Mental Health Literacy Program Research Articles

Innovative Prospects for Suicide Prevention and Action Opportunities for the Public Health Agency of Canada and the Government of Canada

Responsibility for suicide prevention falls to the Government of Canada and Health Canada. The issue of suicide affects Canadians of all ages and in all regions of the country, hence the need for a pan-Canadian strategy aimed at reducing suicide deaths and reaching all Canadians. The availability and accessibility of mental health services constitute important resources for suicide prevention and a target for interventions that can be made to rapidly reduce the suicide rate. Such a strategy to improve services should include quality surveillance and quality control programs, such as suicide audits and the use of linked government administrative databases. Population-based strategies to prevent and treat depression must also be established and should be based on the Nuremberg model. In particular, development of equitable access to psychotherapy and mental health literacy programs should be priority goals.

Interventions to Promote Mental Health Literacy in University Students and Their Clinical Educators. A Systematic Review of Randomised Control Trials

PurposeThe effects of interventions for improving mental health literacy of health professional students and their clinical educators have not been established. This review analysed interventions to: support mental health literacy, deal with stigma, encourage help-seeking behaviour and improve attitudes towards providing help to those experiencing mental health issues. MethodThe full holdings of Medline, PsycINFO, EBM Reviews, Cinahl Plus, ERIC and EMBASE were searched until 16th November 2016. Inclusion criteria were randomised controlled trials of interventions to support mental health delivered to groups or using face to face and / or online delivery methods compared to alternative education, usual curriculum or no intervention; and post-intervention measurements for intervention and control. Studies were appraised using the PEDro scale. ResultsMental health educational interventions were associated with statistically significant improvements in attitudes toward providing help. In one study, Mental Health First Aid (MHFA) resulted in improvements in social associations with a person with a mental health condition. A mental health literacy program improved anxiety literacy. One study of MHFA improved MHFA knowledge. No significant effects were found for attitudes to seeking professional help or mental health stigma. Studies were limited to English and only short term effects were analysed. Method quality was generally poor. DiscussionPreliminary evidence suggests that interventions such as MHFA may potentially help clinical educators and health professional students develop positive attitudes to providing help and increase MHFA knowledge. MHFA may reduce social distance from a person with a mental health condition but the content needs to be refined if they are to change attitudes toward seeking professional help or stigma. High quality research that includes long term follow up is warranted given the importance of the attitudes of health professionals towards those with mental health issues and the mental health challenges of working as health professionals.

Preparing for the Classroom: Mental Health Knowledge Improvement, Stigma Reduction and Enhanced Help-Seeking Efficacy in Canadian Preservice Teachers

Mental health literacy is fundamental to improving knowledge about mental health, decreasing stigma, and, therefore, enhancing help-seeking behaviors. The purpose of this cohort study is to evaluate the impact of a mental health literacy program on preservice teachers’ knowledge, attitudes, and help-seeking efficacy. Sixty preservice teachers in a Canadian university participated in a professional development day and completed a survey of their mental health knowledge, attitudes toward mental illness, and help-seeking efficacy. Compared with baseline data, results demonstrated significant and substantial improvements on all three outcomes immediately following the session and after 3 months. Provision of mental health literacy education among preservice teachers may be an effective approach to help them better address student mental health needs in their future teaching career.

A decision-support tool to inform Australian strategies for preventing suicide and suicidal behaviour.

Dynamic simulation modelling is increasingly being recognised as a valuable decision-support tool to help guide investments and actions to address complex public health issues such as suicide. In particular, participatory system dynamics (SD) modelling provides a useful tool for asking high-level 'what if' questions, and testing the likely impacts of different combinations of policies and interventions at an aggregate level before they are implemented in the real world. We developed an SD model for suicide prevention in Australia, and investigated the hypothesised impacts over the next 10 years (2015-2025) of a combination of current intervention strategies proposed for population interventions in Australia: 1) general practitioner (GP) training, 2) coordinated aftercare in those who have attempted suicide, 3) school-based mental health literacy programs, 4) brief-contact interventions in hospital settings, and 5) psychosocial treatment approaches. Findings suggest that the largest reductions in suicide were associated with GP training (6%) and coordinated aftercare approaches (4%), with total reductions of 12% for all interventions combined. This paper highlights the value of dynamic modelling methods for managing complexity and uncertainty, and demonstrates their potential use as a decision-support tool for policy makers and program planners for community suicide prevention actions.

