Mental Health Literacy Interventions Research Articles

Growing Resilience in Tough Times (GRITT): Development and Randomized Trial of a Farmer Mental Health Literacy Intervention

ABSTRACT Objectives Farmers in the United States (U.S.) are exposed to myriad stressors and experience their negative effects, including higher rates of suicide than individuals in some other occupations. However, interventions to address mental health amongst farmers have faced barriers, such as farmers’ perceived stigma regarding mental health, time constraints, and geographical isolation. Using text-messaging for intervention delivery may help to address some barriers, as text messages are private, delivered directly to one’s phone, and require no travel. Our objective was to develop and assess the feasibility, acceptability, and initial efficacy of a text-messaging mental health literacy intervention tailored to U.S. farmers: Growing Resiliency in Tough Times (GRITT). Methods U.S. farmers (N = 134) were randomly assigned to an intervention group, who received 12 weeks of text messages regarding mental health literacy, or a control group, who received no treatment. Online pre-test and post-test surveys assessed mental health knowledge, familiarity with relevant mental health resources, self-efficacy to manage stress, and perceived stress. Feasibility was assessed via recruitment and retention data, and intervention group participants completed post-test measures to assess acceptability. Results Results indicate that intervention group participants were highly satisfied with the intervention and had higher post-test scores on multiple facets of mental health literacy and self-efficacy to manage farm stress than control group participants. The intervention group experienced a significant drop in perceived stress from pre-test to post-test. Participant retention was relatively high (84%). However, recruitment difficulties call into question intervention feasibility. Conclusion Though the intervention was efficacious in enhancing mental health literacy, improving stress management self-efficacy, and reducing stress, difficulties with participant recruitment indicate the need for continued intervention research in this context.

Evaluating the effectiveness of a school-based mental health literacy intervention from a comprehensive demographic and social-cognitive perspective

Childhood and adolescence are a critical period for the onset of mental and neurodevelopmental disorders and a time when many can be first identified. Research demonstrates that mental health literacy applied in school settings may be an effective approach to address these challenges. In contrast to many existing studies conducted in multicultural and multilingual settings that treated subjects’ language as a demographic feature, the present study recognizes English proficiency as a social-cognitive factor and views the school-based mental health literacy (MHL) intervention as a learning process. The present study aimed to assess the effectiveness of school-based mental health literacy intervention and explore how ethnicity and English proficiency as a social-cognitive factor, as a modified, rather than a fixed variable, impacted the intervention outcomes. Grade 9 students (n = 240) from schools in West Canada with diverse social/cultural background received the intervention in the classroom delivered by trained teachers and completed the pre-test and post-test over a 6-month period. The intervention was effective in improving knowledge and help-seeking attitudes among all students. Non-Chinese and native English-speaking students performed the best on all outcomes. Gender demonstrated an association with changes in stigma, stress and wellbeing. English proficiency was linked to knowledge acquisition, while ethnicity was connected to changes of attitude-related outcomes. These findings deepened our understanding of how demographic and social-cognitive factors underlie changes in mental health literacy outcomes, which will facilitate the development of mental health literacy interventions for diverse student populations.

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

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. 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. We used a random-effects model to conduct meta-analyses and meta-regressions on moderating effects of DMHL interventions on mental health. 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. 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. PROSPERO International Prospective Register of Systematic Reviews CRD42023363995; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023363995.

