Mental Health Literacy Program Research Articles

The Effects of a Universal, School‐Based Mental Health Literacy Program to Improve Resilience and Self‐Efficacy Among 5–6th Grade Students From Three, Title 1 School in Rural Alabama: Advocates 4 All Youth

The Effects of a Universal, School‐Based Mental Health Literacy Program to Improve Resilience and Self‐Efficacy Among 5–6th Grade Students From Three, Title 1 School in Rural Alabama: Advocates 4 All Youth

Universal, School-Based Mental Health Literacy Programs for Middle School Students: A Scoping Review.

Universal, classroom-based mental health literacy (MHL) curricula are associated with improved mental health knowledge, attitudes, and help-seeking behaviors. Young adolescents are an ideal target given their need for and receptivity toward MHL education. We conducted a scoping review to identify universal, school-based MHL programs primarily for students aged 10-14 years, with adequate descriptions of curriculum implementation and content, and measured outcomes. Thirty-one articles describing 24 programs met the inclusion criteria. The content and educational strategies varied, with no two programs having the same curriculum. The studies show promising results for improvement in mental health knowledge, attitudes, help-seeking, and student mental health. Collaborative work between educational and mental health professionals, along with rigorous study of outcomes, aiming to reach a consensus on a core MHL curriculum and best implementation practices, will advance efforts to improve MHL. This scoping review confirmed that existing universal, school-based MHL programs for middle school-aged students improve mental health knowledge. The programs are diverse, and their outcomes are often challenging to compare. Ongoing study in this field to optimize design and implementation for improved effectiveness is needed.

Examining Factors Associated With Intention to Seek Professional Mental Health Support Among First-Generation Iranian Americans.

Research suggests immigrants are at a greater risk of mental health disorders compared to native-born populations. Thus, the current study investigated factors associated with professional mental help-seeking intention among American immigrants. A cross-sectional study was conducted with 207 first-generation Iranian Americans, and data were collected using survey questionnaires. Younger Iranians living in western states in the United States and those with positive attitudes toward professional mental health services had greater intention to seek these services. Unexpectedly, those with better mental health literacy (MHL) held more mental health stigma (MHS). Findings elucidated valuable insights into the complex dynamics among sociodemographic factors, acculturation, MHL, MHS, attitudes, and intentions toward professional mental health help-seeking. We also highlighted the intricate relationship between MHL and MHS, suggesting that strategies to improve MHL may not necessarily mitigate MHS within this community. Therefore, integrating anti-stigma, contact-based approaches to MHL programs could effectively reduce stigma while facilitating mental health help-seeking. [Journal of Psychosocial Nursing and Mental Health Services, xx(xx), xx-xx.].

Teaching mental health in the classroom: A mixed-methods implementation evaluation of a mental health literacy program in elementary schools

ObjectiveMental illnesses are the largest disease burden for adolescents, affecting 20 % of youth in Canada. As mental health needs arise earlier and with greater prevalence, it is essential to work upstream and prepare youth before psychological distress emerges. When implemented in the classroom as part of the educational curriculum, Mental Health Literacy (MHL) fulfills these goals as a universal response to the societal and development stressors experienced by youth.The aim of this implementation evaluation was to explore the experience of educators delivering the Elementary Mental Health Literacy Resources (EMHLR) during a 4-month period across Canada. The specific objectives were to identify the individual (educator) and organizational (district) level barriers and facilitators to delivery of the EMHLR to improve future implementation of the program. MethodsAn explanatory sequential design used data from an existing feedback survey and qualitative data was gathered from group interviews with Educators. Findings were integrated using the RE-AIM framework to identify barriers and facilitators and develop considerations for implementation ResultsSystem level barriers included the pre-existing stigma around mental health, competing priorities for classroom time, and cultivating buy-in from leadership. Individual level barriers included the time and knowledge to teach MHL. The flexible design of the EMHLR curriculum and specific implementation strategies were seen as facilitators. Mental Health Literacy offers language for youth to communicate about their experience clearly and accurately. ConclusionThe EMHLR curriculum offers an evidence-based and adaptable means to build the MHL of youth across Canada. This holds potential for improving youth mental health but requires intentional implementation strategies to be successful.

