Mental Health Literacy Survey Research Articles

Public recognition of mental disorders and beliefs about treatment: changes in Australia over 16 years

A 1995 Australian national survey of mental health literacy showed poor recognition of disorders and beliefs about treatment that differed from those of health professionals. A similar survey carried out in 2003/4 showed some improvements over 8 years. To investigate whether recognition of mental disorders and beliefs about treatment have changed over a 16-year period. A national survey of 6019 adults was carried out in 2011 using the same questions as the 1995 and 2003/4 surveys. Results showed improved recognition of depression and more positive ratings for a range of interventions, including help from mental health professionals and antidepressants. Although beliefs about effective medications and interventions have moved closer to those of health professionals since the previous surveys, there is still potential for mental health literacy gains in the areas of recognition and treatment beliefs for mental disorders. This is particularly the case for schizophrenia.

Differences between landline and mobile‐only respondents in a dual‐frame mental health literacy survey

Differences between landline and mobile‐only respondents in a dual‐frame mental health literacy survey

Stigmatising attitudes towards people with mental disorders: Changes in Australia over 8 years

The aim of the study was to investigate whether Australians' stigmatising attitudes towards people with mental disorders have changed over an 8-year period. In 2011, telephone interviews were carried out with 6019 Australians aged 15 or over. The survey interview used the same questions as those of the 2003/4 national mental health literacy survey, in which participants were presented with a case vignette describing either depression, depression with suicidal thoughts, early schizophrenia or chronic schizophrenia. Questions were asked about stigmatising attitudes, including personal and perceived stigma and social distance. Results showed decreases in social distance scores for all vignettes other than chronic schizophrenia and increases in beliefs about dangerousness and unpredictability. Campaigns to improve mental health literacy and reduce stigmatising attitudes may have had beneficial effects in reducing the desire for social distance from those with mental disorders. However, increase in beliefs about the dangerousness and unpredictability of those with these disorders is of concern and points to the need for public education to address these aspects of stigma.

Stigmatizing Attitudes towards People with Mental Disorders: Findings from an Australian National Survey of Mental Health Literacy and Stigma

This paper reports findings from a national survey on stigmatizing attitudes towards people with depression, anxiety disorders and schizophrenia/psychosis. In 2011 telephone interviews were carried out with 6019 Australians aged 15 or over. Participants were presented with a case vignette describing either depression, depression with suicidal thoughts, early schizophrenia, chronic schizophrenia, social phobia or post-traumatic stress disorder. Questions were asked about stigmatizing attitudes, including perceptions of discrimination, personal and perceived stigma and desire for social distance. Chronic schizophrenia was most likely to be associated with dangerousness, unpredictability and a preference for not employing someone with the problem, while social phobia was most likely to be seen as due to personal weakness. Attitudes concerning dangerousness and social distance were greater in relation to men with mental disorders compared to women. Other people were perceived as more likely to hold stigmatizing attitudes than the respondents reported for themselves. Anti-stigma interventions are more likely to be successful if they focus on individual disorders rather than on 'mental illness' in general. Such interventions may need to address perceptions of social phobia as being due to weakness and those of dangerousness in people with more severe disorders. Such interventions should also focus on bringing beliefs about public perceptions in line with personal beliefs.

Recognition of Mental Disorders and Beliefs about Treatment and Outcome: Findings from an Australian National Survey of Mental Health Literacy and Stigma

The aim of the study was to carry out a national survey in order to assess recognition and beliefs about treatment for affective disorders, anxiety disorders and schizophrenia/psychosis. In 2011, telephone interviews were carried out with 6019 Australians aged 15 or over. Participants were presented with a case vignette describing either depression, depression with suicidal thoughts, early schizophrenia, chronic schizophrenia, social phobia or post-traumatic stress disorder (PTSD). Questions were asked about what was wrong with the person, the likely helpfulness of a broad range of interventions and the likely outcomes for the person with and without appropriate treatment. Rates of recognition of depression were relatively high, with almost 75% of respondents using the correct label. Rates of recognition for the schizophrenia vignettes and PTSD were similar, with around one third of respondents using the correct labels. Only 9.2% of respondents were able to correctly label social phobia. Respondents gave the highest helpfulness ratings to GPs, counsellors, antidepressants, antipsychotics (for schizophrenia) and lifestyle interventions such as physical activity, relaxation and getting out more. Respondents were generally optimistic about recovery following treatment, although relapse was seen as likely. While Australians' beliefs about effective medications and interventions for mental disorders have moved closer to those of health professionals since surveys conducted in 1995 and 2003/4, there is still potential for mental health literacy gains in the areas of recognition and treatment beliefs for mental disorders. This is particularly the case for schizophrenia and anxiety disorders, which are less well recognized and, in the case of social phobia, generally perceived as having less need for professional help.