Assessing the efficacy of the ‘Bicho De 7 Cabeças’ B-learning school-based program in enhancing mental health literacy and reducing stigma

The prevalence of mental disorders in adolescents has a considerable impact on daily life, restricting tasks and diminishing overall quality of life while potentially leading to stigmatization. This study aims to measure the impact of a mental health literacy intervention program, called “Bicho de 7 Cabeças” project, in b-learning format, on the increase of knowledge and the decrease of stigma in young people from Póvoa de Varzim, in Portugal. A quasi-experimental study was conducted, from November 2022 to May 2023, involving an experimental group (“Bicho de 7 Cabeças” protocol) and an active control group (informational brochures), utilizing a pre-test/post-test design. Mental Health Literacy Measure-MHLM, Mental Health Promoting Knowledge Scale-MHPK-10, Mental Illness Knowledge Schedule-MAKS, Reported and Intended Behaviour Scale-RIBS, and Community Attitudes toward People with Mental Illness-CAMI were used. A total of 504 young students from the 9th grade enroll in this study, with a mean age around 14 years old. There is a significant difference between stigma (p <.001) and knowledge (p <.001) scores at baseline and follow-up. The results of this study shows that interventions aimed at young people for the promotion of mental health literacy and stigma reduction are needed and more initiatives should be implemented in schools to address these problems.

A scoping review of the implementation and cultural adaptation of school-based mental health promotion and prevention interventions in low-and middle-income countries.

Effective school-based mental health promotion and prevention interventions in low-and middle-income countries (LMICs) can positively impact the mental health and well-being of large numbers of young people. This scoping review aimed to investigate the implementation of effective mental health promotion and prevention interventions in LMIC schools. A scoping review of the international literature was conducted and followed the Preferred Reporting Items for Systematic reviews and Meta-Analysis extension for Scoping Reviews guidelines. Medline, PsycInfo, Scopus, Embase, CINAHL and Cochrane were searched for peer-reviewed literature published from 2014 to 2022. PsycExtra, Google Scholar and the websites of key organisations were searched for relevant grey literature. Study selection focussed on mental health promotion interventions, including the development of social and emotional skills and mental health literacy, and prevention interventions, including anti-bullying and skill-based interventions for "at-risk" students. Twenty-seven studies evaluating 25 school-based interventions in 17 LMICs were included in the review. Fifteen interventions were developed in the implementing country and 10 were adapted from high-income countries (HICs) or other settings. Findings from the studies reviewed were generally positive, especially when interventions were implemented to a high quality. Universal life-skills interventions were found to increase social and emotional skills, decrease problem behaviours and positively impact students' mental health and well-being. Mental health literacy interventions increased mental health knowledge and decreased stigma among students and school staff. Outcomes for externally facilitated anti-bullying interventions were less positive. All 19 effective studies reported on some aspects of programme implementation, and 15 monitored implementation fidelity. Eleven studies outlined the programme's underpinning theoretical model. Only four studies reported on the cultural adaptation of programmes in detail. Including young people in the adaptation process was reported to facilitate natural cultural adaptation of programmes, while input from programme developers was considered key to ensuring that the core components of interventions were retained. The review findings indicate increasing evidence of effective mental health interventions in LMIC schools. To facilitate the sustainability, replication and scaling-up of these interventions, greater attention is needed to reporting on intervention core components, and the processes of implementation and cultural adaptation in the local setting.

Improving students’ mental health literacy: evaluation of an adapted school intervention in Germany

Abstract Background Mental health problems and mental illness are central concerns for young people's health. As most mental illnesses emerge before the age of 25, young people are considered a key target group for preventive measures. Mental health literacy (MHL) is considered a set of resources and capacities for positive mental health and mental health care. MHL encompasses specific mental health knowledge, positive attitudes towards mental illness, and effective help-seeking behaviors. School-based MHL interventions seem to be promising in reaching young people and educating and empowering them regarding the topic of mental health. Methods An evidence-based Canadian MHL school intervention was adapted for German schools and evaluated for its effectiveness in terms of strengthening different dimensions of MHL (mental health knowledge, stigmatizing attitudes, help-seeking efficacy) as well as its acceptability. The evaluation study included a pre-post intervention control group design. Paired sample t-tests were conducted separately for the intervention and control group in order to verify the improvements in the different dimensions of MHL. Results The sample comprises 251 students aged Ø 15.6 years, with 9 intervention classes (IC) and 5 control classes (CC). The analysis showed significant improvements in the MHL dimensions knowledge, attitudes towards mental illness (personal stigma) and help-seeking for the IC. In addition, the students’ reception of the intervention was highly positive which reflects high acceptance. Conclusions Despite the rather small sample size (due to the COVID-19 pandemic), the evaluation offers insights into the effectiveness in terms of improving the different MHL-dimensions, and applicability of the adapted MHL intervention for students in Germany. Further evaluations are needed to confirm the intervention's effectiveness, especially with regard to long-term effects.