Mental Health Literacy and School Behavioral Health: Introduction to the Special Issue

ABSTRACT Background Mental health literacy is a promising approach to meeting the growing behavioral health needs of youth, and schools offer an ideal setting for this work. Purpose In the introduction to this special issue, we provide an overview of mental health literacy and discuss the connection between mental health literacy and school behavioral health. Methods Literature on mental health literacy and research on school mental health literacy programs are synthesized, followed by an overview of the six papers included in this issue. Results The key components of mental health literacy are defined and contextualized alongside the importance of mental health literacy for promoting well-being. A brief history of research on mental health literacy programs is provided, noting the growth in application to school settings. Discussion Connections between mental health literacy and school behavioral health are discussed, highlighting opportunities for integration with schools’ multi-tiered systems of support. Translation to Health Education Practice This introduction concludes with a discussion of implications for aligning mental health literacy with Health Education.

Multi-Level Adaptations to Promote Implementation of School Mental Health Literacy Programs: A Synthesis and Case Study

ABSTRACT Background School mental health literacy programs, delivered at the universal level, are key to promoting positive behavioral health for all youth. Successfully implementing these programs requires adaptation to ensure the programs are aligned with contextual demands of the schools in which they are implemented. Yet, little is known about how to adapt and implement mental health literacy programs in school settings. Purpose This article describes the process of adapting and implementing an educator-delivered school mental health literacy program in the context of a large comparative effectiveness trial. Adaptations are organized around ecological systems theory to provide a comprehensive account of the changes that were made. Method Examples from 11 middle schools illustrate multilevel adaptations that fostered implementation. Results A case study details specific adaptations made at one school to improve implementation over 3 years. Dosage data portray increasing trends in implementation over time. Discussion Findings are contextualized alongside the adaptations that were made, highlighting the importance of offering flexibility in delivery, identifying champions, and making iterative adaptations over time in response to local and societal changes. Translation to Health Education Practice The article concludes with considerations to researchers and practitioners, including Health Educators, interested in implementing school mental health literacy programs.

Mental health literacy in German teachers – What do they know? What do they need?

Abstract Background Preventing mental health problems and promoting mental wellbeing is the aim of school-based mental health literacy (MHL) programs. Previous research suggests that good MHL (knowledge and skills regarding mental health, resilience, and help-seeking) helps people to take good care of their own and others’ mental health and use support-services. In this context the MHL of teachers is highly relevant, as they act as role models and interact with affected pupils on a regular basis, for which certain knowledge and skills are necessary. In this study, we therefore seek to investigate the level of MHL in German high-school teachers as well as their exposure to impaired students and their desire for further education on pupils’ mental health. Methods The data are collected as part of an effectiveness study of a school-based intervention to strengthen MHL (BEWARE), which was developed by our working group. We collect data from teachers who are involved in BEWARE as coaches as well as from those not directly involved (n ≈ 300). Data collection takes place online at three measurement timepoints (6 months apart each). For the analysis presented here, data of the first measurement timepoint with respect to MHL, skills in handling affected students and wishes for additional education on pupils’ mental health are included. Results As the data collection is still ongoing, statistical analyses are not yet completed. We will present data on the current state of knowledge on MHL in German teachers as well as their abilities to deal with affected pupils and their wish for further education. In addition, we will relate the number of affected pupils they teach to depict the relevance in their daily life at school to the above-mentioned measures. Conclusions The acquired data and respective analyses will give us important insights about the objective and subjective need of MHL training in schoolteachers (based on assessed knowledge and their reported wish of additional education). Key messages • Our study will give us important insights about the objective need of MHL training in high-school teachers based on assessed knowledge. • Our results will depict which formats of training teachers would prefer for additional education on pupils’ mental health, which will be a valuable basis for the development of future programs.