240 Mental Health Literacy Survey of Sri Lankan Carers of Patients with Schizophrenia and Depression

240 Mental Health Literacy Survey of Sri Lankan Carers of Patients with Schizophrenia and Depression

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

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

Pharmacists’ Beliefs About Treatments and Outcomes of Mental Disorders: A Mental Health Literacy Survey

To assess the beliefs of pharmacists about the helpfulness of interventions for schizophrenia and depression. A survey instrument containing a measure of mental health literacy was mailed to a random sample of 2000 pharmacists registered with the Pharmacy Board of New South Wales in November 2009. Vignettes of a person with either depression or psychosis were presented, followed by questions related to the recognition of the disorder, the helpfulness of various interventions, prognosis with and without professional help, the person's long-term functioning in various social roles and the likelihood of the person being discriminated against. A total of 391 responses were received (response rate 19.5%). The majority of pharmacists correctly identified depression (92%) with fewer recognizing schizophrenia (79%). Pharmacists rated medicine use highly for both schizophrenia and depression but were also positive about the use of psychological therapies and lifestyle interventions. Pharmacists had negative views about admission to a psychiatric ward and the use of electroconvulsive therapy (ECT). However, younger pharmacists had significantly more positive views on the use of ECT (p = 0.001). The majority of pharmacists (74%) thought discrimination by the community was highly likely and rated long-term prognosis as poor without appropriate professional help. Their views on the likelihood of specific negative outcomes were mixed, with many pharmacists not recognizing the risk of suicide in schizophrenia and depression. However, both female (p = 0.002) and younger pharmacists (p < 0.001) were significantly more inclined to rate the likelihood of suicide as more likely in a person with schizophrenia or depression. The majority of pharmacists had a high degree of mental health literacy as indicated by the correct identification of, and support for evidence-based interventions for mental illnesses. Pharmacists should be aware that their attitudes and stigma towards mental illness may impact on the patient care they provide.

Community Beliefs About Causes and Risks for Mental Disorders: a Mental Health Literacy Survey in a Rural Area of Maharashtra, India

Explanations for mental disorders in India can be influenced by biomedicine, systems of traditional medicine and supernatural beliefs. Community beliefs about causes of mental distress influence help-seeking behaviours. This study aimed to assess local knowledge and understanding of causes and risks for mental disorders in a rural area of Maharashtra, and to assess the prevalence of possible common mental disorders. A cross-sectional mental health literacy survey was undertaken in late 2007. A questionnaire was administered to 240 systematically sampled community members and 60 village health workers (VHWs). Participants were presented with two vignettes describing people experiencing symptoms of mental disorders (depression, psychosis); they were asked about the causes of the problems and the vulnerabilities of community sub-groups. Additionally, the General Health Questionnaire (GHQ12) was administered to assess prevalence of possible common mental disorders. The most commonly acknowledged causes of the problems were a range of socioeconomic factors. Supernatural and biological explanations were not widely endorsed. Women, the unemployed and the poor were judged as more likely to develop mental disorders, while both young and older people were perceived to be less vulnerable. Results of the GHQ12 indicated that 27% had a possible common mental disorder and that the elderly were at increased risk, contrary to community perceptions. Enhancing mental health literacy of both VHWs and community members using approaches that are sensitive to local conceptualizations of mental health and illness will contribute to improved treatment and care for people with mental disorders. Further investigation of mental health among the elderly in this community is indicated.