The effect of a mental health literacy intervention on Chinese team officials and staff in elite sports: a two-arm non-randomised controlled trial

ABSTRACT Mental health issues among elite athletes have received much attention in recent years. A supportive sport promotes the mental health of its athletes, team officials and staff play a crucial role in assisting athletes to seek help for their mental health when needed. However, studies have demonstrated that these individuals do not have sufficient knowledge to provide the appropriate support and assistance. Mental health literacy (MHL) is a major factor influencing support and help-seeking attitudes. Therefore, the current study aimed to provide support staff with knowledge about MHL to increase their MHL levels, reduce their stigma towards mental health issues, and improve their help-seeking attitude and their confidence in helping athletes with mental health issues. To this end, a two-arm non-randomised controlled trial was used, during which one 4-hour MHL workshop was delivered to 74 team officials and staff between the ages of 22–54 (M = 35.65, SD = 8.16). Data were collected at three time points (pre-intervention, post- intervention and follow-up). The results showed that the participants in the MHL group significantly outperformed those in the wait list control (WLC) group in terms of improved MHL and help-seeking attitude and reduced stigma. However, compared with the WLC group, the participants’ confidence in helping athletes with mental health issues did not significantly improve at post- and follow-up examinations. This study has practical implications for interventions designed to promote MHL among Chinese team officials and staff in elite sports and provides suggestions for future research on MHL and help-seeking.

Evaluating the effect of an adapted mental health literacy intervention on mental health related stigma among secondary students in Germany: results of a pre-post evaluation study

BackgroundMost mental health problems develop during youth, with about three quarter emerging before age 25. In adolescence, stigmatizing attitudes related to mental illness become more nuanced and consolidate into one’s belief system. As the stigma of mental illness is still one of the leading barriers to help-seeking, intervention measures should explicitly address it before it becomes entrenched over time. Preventive measures, for example, based on promoting mental health literacy (MHL), can be used to address and tackle stigmatizing attitudes. The Canadian MHL-based intervention “the Guide” was translated and adapted for the use in German schools. The present study evaluates the effect of the German version of the Guide on attitudes towards mental illness among students in Germany.MethodsThe first-time application of the Guide (German version) was evaluated with a pre-post-evaluation study with an intervention and a control group. The evaluation data of 188 students (intervention group n = 106, control group n = 82) were statistically analyzed focusing on the outcomes social stigma, social distance, and self-stigma.ResultsThe analysis showed that participants do not tend to hold stigmatizing attitudes even before the intervention. Nevertheless, the intervention was effective in reducing social stigma, but not in reducing social distance and self-stigma. Neither gender, pre-existing experience with mental illness, nor the delivery modality of the contact element within the intervention (speaker vs. video) seemed to influence the outcomes.ConclusionsThe German version of the MHL-based intervention, the Guide, seems to be a suitable intervention to improve attitudes towards mental illness among students in Germany. More extensive research is necessary to confirm the findings and further explore factors that influence the program’s effects on attitudes short- and long-term.

The Design and Implementation of a Novel Mental Health Literacy Educational Intervention Program in Gaelic Footballers.