Development of a Faith-Based Mental Health Literacy Program to Improve Treatment Engagement Among Caribbean Latinos in the Northeastern United States of America.

Depression is one of the leading causes of years lived with disability (YLDs) worldwide. Although depression can be successfully treated, 75% of Americans do not receive care. Treatment rates among Latinos immigrants are significantly lower than non-immigrant Latinos and non-Hispanic Whites. Known factors for mental health-care disparities such as poverty, insurance coverage, language barriers, and access to specialty mental health services in Latino neighborhoods do not fully explain the differences in treatment rates. Significant, but poorly understood factors influencing depression treatment among Latinos in the United States are lack of culturally congruent care, low mental health literacy, and stigma. Even though churches are a major source of health information, social and spiritual support for Latinos, the conceptualization of culturally congruent care rarely addresses religious beliefs. Therefore, one strategy to reduce disparities in depression treatment is to partner with churches to address faith-based stigma. Community-based participatory research is recognized as a methodology particularly well suited for creating successful culturally targeted interventions. The purpose of this article is to describe the process of creating a faith-based mental health literacy intervention in the Caribbean Latino community using the principles of community-based participatory research.

Mental health literacy among caregivers of persons with mental illness: A descriptive survey.

Background:Despite of growing evidence of mental disorders in developing countries, research on mental health literacy is limited from India.Aim:To examine mental health literacy among caregivers of persons with mental illnessMaterials and Methods:A cross-sectional descriptive survey was carried out among 161 randomly selected caregivers of persons with mental illness at outpatient department of a tertiary care centre. Data was collected through face to face interview using a structured questionnaire.Results:Regarding the causes of mental illness, a majority agreed that genetic inheritance (69%), substance abuse (64%) and brain disease (59.6%) are main factors for developing mental illness. Although more than two-thirds agreed that anyone could suffer from mental illness, 61.5% also agreed that people with mental health problems are largely to blame for their condition. The majority of the participants also agreed that mentally ill are not able to maintain friendships (45.9%), are dangerous (54%), and not capable to work (59.1%). Just over half (55.9%) of the participants would not want people to know if they had a mental illness and nearly half of them also expressed that they would feel ashamed if a family member had a mental illness.Conclusion:Based on the findings of the present study researchers suggest that there is an urgent need to educate and change the attitudes of caregivers through mental health literacy programs specifically designed for them.

Sustained improvements in students' mental health literacy with use of a mental health curriculum in Canadian schools.

BackgroundEnhancement of mental health literacy for youth is a focus of increasing interest for mental health professionals and educators alike. Schools are an ideal site for addressing mental health literacy in young people. Currently, there is limited evidence regarding the impact of curriculum-based interventions within high school settings. We examined the effect of a high-school mental health curriculum (The Guide) in enhancing mental health literacy in Canadian schools.MethodsWe conducted a secondary analysis on surveys of students who participated in a classroom mental health course taught by their usual teachers. Evaluation of students’ mental health literacy (knowledge/attitudes) was completed before and after classroom implementation and at 2-month follow-up. We used paired-samples t-tests and Cohen’s d value to determine the significance and impact of change.ResultsThere were 265 students who completed all surveys. Students’ knowledge significantly improved between pre- and post-tests (p < 0.001; d = 0.90) and was maintained at follow-up (p < 0.001; d = 0.73). Similarly, attitude significantly improved between pre- and post-tests (p < 0.001; d = 0.25) and was significantly higher at follow-up than base-line (p < 0.007; d = 0.18)ConclusionsThe Guide, applied by usual teachers in usual classroom curriculum, may help improve student knowledge and attitudes regarding mental health. This is the first study to demonstrate the positive impact of a curriculum-based mental health literacy program in a Canadian high school population.Electronic supplementary materialThe online version of this article (doi:10.1186/s12888-014-0379-4) contains supplementary material, which is available to authorized users.

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...

Can Corrective Information Reduce Negative Appraisals of Intrusive Thoughts in a Community Sample?