Community beliefs about treatments and outcomes of mental disorders: A mental health literacy survey in a rural area of Maharashtra, India

Mental health remains a neglected issue in most developing countries, especially in rural areas where access to effective mental health services is limited. The integration of mental health into primary health care is being promoted as a strategy to address this problem. Consequently, there is an urgent need to enhance mental health awareness among communities, and to provide mental health training for primary healthcare staff. In order to do this effectively, it is important to understand and take account of local views on mental health and illness. As such, a mental health literacy (MHL) assessment was undertaken in a poor, rural area of Maharashtra, India to inform the development of a mental health training programme. A cross-sectional MHL survey was undertaken in late 2007. Data were collected from 240 systematically sampled community members and 60 purposively sampled village health workers (VHWs) using an interviewer-administered questionnaire. Participants were presented with two vignettes describing people experiencing symptoms of mental disorders (depression, psychosis), and were asked to name the problems, and to identify the treatments and people that were most likely to be helpful (or otherwise), and the likely outcomes for people with such problems. Most participants recognized that the people in the vignettes were experiencing a mental health problem. 'Depression' was the most common label for the problems experienced in the depression vignette, and 'a mind/brain problem' was the most common label in the case of the psychosis vignette. Socio-economic interventions provided by family, friends and neighbours were considered to be most helpful. Local VHWs and doctors were also viewed as potentially helpful, but psychiatrists less so. Approximately half of the sample thought that dealing with the problem alone would be helpful. Special diets, tonics, appetite stimulants and sleeping pills were also strongly endorsed, but awareness of psychiatric medications was negligible. The findings from this study highlight the need to enhance MHL in this community. Additionally, there is a need to build the capacity of the primary healthcare staff, including the VHWs, so that they are equipped to provide an effective local response for people experiencing mental health problems.

Attitudes to people with mental disorders: a mental health literacy survey in a rural area of Maharashtra, India

People with mental disorders experience discrimination as a consequence of stigmatising attitudes that are largely socio-culturally constructed. Thus, there is a need to understand local contexts in order to develop effective programs to change such attitudes. We undertook a mental health literacy survey in rural Maharashtra, India, prior to developing a mental health training program for village health workers (VHWs) in a primary health care setting. A cross-sectional mental health literacy survey was undertaken in late 2007, which involved interviewer-administration of a questionnaire to 240 systematically sampled community members, and 60 purposively sampled VHWs. Participants were presented with two vignettes describing people experiencing symptoms of mental disorders (depression, psychosis), and were asked about attitudes towards, and desired social distance from, the people in the vignettes (the latter being a proxy measure for stigma). Linear regression modelling was undertaken to identify predictors of social distance. Although the community was relatively accepting of people with mental disorders, false beliefs and negative attitudes were still evident. Desired social distance was consistently greater for the person depicted in the psychosis vignette compared to the depression vignette. For both vignettes, the main predictor of greater social distance was perceiving the person as dangerous, and the predictors of reduced social distance were being a VHW, and seeing the problem as a sign of personal weakness. For depression, believing the cause to be family tensions also reduced social distance. For psychosis, labelling the disorder as a mind/brain problem, and believing the cause to be lack of control over life or genetic factors increased social distance. The vast majority did not agree that the problems experienced in the vignettes were 'a real medical illness'. Promoting bio-medical explanations for mental disorders in this setting may exacerbate discriminatory attitudes. Provision of contextually relevant mental health training for the VHWs so that they are able to communicate, model and shape more positive attitudes is the next step.

Late life depression and dementia: a mental health literacy survey of Australian general practitioners