Lack of education, stigma, and negative self-attitudes are key barriers to help-seeking in Gaelic footballers. With the prevalence of mental health issues in Gaelic footballers and the increased risk of experiencing mental health challenges after injury, mental health literacy (MHL) interventions are necessary. To design and implement a novel MHL educational intervention program in Gaelic footballers. Controlled laboratory study. Online. Elite and subelite Gaelic footballers divided into intervention (n = 70; age = 25.1 ± 4.5 years) and control (n = 75; age = 24.4 ± 6.0 years) groups. In the intervention group, 85 participants were recruited, but 15 dropped out after completing baseline measures. A novel educational intervention program, "GAA [Gaelic Athletic Association] and Mental Health-Injury and a Healthy Mind," was designed to address the key components of MHL and was underpinned by the Theory of Planned Behavior and the Help-Seeking Model. The intervention was implemented online via a brief 25-minute presentation. Measures of stigma, help-seeking attitudes, and MHL were completed by the intervention group at baseline, immediately after viewing the MHL program, and at 1 week and 1 month after the intervention. The control group completed the measures at similar time points. Stigma decreased, and attitudes toward help-seeking and MHL increased in the intervention group from baseline to after the intervention (P < .05), with significant differences sustained at 1-week and 1-month follow-ups. Our results showed differences in stigma, attitudes, and MHL between groups across time points. Intervention participants provided positive feedback, and the program was appraised as informative. Remote online delivery of a novel MHL educational program can effectively decrease mental health stigma, improve attitudes toward help-seeking, and increase the recognition and knowledge of mental health issues. Gaelic footballers with improved MHL may be better equipped to manage their mental health and cope with stressors, leading to improved mental health outcomes and overall mental well-being.

Piloting a Mental Health Literacy Intervention Among BIPOC Adolescent Peer Health Leaders From Underresourced Communities

Piloting a Mental Health Literacy Intervention Among BIPOC Adolescent Peer Health Leaders From Underresourced Communities

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.

The effectiveness of mental health literacy interventions in young people: a meta-analysis

PurposeAdolescence and young adulthood are recognised as critical time for developing mental health literacy (MHL). The purpose of this study is to analyse the effectiveness of current MHL interventions to guide the future development of MHL intervention strategies.Design/methodology/approachA meta-analysis adopting the PRISMA framework for systematically reviewing the literature was adopted. Three authors independently reviewed studies and extrapolated key data for analysis. A robust random-effects model with adjustments for small study biases was conducted to establish the effect sizes of all included MHL interventions. Moderator analysis was conducted to examine the effects of intervention length in MHL.FindingsA total of 11 intervention studies were identified and analysed, resulting in a medium to large pooled effect size of 0.62 (95% CI: 0.28; 0.96). Moderator analysis found that short interventions had an estimated standard mean difference (SMD) effect size of 0.9220 (95% CI: −1.1555; 2.9995). This was greater than the medium length interventions, with an estimated SMD effect size of 0.4967 (95% CI: 0.0452; 0.9483), and long interventions, with an estimated SMD effect size of 0.5628 (95% CI: −0.2726; 1.3983). As a result, MHL interventions are proficient in improving young adults’ MHL, with shorter interventions (45–50 min) having the largest effect size. This study highlights several inconsistencies in methodological rigour and reporting from studies in this area, which future research should look to address.Originality/valueTo date, MHL review studies have often focused their attention on a specific domain, most notably education and school-based setting. To the best of the authors’ knowledge, no reviews have conducted a meta-analysis across contexts and domains with a specific focus on MHL intervention strategies for young adults.

Construction and Validation of the Positive Mental Health Literacy Assessment Scale in Adults.