Improving mental health literacy in the general population is important as it is associated with early detection and treatment-seeking for mental health problems. Target areas for mental health literacy programs should be guided by research that tests the impact of improving knowledge of psychological constructs associated with the development of mental health problems. This study investigated the impact of providing corrective information about the nature of intrusive thoughts on their subsequent appraisal in a community sample. In an online, experimental design, 148 community participants completed measures of obsessive-compulsive symptoms and appraisals (Obsessive Compulsive Inventory-Revised [OCI-R]; Intrusions Inventory [III]). Individuals were instructed to read either a brief informational text about the nature of intrusive thoughts or a control text. All participants then completed post-test measurements of appraisals. Intervention effectiveness was analysed using hierarchical multiple regression. Individuals in the intervention group reported significantly lower levels of maladaptive appraisals than those in the control group (α = .05). The results of this study support the efficacy of provision of brief written information in reducing negative appraisals of intrusive thoughts in a community sample. It suggests a possible role for education about intrusive thoughts as a prevention strategy for obsessive-compulsive disorder.

A school intervention for mental health literacy in adolescents: effects of a non-randomized cluster controlled trial

Background“Mental health for everyone” is a school program for mental health literacy and prevention aimed at secondary schools (13–15 yrs). The main aim was to investigate whether mental health literacy, could be improved by a 3-days universal education programme by: a) improving naming of symptom profiles of mental disorder, b) reducing prejudiced beliefs, and c) improving knowledge about where to seek help for mental health problems. A secondary aim was to investigate whether adolescent sex and age influenced the above mentioned variables. A third aim was to investigate whether prejudiced beliefs influenced knowledge about available help.MethodThis non-randomized cluster controlled trial included 1070 adolescents (53.9% boys, M age14 yrs) from three schools in a Norwegian town. One school (n = 520) received the intervention, and two schools (n = 550) formed the control group. Pre-test and follow-up were three months apart. Linear mixed models and generalized estimating equations models were employed for analysis.ResultsMental health literacy improved contingent on the intervention, and there was a shift towards suggesting primary health care as a place to seek help. Those with more prejudiced beleifs did not suggest places to seek help for mental health problems. Generally, girls and older adolescents recognized symptom profiles better and had lower levels of prejudiced beliefs.ConclusionsA low cost general school program may improve mental health literacy in adolescents. Gender specific programs and attention to the age and maturity of the students should be considered when mental health literacy programmes are designed and tried out. Prejudice should be addressed before imparting information about mental health issues.

Gender differences in mental health literacy of family caregivers of persons with mental illness: an Indian perspective

Research on mental health literacy in India is limited despite increasing growing evidence of mental illness among general population. Therefore, this study aimed to investigate gender differences in mental health literacy of family caregivers of persons with mental illness. A cross-sectional descriptive survey was carried out among 161 randomly selected caregivers of persons with mental illness at outpatient department of a tertiary care centre. Data were collected through face-to-face interview using a structured questionnaire. This study supports the previous research that gender differences exist in mental health literacy of persons with mental illness. Men were less literate than women regarding knowledge of people with mental illness as well women hold better positive attitudes towards persons with mental illness. Hence, gender differences need to be considered in developing mental health literacy programmes for family caregivers of mentally ill and general population.

The effectiveness of school mental health literacy programs to address knowledge, attitudes and help seeking among youth

Conduct a systematic review for the effectiveness of school mental health literacy programs to enhance knowledge, reduce stigmatizing attitudes and improve help-seeking behaviours among youth (12-25 years of age). Reviewers independently searched PubMed, PsycINFO, Cochrane Library, CINAHL, ERIC, grey literature and reference lists of included studies. They reached a consensus on the included studies, and rated the risk of bias of each study. Studies that reported three outcomes: knowledge acquisition, stigmatizing attitudes and help-seeking behaviours; and were randomized controlled trials (RCTs), cluster RCTs, quasi-experimental studies, and controlled-before-and-after studies, were eligible. This review resulted in 27 articles including 5 RCTs, 13 quasi-experimental studies, and 9 controlled-before-and-after studies. Whereas most included studies claimed school-based mental health literacy programs improve knowledge, attitudes and help-seeking behaviour, 17 studies met criteria for high risk of bias, 10 studies for moderate risk of bias, and no studies for low risk of bias. Common limitations included the lack of randomization, control for confounding factors, validated measures and report on attrition in most studies. The overall quality of the evidence for knowledge and help-seeking behaviour outcomes was very low, and low for the attitude outcome. Research into school-based mental health literacy is still in its infancy and there is insufficient evidence to claim for positive impact of school mental health literacy programs on knowledge improvement, attitudinal change or help-seeking behaviour. Future research should focus on methods to appropriately determine the evidence of effectiveness on school-based mental health literacy programs, considering the values of both RCTs and other research designs in this approach. Educators should consider the strengths and weaknesses of current mental health literacy programs to inform decisions regarding possible implementation.

