems. Improving mental health education is critical to reducing stigma and improving access to appropriate care when needed. Here we examine the impact of a mental health literacy programme (Guide Cymru) in young adolescents in the UK. A randomised controlled trial assessed the effectiveness of the Guide Cymru intervention.MethodA total of 1,926 pupils (860 males and 1066 females) aged 13–14 (year 9) took part in the study. The secondary schools were randomised into the active and control arms of the study. Teachers in the active arm of the study were trained on the Guide Cymru and then delivered the intervention to their pupils. Pupils in the active groups received six modules of mental health literacy (the Guide Cymru), and control schools received teaching as usual. Mental health literacy across several domains (e.g., knowledge, stigma, help-seeking intentions) were assessed both before and after the intervention. Data collection for the randomised controlled trial ran from September 2019 to March 2020. Multi-level modelling analysis was conducted to account for the clustered nature of the design.ResultsAll aspects of mental health literacy, including mental health knowledge (g = 0.32), good mental health behaviours (g = 0.22), mental health stigmas (g = 0.16), intentions to seek help (g = 0.15), and avoidant coping (g = 0.14) improved after completing the Guide Cymru programme (ps < .001).DiscussionThe current study presents evidence for the Guide Cymru’s effectiveness in improving secondary school pupils' mental health literacy. We demonstrate that providing teachers with appropriate resources and training to deliver the Guide Cymru programme within their classrooms can improve the mental health literacy of pupils. These findings have important implications for the beneficial impacts the secondary school system can have on reducing the burden of mental health problems at a critical point in a young person’s life.Trial registrationISRCTN15462041. Registered 03/10/2019.

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.

Development and psychometric properties of the Knowledge and Attitudes to Mental Health Scales (KAMHS): a psychometric measure of mental health literacy in children and adolescents

BackgroundAdolescence is a crucial period for the acquisition of good mental health behaviours, which are the foundation for health and wellbeing in later life. Improved knowledge about mental health and improved help-seeking behaviours have been shown to lead to better mental health outcomes. Mental health literacy (MHL) is multifaceted (e.g., knowledge about symptoms, the stigma around mental health, good mental health practices, etc.). Measures are needed that can assess these different aspects of MHL. Measurement of mental health literacy is currently limited due to a lack of reported psychometric instruments with known psychometric properties. Given that most mental health problems start in early adolescence, a scale is needed that is reliable and valid in this age group.MethodsThe development and validation of the psychometric instrument (termed the Knowledge and Attitudes to Mental Health Scales: KAMHS) entailed two phases: 1) item generation based on an evidence-based intervention programme: The Guide; and 2) item reduction through exploratory factor analysis (EFA), and confirmatory factor analysis (CFA) for factor structure and psychometric assessment. Participants were 559 Year 9 pupils in secondary schools across Wales aged between 13 and 14 years.ResultsResults from the CFA indicated an acceptable fit of the model to the data. The KAMHS showed good internal constancy and moderate test-retest validity (.40–.64).ConclusionsThe final version of the KAMHS contains 50 items that are appropriate for use in children and adolescents. These results suggest that the KAMHS can be used over time to assess the efficacy of interventions aimed at increasing the mental health literacy of adolescent populations.

Attitudes about mental illness and help seeking among adolescent males

Adolescent males are at particularly high risk of mental health problems and suicide. However, many in need are left undetected and untreated, and rates of help-seeking are low. To help explain this unmet need, the current study aimed to utilise Exploratory Factor Analysis to validate a measure of help-seeking attitudes using 16 items of the Mental Health Literacy Scale. Convergent validity was assessed through correlations of the factors with other measures capturing aspects of mental health literacy and psychological distress. Male adolescent sport participants (N=361) aged between 12 and 18 years participated in the study. The results revealed a distinct four-factor structure: social distance, stigmatising attitudes, confidence accessing information about mental health, and negative help-seeking attitudes. Each factor had satisfactory levels of internal consistency. The patterns of relationships suggest that the four factors may differentiate between important influencers of mental health help-seeking. The measure is brief and is likely to have high utility in measuring attitudes about mental illness and help-seeking among adolescent males. This may have implications for understanding the processes that could influence or improve help-seeking amongst this vulnerable group.