Youth voices: A participatory approach to promoting mental health literacy through digital means

Abstract A concerning number of young people worldwide experience mental health challenges, often compounded by limited mental health literacy, such as a lack of knowledge about how to recognize mental disorders and strategies for seeking help (Cairns & Rossetto, 2019). Therefore, it is crucial to promote mental health literacy among youth. Due to the scarcity and often high cost of readily available mental health services, as well as concerns about anonymity, digital programs have become an alternative means of reaching youth. To this end, a digital prevention program was developed. The pivotal question now is how to effectively promote young people’s mental health literacy through digital means, more specifically: How to develop (1) evidence-based and (2) target group-specific content? To investigate these questions, two systematic reviews were conducted that analyzed a total of 65 digital evidence-based mental health programs. Since the active use of programs also depends on how suitable and appealing the content is for the target group, a participatory approach was chosen to actively involve the target group in the process of developing the program’s design and content. Therefore, four participatory workshops were conducted in Slovenia, Poland, and Austria, with 12-15-year-old students (N = 182). Selected results from the systematic reviews and cross-national results from the workshops will be presented. It was found that psychoeducation is an important and effective method for promoting mental health literacy among youth and that young people prefer this content to be delivered as briefly and concisely as possible, and in a multimodal format. The discussion will highlight key takeaways regarding the benefits and challenges of this approach, emphasizing the necessity of including student voices in the creation of psychoeducational content for a digital mental health program in order to highlight and recognize young people’s right to participate. Key messages • The value of youth participation - Involving young people in the development of content for a digital mental health literacy program is a means to increase its relevance and appeal to them. • The intricacies of youth participation - Involving young people in the development of a digital mental health literacy program presents challenges that require careful consideration.

Amplifying School Mental Health Literacy Through Neuroscience Education.

Children and adolescents face a wide variety of developmental changes and environmental challenges, and it is estimated that at least one in five children aged 3-17 will experience behavioral or mental health issues. This period of life coincides with major changes in brain structure and function that have profound long-term consequences for learning, decision-making (including risk taking), and emotional processing. For example, continued development of the prefrontal cortex in adolescence is a sensitive period during which individuals are particularly susceptible to risky behaviors, environmental stressors, and substance use. While recent advances in mental health literacy programs have paved the way for increased awareness of the benefits of mental health curricula in schools, these efforts could be greatly bolstered with support in basic neuroscience education in developmentally appropriate and area-specific content. Here, we provide a discussion on the basic structural and functional changes occurring in the brain throughout childhood, how this contributes to changes in cognitive function, and the risk factors posed by early life adversity, stress, and drug use. Finally, we provide a perspective on the benefits of integrating findings from the field of neuroscience and suggestions for tools to better equip students, teachers, administrators, and school mental health staff to provide new directions for addressing the mental health crises faced by millions of children and youth each year.

Pilot evaluation of an innovative school-based mental health literacy program for teachers and students: The Decode Mental Health and Wellbeing Program

Pilot evaluation of an innovative school-based mental health literacy program for teachers and students: The Decode Mental Health and Wellbeing Program

Supporting the Mental Health Needs of Neurodivergent Students: Outcomes of a Mental Health Literacy Program for Primary School Educators

This study evaluated the effectiveness of neurodiversity training modules from a mental health literacy program for primary school staff offered over a three-year period (2013–2015), entitled ‘Teaching and Mental Health’. Using archival data, this study aimed to identify how much teachers learned, how confident they were about using this newly acquired knowledge, and how well the training met the teachers’ learning needs. This study also aimed to explore the relationship between knowledge and confidence, and how satisfaction indicators affected this relationship. Key ethical considerations of neurodiversity training and outcome measurement are discussed. A pre-test and post-test survey design was conducted with 99 primary school teachers from the Brisbane region in Australia. Analyses included three paired-samples t-tests, descriptive statistics, a linear regression analysis, and a mediation analysis. Significant increases of knowledge and confidence were found compared to baseline, and mean satisfaction ratings were high. Knowledge was a significant predictor of confidence, and mental health presenter ratings partially mediated this relationship. It is proposed that future delivery of the program should invest in improving presenter effectiveness.