Low mental health literacy levels have a profound negative effect on healthcare outcomes, usage of healthcare services and healthcare expenditure. To date, there is little research and a lack of instruments available to address and assess positive mental health literacy levels in community-dwelling adults. Thus, this study sought to develop an instrument to assess positive mental health literacy in adults and to evaluate its psychometric properties. A scale developed in European Portuguese and composed of 32 items was designed to assess positive mental health literacy among community-dwelling adults and was validated using exploratory factor analysis. Five latent factors were identified (decision making, prosocial attitudes, perception of resources, community involvement, and problem solving), whose hypothesised structure was confirmed by confirmatory factor analysis using structural equation modelling. Evidence showed that the scale's factor structure is reliable and valid and adequately represents the theorised constructs. Thus, this may be a useful assessment tool for clinical practice since it will allow a more rigorous assessment of positive mental health literacy and better mental health promotion interventions in the population.

Evaluating a prototype digital mental health literacy intervention for children and young people aged 11–15 in Java, Indonesia: a mixed methods, multi-site case study evaluation

BackgroundThe Improving Mental Health Literacy Among Children and Young People in Indonesia (IMPeTUs) intervention is a co-produced, evidence-based digital intervention designed to improve anxiety and depression focused mental health literacy and self-management among people aged 11–15 in Java, Indonesia. This study aimed to evaluate the usability, feasibility and preliminary impact of our intervention.MethodsMixed methods, multi-site case studies based on a theory of change. Pre-and post-assessments of a range of outcomes and qualitative interviews/focus groups with children and young people (CYP), parents and facilitators. The intervention was implemented in 8 health, school and community sites across Java, Indonesia (Megelang, Jakarta and Bogor).Quantitative data designed to understand the impact of and feasibility of evaluating the intervention collected from 78 CYP who used the intervention were analysed descriptively. Qualitative data from interviews and focus groups collected from 56 CYP, 49 parents/caregivers and 18 facilitators were analysed using framework analysis.ResultsQualitative data analysis indicated high levels of usability and acceptability for the interface aesthetic, personalisation, message presentation and navigation. Participants reported minimal burden and no negative outcomes associated with the intervention. CYP, parents and facilitators identified a range of direct and spill over effects of interventions engagement, some of which were not anticipated at study outset. Quantitative data highlighted the feasibility of intervention evaluation, with high levels of recruitment and retention across study time points. Minimal changes were identified in outcomes pre-to-post intervention, which may in part be due to a lack of scale relevance and/or sensitivity to the intervention mechanisms indicated in the qualitative data.ConclusionsDigital mental health literacy applications are potentially an acceptable and feasible way to prevent burdens of common mental health problems amongst CYP in Indonesia. Our intervention and evaluative processes will be further refined prior to definitive evaluation.

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.

Mental Health Literacy Intervention to Reduce Stigma Toward Mental Health Symptoms and Disorders in Women Rugby Players: A Feasibility Study

This feasibility study aimed to evaluate the effectiveness of an educational intervention on stigma toward mental health symptoms and disorders, mental health literacy, and help-seeking intentions among U.K. semielite women rugby players. Seven semielite women rugby players participated. An A-B-A single-case experimental research design was used to assess stigma toward mental health symptoms and disorders, mental health literacy, and help-seeking intentions at baseline, intervention, and follow-up phases. The intervention was successful in enhancing the players’ mental health literacy and reducing stigmatizing attitudes toward seeking professional psychological help. Acknowledging the study’s small sample size, the findings revealed that there is a need for scaffolding to support future developments, advancements, and maintenance of mental health support in women’s rugby. Practical implications of future findings from a larger-scale study may lead to policy reformation across the game to inform and improve systemic mental health support for women rugby players.

Applying a theory of change approach to develop and pilot a universal mental health literacy curriculum for adolescents

AbstractUniversal evidence‐based prevention and promotion programs lack in availability and scalability for child and adolescent mental health in Central and Eastern Europe. This paper describes the process of applying the theory of change to plan, develop, and pilot a mental health literacy intervention in Czech schools. The process of using theory of change to develop a complex intervention for mental health literacy is described across three stages: formative development, piloting, and evaluation. The application of evidence‐based intervention was discussed within 64 diverse stakeholder meetings and tested over 2 years of piloting. The resulting theory of change map is described in the context of consideration for modifications, revisions, and recommendations for successful implementation of the developed intervention. Continued monitoring and evaluation and a formal evaluation of the effectiveness of mental health literacy curriculum within the region will be essential before scale‐up.