The Effectiveness of the Pilot Implementation of Iran's Comprehensive Mental and Social Health Services (the SERAJ Program): A Controlled Community Trial.

Objective: A national program on providing comprehensive social and mental health services, entitled “SERAJ” was developed and piloted in three districts of Iran. The present study aimed to evaluate the effectiveness of SERAJ by conducting assessments before and after the implementation in the intervention and the control areas. Method : This was a controlled community trial that was assessed by conducting repeated surveys in the intervention and the control areas. In total, 2952 and 2874 individuals were assessed in the intervention and the control areas, respectively. The change in prevalence of mental disorders (using the Composite International Diagnostic Interview; CIDI), service utilization, mental health literacy, happiness, and perceived social support were measured over 18 months in three districts of Osko, Bardsir, and Quchan as the intervention areas, which were compared with three matched districts as the control areas. Results: No significant difference was found in the mean score of happiness between the intervention and the control areas throughout the study period. Most aspects of mental health literacy were improved in the intervention areas after implementing the intervention. The mean score of social support decreased after implementing the intervention in all areas. The prevalence of mental disorders in the intervention districts was significantly reduced after 18 months. The rate of using any mental health services after the intervention was not statistically different between the intervention and the control areas. Conclusion: There was no significant change in some indicators in the intervention compared with the control areas. We suggest evaluating SERAJ’s achievements and challenges in the three intervention districts before expanding the implementation of this pilot experience into other districts.

Improving the mental wellbeing of Arabic speaking refugees: an evaluation of a mental health promotion program

BackgroundRefugee populations have particularly high rates of mental health problems, including Posttraumatic Stress Disorder (PTSD) and depression. However, uptake of mental health care may be low even when severe depression and PTSD symptoms are present in individuals following resettlement. This is likely due, at least in part, to cultural influences on refugees’ knowledge and beliefs about mental health problems and their treatment. We sought to provide preliminary evidence for the effectiveness of a culturally tailored mental health promotion program for Arabic-speaking refugees.MethodsA total of 33 Arabic-speaking refugees resettled in South Western Sydney were recruited and completed intervention which consisted of weekly three-hour sessions for 4 weeks delivered in Arabic. Key aspects of mental health literacy, help-seeking intentions and levels of general psychological distress were assessed, by means of a self-report survey, pre-intervention, (immediately) post-intervention and 3 months following intervention.ResultsOf the 33 participants that completed the intervention, 31 completed the immediate post-intervention survey and 29 completed the 3 months follow-up survey. Improvements in most aspects of mental health literacy assessed were found immediately post-intervention and at follow-up, although only changes relating to stigmatising attitudes were statistically significant. Additionally, a statistically significant decrease in participants’ levels of general psychological distress was observed immediately following the intervention, and this decrease was sustained at follow-up.ConclusionWhile further research employing a more rigorous study design and larger sample size will be needed, results of this initial trial suggest that a culturally tailored mental health promotion program targeting key aspects of mental health literacy can improve the mental health of Arabic-speaking refugees resettled in a Western nation.

Mental Health Literacy, Help-Seeking Behaviour and Wellbeing in Young People: Implications for Practice

Research indicates that individuals who have high levels of mental health literacy engage in help-seeking for mental health issues more in comparison to those with low mental health literacy. It is therefore important to ensure that young people are able to identify signs of psychological distress and identify appropriate supports and resources when necessary. Preliminary research has identified gender differences in help-seeking and identification of mental health problems. This study aimed to investigate the relationship between mental health literacy, help-seeking intentions and wellbeing in senior high school students. The sample consisted of 22 females and 10 male students, ranging from 16–18 years. Findings indicated a positive correlation between wellbeing and general help-seeking, as well as wellbeing and help-seeking for suicidal ideation. Gender differences were identified for aspects of mental health literacy and help-seeking intentions. Results of this research have implications for practitioners in fostering positive outcomes and developing targeted interventions towards improving mental health literacy and help-seeking behaviour in the future.