Effectiveness of mental health literacy intervention and contact-based education on knowledge, attitude, and stigma towards mental health among secondary school students in Chennai, South India: A cluster randomized controlled trial

BackgroundGlobal trends indicate a rise in mental health disorders among youth, prompting need for effective interventions. Mental health literacy interventions have demonstrated benefits such as improved knowledge, treatment understanding, help-seeking behaviors, and stigma reduction. This study aimed to assess the impact of a comprehensive mental health literacy program on knowledge, attitudes, and stigma related to mental health among secondary school students in Chennai. MethodsCluster-randomized controlled trial was conducted among students from four secondary schools. Randomization was at cluster level to minimize contamination. Participating schools provided consent, and all ninth-grade students were invited to participate. Written informed consent was obtained from parents/guardians, and assent was obtained from students. There were no specific exclusion criteria, except for students who declined to participate. Analyses were performed using intention-to-treat principles, with multiple imputation for missing outcome data. ResultsAfter adjusting for cluster effects, the intervention group showed a significant improvement in attitude scores compared to the control group (mean difference 0.85, 95 % CI: 0.32–1.39, p = 0.002). However, no significant differences were observed between the two groups in terms of knowledge and stigma. ConclusionThe findings suggest that delivering a mental health literacy curriculum alongside contact-based education involving individuals with lived experiences of mental disorders positively influences students' attitudes toward mental health. Although no significant changes were observed in knowledge and stigma levels, the integration of mental health literacy programs with personal narratives from those with lived experiences holds promise for addressing mental health stigma and promoting positive attitudes among school students.

The effects of a teacher-led online mental health literacy program for high school students: a pilot cluster randomized controlled trial

Background Adolescents are vulnerable to mental health problems, and this vulnerability may be enhanced in situations such as the present COVID-19 pandemic. Online mental health literacy (MHL) education may help adolescents maintain/improve their mental health, especially in situations where face-to-face education is difficult. Aims To evaluate the effects of a teacher-led “online Short MHL Program (o-SMHLP)” delivered online to grade 10 students in their classrooms. Methods Students (age 15–16) were randomly assigned to an o-SMHLP group (n = 115 (3 classes)) or a control group (n = 155 (4 classes)) at the class level. The program consisted of a 20-minute session which included an animated video. The students completed a self-report questionnaire pre- and post-intervention assessing outcomes including: “Knowledge about mental health/illnesses”, “Recognition of necessity to seek help”, “Intention to seek help”, and “Unwillingness to socialize with people having mental illness”. Mixed effects modeling was employed for analyses. Results All outcomes were significantly improved in the intervention group compared to the control group post-intervention, except for “intention to seek help”. Conclusions The present study shows the effectiveness of an online MHL intervention while identifying the need for the development of effective online programs targeting adolescents’ “intention to seek help”.

Qualitative Evaluation of the Impact of a School Mental Health Literacy Curriculum on Student-Teacher Relationships.

Mental health literacy (MHL) programs, which aim to improve knowledge, reduce stigma and promote help-seeking behavior, are a promising approach to meeting the growing mental and behavioral health needs of youth. This study aimed to understand the relational impacts of a MHL curriculum on students and teachers. A MHL curriculum was delivered in middle school classrooms across 11 schools in two diverse school districts in the Mid-Atlantic and Southeast regions. Fifteen teachers and counselors who delivered the MHL curriculum participated in focus groups to describe their experiences using the curriculum and perceptions of its impact. Qualitative focus group data were analyzed via team-based inductive thematic analysis following a grounded theory approach. Findings indicate that educators perceived the universal school MHL program to have a positive impact on relationships amongst students and between students and teachers. Participants reported that the MHL curriculum helped to open conversations about mental health and related topics by developing common language and providing an opportunity to model vulnerability. Having these conversations improved classroom rapport and helped teachers develop deeper connections with students. As a result, teachers and students achieved greater empathy and students advocated more for themselves and their peers. Implications for integrating MHL programs into multi-tiered frameworks in schools to expand access to mental health supports are discussed.