Whilst previous surveys of mental health literacy of general practitioners (GPs) have shown high rates of recognition of common mental disorders, few studies have been carried out into GPs' understanding of presentations in late life. This study aims to determine GPs' recognition of mental disorders in older people, their intentions regarding investigation, specialist referral and treatment, and their beliefs about prognosis. Australian GPs who attended an educational seminar were administered questions based on clinical vignettes describing older people with depression, dementia and coronary heart disease. There was a high rate of recognition of all disorders amongst the 436 respondents. GPs demonstrated a high level of consistency about screening questionnaires, investigations and specialist referral in the dementia vignette. In contrast, less than half of GPs endorsed using a screening questionnaire or neuroimaging, and considered referral to a variety of medical specialties in the depression vignette. For both the depression and dementia vignettes, self-help treatments like walking, dietary advice or alcohol reduction were endorsed more frequently than an antidepressant or cholinesterase inhibitor respectively. Dementia tended to be viewed as having a poor prognosis, and late-life depression a moderate prognosis. Actual or intended rates of diagnostic recognition, specialist referral and benzodiazepine prescription found in this study may not translate into clinical practice for a number of reasons. Non-specific treatments without a clear evidence base were considered as often as those with a stronger evidence base. There is a need to improve the knowledge of GPs with regard to screening and investigating late life depression and managing dementia.

Awareness of Beyondblue: The National Depression Initiative in Australian Young People

To measure awareness of beyondblue: the national depression initiative and Ybblue (the youth program of beyondblue) in Australian young people and associations between awareness and measures of mental health literacy. A national telephone survey of mental health literacy was conducted with 3746 young people aged 12-25 years. Participants were asked to spontaneously recall organizations related to mental health problems, as well as whether they recognized beyondblue. Overall, 44% of young people were aware of beyondblue, including 12.1% who spontaneously recalled beyondblue as an organization related to mental health problems. Awareness was lower in males and generally increased with age. Awareness of beyondblue was associated with better recognition of depression and greater exposure to depression in self or family and friends. Participants aware of beyondblue were more likely to rate antidepressants and some professional interventions as helpful for depression, and were less likely to rate dealing with the problem alone or using alcohol as helpful. Awareness was not associated with social distance scores or psychological distress. beyondblue: the national depression initiative has reached a good proportion of Australian young people, and awareness is associated with better mental health literacy. Males and younger adolescents could be targeted for improvements in awareness.

S.08.04 Dopamine D3 receptors as a target for the treatment of schizophrenia: contrasting actions of antipsychotic agents

This study investigated the Australian public׳s beliefs about the causes of schizophrenia and whether these beliefs have changed over a 16-year period. Data came from the 2011 Australian National Survey of Mental Health Literacy and Stigma which involved telephone interviews with 1995 Australians aged 15 or over. The survey interview used the same questions as those of the 2003/4 and 1995 national mental health literacy surveys, in which participants were presented with a case vignette describing either early or chronic schizophrenia. Questions were asked about recognition of, exposure to and causal beliefs about these disorders, including those relating to psychosocial, biogenetic and personality factors. Results showed that most Australians believe in multifactorial causes of schizophrenia and that, between 1995 and 2011, belief in problems from childhood and inherited or genetic causes of early schizophrenia increased while belief in weakness of character decreased. Overall, the findings are consistent with evidence that mental health literacy in Australia has improved over a 16-year period.

Adolescents' Responses to Peers with Depression or Conduct Disorder

To determine how young people are likely to respond to a peer with mental illness, or who has severe behavioural problems. A mental health literacy survey was conducted with 1137 adolescents in years 8, 9 and 10 in South Australia and the Australian Capital Territory. Respondents were presented with a vignette of either a 16-year-old boy meeting criteria for conduct disorder or a 16-year-old girl meeting criteria for major depression. As part of the survey, respondents were asked to write in words what they would do if the person in the vignette was a friend of theirs and they wished to help. Responses were coded into categories. Over half the sample (53%) described positive social support as the only action they would take to help. A further 23% said they would engage an adult such as a parent, teacher or school counsellor to help with the situation. Those responding to the conduct disorder vignette were more likely to describe engaging an adult to help and males were more likely to say they would do nothing. Female students tended to answer differently to the conduct disorder and depression vignettes, while male students responded similarly to the two vignettes. Many adolescents do not respond to friends' distress in ways which are likely to facilitate appropriate help. Mental health education in schools should include skills for offering help and encouraging peers to seek help.