Mental health literacy in adolescents: ability to recognise problems, helpful interventions and outcomes

BackgroundAlthough mental health literacy has been widely studied in adults, there are still relatively few studies on adolescent populations. In Sri Lanka, adolescents account for about one fifth of the population. Current evidence shows that most mental health problems diagnosed in adulthood begin in adolescence. There is also growing evidence that the trajectories of these disorders can be altered through early recognition and intervention. Although, help-seeking for mental health problems is known to be poor in adolescents, mental health literacy improves help-seeking. It is also known that adolescents may act as agents of change regarding mental health in their wider communities. Thus, mental health literacy in adolescents is an important aspect of community mental health initiatives. The objective of this study was to describe aspects of mental health literacy in terms of ability to recognise problems, helpful interventions, helpful referral options and outcomes in a target adolescent population in Sri Lanka. The association between socio economic variables and recognition of mental health problems was also examined.MethodsThis descriptive cross sectional study used a pretested questionnaire on 1002 adolescents aged between 13 and 16, where mental health literacy was assessed using 4 case vignettes. The vignettes represented depression with suicidal ideation, social phobia, psychosis and diabetes, where the last was for comparison.ResultsThe response rates for recognition as a mental health problem was 82.2% (n = 824) for the vignette depicting depression, 68.7% (n = 689) for the psychosis vignette and 62.3% (n = 623) for the social phobia vignette. “Talking to the person”, was responded to as helpful by 49.9% (n = 500), for the depression vignette followed by 49.8% (n = 499) for social phobia, 39.5% (n = 396) for psychosis and 19.5% (n = 195) for the diabetes vignette. The response rate for exercise being a helpful intervention was 25% (n = 251) for the diabetes vignette, followed by 21% (n = 210) for social phobia, 18.7% (n = 187) for psychosis vignette and 18.4% (n = 184) for the depression vignette. While 70.2% (n = 704) responded that there would be benefit in seeing a doctor for the diabetes vignette, the response rates for psychosis was 48.5% (n = 486), and for both depression and social phobia it was 48.2% (n = 483). The responses for the persons in the vignettes becoming better with treatment was 81.4% (n = 816) for the diabetes, 79.5% (n = 797) for depression, 75.6% (n = 758) for psychosis and 63.4% (n = 636) for the social phobia vignette. A statistically significant association was found between the income level of the family and appropriate recognition as mental health problems, for all the 3 mental health related vignettes.ConclusionsThe ability to recognise mental health problems, helpful interventions and outcomes in this population was comparable to those of adolescent populations in other countries, with some exceptions. The main differences were in relation to the identification and interventions in response to the psychosis and social phobia vignettes.

The African Guide: One Year Impact and Outcomes from the Implementation of a School Mental Health Literacy Curriculum Resource in Tanzania

little research is available. Schools are an ideal location in which to address mental health literacy. A Canadian school-based mental health literacy resource was adapted for application in sub-Saharan Africa called the African Guide (AG). The AG is a classroom ready curriculum resource addressing all aspects of mental health literacy. Herein we provide teacher reported activity impacts and MHL outcomes from the implementation of the AG in Tanzania. Following training, survey data addressing teacher reported AG impact and MHL outcomes was collected at three time points over a one year period. Over a period of one year, 32 teachers from 29 different schools reported that over: 4,600 students were taught MHL; 150 peer teachers were trained on the AG; 390 students approached teachers with a mental health concern; 450 students were referred to previously trained community care providers for diagnosis and treatment of Depression; and most students were considered to have demonstrated improved or very much improved knowledge, attitudes and help-seeking efficacy, with similar outcomes reported for teachers. Results of this study demonstrate a substantial positive impact on MHL related activities and outcomes for both students and teachers using the AG resource in Tanzania. Taken together with previously published research on enhancing MHL in both Malawi and Tanzania, if replicated in another setting, these results will provide additional support for the scale up of this intervention across sub-Saharan Africa.