Mental health literacy in Australian schools: evaluation of the Australian adapted youth education and support program

ABSTRACT Objective The prevalence of youth mental illness is increasing, and accessible preventative approaches, such as school-based mental health literacy programs, are needed. Mental health literacy is the ability to understand how to obtain and maintain good mental health. Schools are an ideal and accessible setting to base programs targeting mental health literacy. Method This study used a non-randomised waitlist control design to evaluate the effects of the Youth Education and Support (YES) program on mental health literacy, help seeking, and resilience for 38 Australian youth (12 male, 26 female) aged 12–16 years (M = 14.05, SD = 1.01). Data was analysed using t-tests, frequency analyses, mixed-model repeated measures analysis of variance, and directed content analysis. Results No significant interaction effect on mental health literacy from pre to post intervention was found between participants in the YES condition and control condition. Participants (n = 26) were significantly more likely to seek help from a helpline for suicidal ideation than control (n = 12) postintervention. Participants within the YES condition demonstrated significantly improved mental health literacy from pre to postintervention. Conclusions This study provides initial evidence supporting the inclusion of mental health literacy programs in Australian school environments.

Educator Knowledge of Childhood Conduct Problems and Callous-Unemotional Traits

Research evaluating mental health literacy (MHL) of adults who support children with mental health difficulties is relatively scarce. To date, no studies have investigated educator knowledge of conduct problems and callous-unemotional (CU) traits. This is a significant gap in the literature since conduct problems are among the most prevalent childhood mental disorders, while CU traits are associated with poor academic, behavioral, and social outcomes in school settings. In the current study, we assessed educators’ knowledge of the characteristics and management of conduct problems and CU traits. Participants were N = 390 preschool and primary/elementary school educators (Mage = 38.62 years, SD = 11.66; 91% woman-identifying; 71% White) who completed a Knowledge Test and survey assessing educator characteristics and various student-educator outcomes. Averaged across items, educators scored 57.1% on the Knowledge Test. We identified gaps in educator knowledge with respect to identifying characteristics associated with distinct domains of externalizing difficulties and evidence-based management strategies. Educators’ years of experience and accreditation status were not associated with knowledge. Paraeducators had significantly lower knowledge scores than teachers and leadership. Unexpectedly, greater knowledge was not associated with better student-teacher relationship quality or more positive perceptions of students with conduct problems. Findings support the need for universal MHL programs focused on conduct problems and CU traits, especially among paraeducators, while also suggesting that more intensive interventions may be required to improve educator-student relationship quality.

Evaluation of school-based mental health literacy program in high school students: a scoping review protocol

Evaluation of school-based mental health literacy program in high school students: a scoping review protocol

Help-Seeking Intention and Its Determining Factors Among High School Students in Iran