Literasi Kesehatan Mental di Institusi Kesehatan

This study aims to identify literacy in health institutions regarding mental health as a foundation for designing mental health literacy improvement programs. A survey was conducted with students and staff of college health education institutions to investigate the Understanding of depression, intentions to seek help, beliefs about interventions, and stigmatizing attitudes. Methods: This study used a cross-sectional and quantitative approach to determine the percentage of mental health literacy. The participants in this study were nursing students from several health institutions in Indonesia and involved staff from participating health institutions via telephone interviews. Participants answered research questions related to mental health literacy. The results showed that after the interviews were completed, 270 students (91%) and 24 staff (9%). More than 60% of students and staff can recognize depression, and most are female. Some 75% of respondents said they would seek help if they had a problem similar to the illustration for depression. However, the level of intention to seek special assistance for students is relatively low; only 20% choose a doctor, and only 2% seek the help of a counselor in dealing with mental health problems. Factors related to stigmatization include male gender, younger age, lower education level, and lack of Understanding of depression. In conclusion, there is a need for mental health literacy interventions aimed at college students, especially those who are younger, male, and with lower levels of education. A need fulfillment strategy is needed to help seek professional assistance, referring to the results of exploring the complexity of the obstacles experienced.&#x0D; &#x0D; Keywords: Health institutions, Mental health literacy, Understanding

Graduate students’ perspectives on the role of faculty advisors in helping students with mental health problems

Objective: Graduate students are more likely to experience mental illness than their peers in the general population. One potential source of support for personal issues and/or mental illness is a graduate student’s faculty advisor. Although the relationship between faculty advisors and graduate students can positively influence the success and overall well-being of graduate students, graduate students may be reluctant to disclose mental health issues to their advisors. This study explores graduate students’ perspectives on factors that influence their decision to disclose, or not to disclose, personal mental health information to their faculty advisor. Participants: The participants for this study were 28 graduate students from three universities in the southern United States. Methods: Four semi-structured focus groups were conducted over Zoom. Results: Thematic analysis of a series of focus groups with graduate students identified several consistent themes related to this disclosure decision-making process. Conclusions: Results have implications for mental health literacy and interpersonal communication interventions for those charged with mentoring graduate students.

Schools as a Source of Mental Health Literacy: Adjusting and Validating a Mental Health Literacy Scale.

Over the last decade, there has been a growing interest in mental health literacy (MHL) in health promotion, largely motivated by increased awareness of MHL as a modifiable determinant of mental health. Accordingly, MHL has been associated with the health-promoting school approach emerging over the last 20 years. To succeed in promoting MHL, it is of vast importance to evaluate working strategies and interventions to address MHL using validated instruments. The current study describes the revision and psychometric testing of a modified version of the 10-item adolescents' positive MHL measure, the MHPK-10, the only identified instrument measuring adolescents' positive MHL. The MHPK-10 was adjusted to address the previously documented ceiling effects and was further optimized for use in schools by reworking it to measure learning rather than self-reported knowledge, becoming the new nine-item Mental Health Learning Scale (MHLS-9). The MHLS-9 was tested on a national sample of N = 2,012 Norwegian ninth graders. Data were analyzed by confirmatory factor analysis (CFA) and tests of reliability and validity. The revised CFA model for the MHLS-9 showed an improved fit over the original CFA model for the MHPK-10. The MHLS-9s' CFA model revealed excellent factor determinacy (.95) and scale reliability (ω = .91). Thus, the MHLS-9 is an improved measure for the positive component of MHL for use in school settings, enabling researchers and practitioners to evaluate and focus positive MHL interventions in schools using a short, reliable, and valid measure for adolescents' learning about the factors promoting good mental health.