Residential group care workers' recognition of depression: Assessment of mental health literacy using clinical vignettes

BackgroundResidential group-care workers have a critical role to play in recognizing mental health problems amongst children in their care. However, little is known about the extent to which workers recognize and respond to mental health and behavioral concerns. MethodA sample of 124 residential group care workers completed an online survey in which vignettes of children experiencing either internalized or externalized symptoms of depression and ‘typical’ behavior were presented. In order to explore aspects of mental health literacy, workers were asked to rate each vignette for severity of a specific mental health concern (adolescent depression), portrayed as internalized or externalized behavior. Ratings of worker confidence and concern for the young person were also obtained. ResultsWorkers were able to recognize the existence of depression in these fictional vignettes. Depression in the presence of externalized behavior was rated as both more severe and more concerning than depression accompanied by internalized behaviors. Furthermore, workers had greater confidence in endorsing the presence of a mental health issue when accompanied by externalized behavior compared to an internalized presentation. ConclusionsResidential group-care workers are able to recognize the existence of depression amongst children in their care. Externalized presentation of mental health appears to be more easily recognized by workers and they are also more confident in identifying mental health concern when it is accompanied by externalized, compared with internalized behaviors. The implications for training and support of residential group care workers are discussed.

The influence of psychological symptoms on mental health literacy of college students.

Psychological problems, such as depression and anxiety, are common among college students, but few receive treatment for it. Mental health literacy may partially account for low rates of mental health treatment utilization. We report 2 studies that investigated mental health literacy among individuals with varying degrees of psychological symptoms, using cross-sectional online survey methodology. Study 1 involved 332 college students, of which 32% were categorized as high depressed using an established measure of depression, and mental health literacy for depression was assessed using a vignette. Logistic regression results showed that high depressed individuals were less likely to recognize depression compared to low depressed individuals, and depression recognition was associated with recommendations to seek help. Study 2 replicated and extended findings of Study 1 using a separate sample of 1,321 college students with varying degrees of psychological distress (32% no/mild distress, 55% moderate distress, and 13% serious distress) and examining mental health literacy for anxiety in addition to depression. Results indicated that compared to those with no/mild distress, those with moderate distress had lower recognition of depression, and those with moderate and serious distress were less likely to recommend help-seeking. In contrast, there were no differences in mental health literacy for anxiety, which was low across all participants. These findings suggest that psychological symptoms can impact certain aspects of mental health literacy, and these results have implications for targeting mental health literacy to increase mental health services utilization among individuals in need of help. (PsycINFO Database Record

Beliefs and attitudes towards mental illness: an examination of the sex differences in mental health literacy in a community sample.

Objectives. The current study investigated mental health literacy in an Australian sample to examine sex differences in the identification of and attitudes towards various aspects of mental illness.Method. An online questionnaire was completed by 373 participants (M = 34.87 years). Participants were randomly assigned either a male or female version of a vignette depicting an individual exhibiting the symptoms of one of three types of mental illness (depression, anxiety, or psychosis) and asked to answer questions relating to aspects of mental health literacy.Results. Males exhibited poorer mental health literacy skills compared to females. Males were less likely to correctly identify the type of mental illness, more likely to rate symptoms as less serious, to perceive the individual as having greater personal control over such symptoms, and less likely to endorse the need for treatment for anxiety or psychosis.Conclusion. Generally, the sample was relatively proficient at correctly identifying mental illness but overall males displayed poorer mental health literacy skills than females.

An integrated approach to workplace mental health: an Australian feasibility study

We developed and implemented an integrated workplace mental health promotion intervention combining job stress reduction with a workplace mental health literacy program. The intervention was evaluated using an uncontrolled design, with organizationorganisation-wide census employee surveys of working conditions and mental health literacy pre-intervention, followed by a 1-year action planning and intervention period, then a post-intervention survey. All employees were invited to be surveyed, and all respondents were included in analysis, independent of participation in intervention activities or employment status (44% response rate at baseline, 37% at final). No significant changes were observed in the targeted psychosocial working conditions – job control, job demands, and social support at work. In contrast, significant improvements in some aspects of mental health literacy were observed, particularly in helping behaviours. Acknowledging the limitations of this being an uncontrolled pilot study, our resul...