Background: With a global prevalence of mental disorders among adolescents, exacerbated by the coronavirus disease 2019 (COVID-19)’s impact, understanding the dynamics of seeking assistance is crucial. Therefore, this study determined the status of the help-seeking intention and the factors affecting it among high school students in Saveh (center of Iran). Methods: In this cross-sectional study conducted in 2023, 400 students from different high schools were selected by a multi-stage stratified random sampling procedure. They were studied using the Short Form of Mental Health Continuum Questionnaire (MHC-SF), Attitude Toward Seeking Professional Psychological Help Questionnaire (ATSPPH), Help-seeking Intention Questionnaire (GHSQ), and perceived barriers related to mental health services. Data were analyzed via SPSS 21 software using linear regression and descriptive statistical methods. Furthermore, P<0.05 was considered statistically significant. Results: The mean score attitude toward mental health services, perceived barriers to mental health services, and positive mental health were 33.8±5.5, 23.5±3.8, and 42.36±10.39, respectively. Close friends were favored for informal help-seeking (4.3±0.97), while doctors preferred formal help-seeking (3.4±0.91). Furthermore, attitude toward mental health services was the most important predictor of formal help-seeking (P value<0.001; β=3.89), while positive mental health was the most important predictor of informal help-seeking (P value<0.001; β=2.93). Conclusion: The findings of this study identified friends, family, and doctors as primary sources of informal and formal help-seeking among adolescents. Mental health literacy education is crucial for these groups. Given boys’ lower help-seeking intentions and the influence of attitudes and perceived barriers, comprehensive training is recommended. Hence, it is essential to incorporate mental health literacy programs within school curricula. Moreover, school counselors should receive comprehensive training to identify and address mental health issues effectively among students.

Validation and evaluation of school-based mental health literacy training program "The Guide Cymru" in Iranian adolescent students aged 13–15: study protocol

BackgroundSchools are an ideal setting for enhancing mental health literacy, a crucial strategy for improving adolescents’ mental health knowledge and attitudes and promoting help-seeking. "The Guide Cymru" program is an adaptation of the mental health literacy program" The Guide" that was developed in Canada. The program will be culturally adapted for 13- to 15-year-old Iranian adolescent students in the first secondary schools.MethodsIn this randomized controlled trial, using the stratified random sampling procedure, the whole eighth and ninth grade student body (aged 13 to 15) from Sirjan City's first secondary schools will be included in the study. Twenty first secondary schools will be randomly assigned to one of two groups: control or intervention. Finally, 562 students and 40 teachers will participate in the research. The tools of mental health literacy scale (MHLs), mental health general knowledge and attitudes related to mental disorders/illnesses are employed in this study.DiscussionThis trial aims to be to explore whether "The Guide Cymru", a mental health literacy program offered to students as part of the school curriculum, can decrease the stigma associated with mental health and promote help-seeking behaviors among students.

Understanding the impacts of COVID-19 pandemic on mental health and well-being among university students in Dhaka, Bangladesh: A nested mixed-methods study

BackgroundUniversity students are more at risk of mental illness compared with the general population. Declaration of a global COVID-19 pandemic led the Bangladesh government in March 2020 to implement a national lockdown, home quarantining, social distancing measures, and closure of educational institutions. We aimed to explore the impact of lockdown on the mental health and well-being of university students in Bangladesh. MethodsA nested mixed-methods survey design was undertaken using a semi structured questionnaire and in-depth interviews conducted by telephone of 73 university students (mean age of 22 years, range 18 to 26-years-old) attending public and private academic institutions in Dhaka. A questionnaire was developed de-novo and pre-tested. Qualitative, open-ended questions were used to understand experiences regarding students’ mental health and well-being, their perceptions of COVID–19, and coping strategies. ResultsFifty nine percent of students reported that lockdown had a significant impact on their mental health and well-being. They described difficulties with social isolation and loneliness, motivation, and interpersonal conflict within families. Students' knowledge of COVID-19 were high with television, newspapers, online, and social media were main sources of information; few relied on government reports. Most pressing concerns were timely graduation and employment (83%), not being able to socialize (46%), being stuck at home (37%), and financial difficulties regarding university fees (29%). Additional underlying stressors included financial insecurity of respondents’ households and parental health. Coping strategies included watching television or films, online meetings with friends, social media, as well interactions with family. ConclusionAs a result of Bangladesh's first national lockdown, university students experienced negative effects on their mental health and well-being. There is an urgent need for greater proactive measures within educational settings, such as mental health literacy programmes and diagnosis management that could mitigate and prevent adverse impacts of future lockdowns.