Assumptions associated with mental health literacy training – Insights from initiatives in rural Australia

The impact of depression on the Australian community is well established. A number of approaches have been proposed to address this problem, including targeted programs to promote mental health literacy. This paper explores four assumptions associated with community mental health literacy programs: that individuals would increase their mental health knowledge; increase their confidence to help others experiencing mental ill health; report reduced stigmatising attitudes towards mental illness; and help others experiencing mental ill health. Findings from a rural Victorian community mental health literacy program focused on sports team coaches and other club leaders is reported in the context of these assumptions. Pre–post questionnaire data and focus group data were collected from participants in the mental health literacy program. Participants reported increased knowledge of key mental health conditions, increased confidence to help others experiencing mental ill health and less stigmatizing attitudes toward mental ill health. Limited evidence was noted to support the assumption that, following training, individuals will help others experiencing mental ill health.Difficulties in determining if transfer of benefit to others has occurred following mental health literacy training are discussed, along with a number of mechanisms that, if included in training, may extend the benefit of that mental health literacy training to others.

Depression Health Literacy and Help-seeking Intention of the Aged Receiving Customized Home Visiting Health Care Services

Purpose: The purpose of this study was to understand levels of both mental health literacy of depression and intention of help-seeking, and then to identify the relationship of them in Korean older adults. Methods: Participants in this cross-sectional survey were 395 persons over 65 years old receiving customized home visiting health care services at Chungnam province. Data were collected through interviews by visiting nurses in 2011. Results: The proportion of participants with depression was 61.8% (6.7±3.6). 78.2% of subjects appeared to have help-seeking intention for solving depression. The proportions of participants with ability to recognize depression was 69.1%. Although the level about knowledge and belief in self-help interventions were varied according to questionnaires, subjects understood self-help intervention of smoking accurately (86.3%) and physical activity (85.5%). Ability to recognize depression, knowledge and belief about self-help managements, and opinion of medication for treatment among health literacy variables measured in this study were related to help-seeking intention. In addition, women, visual impairment, and lower depression scores were related to help-seeking intention. Conclusion: Results demonstrate that it is necessary to improve depression health literacy to manage effectively depression of vulnerable elderly in communities. These results could be used in developing mental health literacy programs.

Transitions: A Mental Health Literacy Program for Postsecondary Students

Enhancement of mental health literacy is a mental health promotion strategy that may be effective at destigmatizing mental illness and increasing self-seeking behavior. Transitions is a mental health literacy program intended to heighten students' awareness and discussion of mental health problems and promote help-seeking behaviors. Transitions was launched in Nova Scotia in 2007 and distributed to 8,000 students. Transitions has since been launched nationally and is in the process of launching internationally. A follow-up study indicated over 95% of students felt they could relate to Transitions and enjoyed reading it, and 40% discussed Transitions with a friend.

Public Knowledge and Beliefs About Depression Among Urban and Rural Malays in Malaysia

This study examined knowledge and beliefs about depression among Malaysian Malays varying in socioeconomic status. A total of 153 urban and 189 rural participants completed a questionnaire in which they had to identify two cases of depression and rate a series of items about the causes and best treatments for depression. Results showed that urban participants were more likely to use psychiatric labels ('depression') for the two vignettes, whereas rural participants tended to use more generic terms ('emotional stress'). Principal components analysis (PCA) showed that beliefs about the causes of depression factored into five components, of which stressful life events was most strongly endorsed by both groups. PCA of treatment items revealed four stable components, of which religious factors were most strongly endorsed. There were also a number of significant between-group differences in the endorsement of these factors (eta(p) (2) = .03-.11), with rural participants generally rating supernatural and religious factors more strongly than urban Malays. These results are discussed in relation to mental health literacy programmes in Malaysia.