What Is Narcissistic Personality Disorder? Lay Theories of Narcissism

There are various studies on mental health literacy which examine lay people’s knowledge and understanding of various mental disorders. Many are interested in beliefs about cause, manifestation and cure as well as the relationship between those beliefs. This study examines lay beliefs regarding the manifestations, aetiology and treatment of Narcissistic Personality Disorder (NPD), and their determinants using a questionnaire divided into three parts. Participants (N = 201) answered 45 attitudinal statements designed for this study regarding NPD. They consisted of 18 manifestation items, 15 aetiology items and 12 treatment items referring to NPD. They also completed the Narcissistic Personality Inventory. Each section of the questionnaire was factor analysed to determine the structure of those beliefs. Factors derived from a principle component analysis of lay beliefs demonstrate poor knowledge of NPD. Factors derived from the manifestations, aetiology and treatment section were modestly and coherently correlated. No demographic factors correlated with all aspects of mental health literacy and lay theories. People are surprisingly misinformed about NPD. They believed that narcissists manifested superficiality and social problems, business abilities and fragility. No distinction was made between biological and psychological causes or genetics and early negative events. Inability to identify NPD may account for many reports of sub-clinical narcissism being associated with leadership derailment.

A mental health training program for community health workers in India: impact on knowledge and attitudes

BackgroundUnmet needs for mental health treatment in low income countries are pervasive. If mental health is to be effectively integrated into primary health care in low income countries like India then grass-roots workers need to acquire relevant knowledge and skills to be able to recognise, refer and support people experiencing mental disorders in their own communities. This study aims to provide a mental health training intervention to community health workers in Bangalore Rural District, Karnataka, India, and to evaluate the impact of this training on mental health literacy.MethodsA pre-test post-test study design was undertaken with assessment of mental health literacy at three time points; baseline, completion of the training, and three month follow-up. Mental health literacy was assessed using the interviewer-administered Mental Health Literacy Survey. The training intervention was a four day course based on a facilitator's manual developed specifically for community health workers in India.Results70 community health workers from Doddaballapur, Bangalore Rural District were recuited for the study. The training course improved participants' ability to recognize a mental disorder in a vignette, and reduced participants' faith in unhelpful and potentially harmful pharmacological interventions. There was evidence of a minor reduction in stigmatizing attitudes, and it was unclear if the training resulted in a change in participants' faith in recovery following treatment.ConclusionThe findings from this study indicate that the training course demonstrated potential to be an effective way to improve some aspects of mental health literacy, and highlights strategies for strengthening the training course.

Mental health literacy among young people in a small US town: recognition of disorders and hypothetical helping responses

Mental health literacy may be a factor in early detection and prompt treatment for mental, emotional and behavioural disorders among young people. Building on previous research in Australia, this study assessed aspects of mental health literacy among adolescents in classrooms in a small town in the eastern USA. The students were provided brief, hypothetical, gender-matched scenarios about adolescents experiencing negative emotions and exhibiting related behaviours; some scenarios depicted diagnosable disorders. The respondents were asked to characterize each scenario as describing a mental health problem or other teen problem and indicate how they would respond to a peer who had such a problem. Overall levels of recognition of mental disorders were low (27.5% identified anxiety and 42.4% identified depression as 'a mental health problem or illness'). However, the respondents who recognized a disorder were three to four times more likely than those who did not to say they would take some helping action, such as telling an adult about the problem (depression: odds ratio 3.27; CI 1.43-7.46, anxiety: OR 4.43; CI 2.23-8.79). Few students (27.7%) remembered in-class discussions of mental health, a mandated health topic for schools in their area. There appears to be substantial room for improvement in mental health literacy among young people, and the development of interventions to enhance mental health literacy among students may be justified.

Lay perceptions about mental health: where is age and where is Alzheimer's disease?

Studies on laypersons' beliefs and knowledge about mental disorders have proliferated in recent years. However, attention has been focused mainly on depression and schizophrenia and on young adults. The aim of this paper is to summarize research in the area, and to discuss the need to expand research in the elderly population. The unique characteristics of older persons in terms of the prevalence and type of mental disorders, especially Alzheimer's disease (AD) and other dementias, as well as in terms of their being victims of "double jeopardy" require special attention and research. The present review has three main objectives. First, it summarizes the findings of studies examining different aspects of mental health literacy. Second, the importance of age in the study of mental health literacy is discussed. Third, findings of the few studies examining laypersons' beliefs in the area of AD are presented. Finally, research directions are suggested with special emphasis on the importance of geriatric mental health and mental health literacy.