Adolescents' responses to peers with depression or conduct disorder

To determine how young people are likely to respond to a peer with mental illness, or who has severe behavioural problems.A mental health literacy survey was conducted with 1137 adolescents in years 8, 9 and 10 in South Australia and the Australian Capital Territory. Respondents were presented with a vignette of either a 16-year-old boy meeting criteria for conduct disorder or a 16-year-old girl meeting criteria for major depression. As part of the survey, respondents were asked to write in words what they would do if the person in the vignette was a friend of theirs and they wished to help. Responses were coded into categories.Over half the sample (53%) described positive social support as the only action they would take to help. A further 23% said they would engage an adult such as a parent, teacher or school counsellor to help with the situation. Those responding to the conduct disorder vignette were more likely to describe engaging an adult to help and males were more likely to say they would do nothing. Female students tended to answer differently to the conduct disorder and depression vignettes, while male students responded similarly to the two vignettes.Many adolescents do not respond to friends' distress in ways which are likely to facilitate appropriate help. Mental health education in schools should include skills for offering help and encouraging peers to seek help.

A program of supported education for adult Israeli students with schizophrenia.

This report describes a supported education program (SEP), a novel community-based program of rehabilitation for psychiatric patients, started in Israel in 1999. Objectives, target population and activities are described. In addition, initial findings of two program-related studies are presented. One study explored the relationship of psychological distress with students' coping strategies and perceived social support. The second study is a survey of mental health literacy and attitudes of heads of schools for adult education where the SEP was implemented. Studies' findings suggested a "case for action" with the following objectives: to develop interventions to prevent distress among SEP users, and to enhance mental health knowledge and foster positive attitudes among school personnel aimed at decreasing dropout rates and encourage the utilization of the opportunities provided by SEP.

Mental health literacy survey of psychiatrically and generally trained nurses employed in a Singapore psychiatric hospital.

Mental health literacy studies consider the capacity of respondents to recognize certain psychiatric disorders, judge the comparative utility of a range of interventions, and make estimates about outcome and prognostic issues. We report such a study involving a sample of nursing staff employed at a large psychiatric institution in Singapore, and who were provided with separate brief vignettes of mania, schizophrenia and depression. Subjects were highly accurate in 'diagnosing' schizophrenia, less accurate for depression and even less accurate in diagnosing mania. Depression was alternately diagnosed as stress, mania was most commonly misdiagnosed as schizophrenia, and for both psychotic conditions, a percentage returned non-psychotic diagnoses. In terms of treatment options, staff distinctly favoured a 'medical model' and viewed traditional and alternative healing options as distinctly harmful. Analyses contrasted psychiatrically trained and generally trained nurses, but identified few significant differences. Such information has the potential to shape the education and training of mental health professional staff, as well as provide important insights about how nurses may diagnose, view and favour alternative treatments and strategies to assist those with common psychiatric disorders.

Mental Health Literacy Study of General Practitioners: A Comparative Study in Singapore and Australia

Objective: To compare responses to a mental health literacy survey by general practitioners in Singapore and Australia. Method: Cross-sectional surveys of general practitioners were undertaken in Australia in 1996 (n = 872) and in Singapore in 1999 (n = 264). Questionnaires provided vignettes of schizophrenia and depression, and sought responses to a range of information assessing mental health literacy. Results: The two groups returned generally similar responses, with high diagnostic accuracy and distinctly high agreement in judging the likely helpfulness of a range of resource people, activities and therapies. In addition to a few minor differences, the Singaporean practitioners tended to view outcome for the disorders more optimistically and to differentiate less in estimating outcome for the two disorders. Conclusions: Previous reports of the responses by the Australian general practitioners had generally shown their views to be consistent with mental health professionals and, on several important parameters, discordant with the views of the Australian general public. This report highlights distinct similarities in general practitioner responses across cultures.

A comparative mental health literacy survey of psychiatrists and other mental health professionals in Singapore

Objective: The objectives of this study are, first, to replicate and extend an Australian approach to assessing mental health literacy by studying a sample of Singapore mental health professionals, and to focus on differences between judgements made by the psychiatrists in comparison with the other mental health professionals. Second, to compare the psychiatrists' judgements with those of Australian psychiatrists.Method: The Australian questionnaire, assessing responses in relation to vignettes of major depression and to schizophrenia was extended by adding a third vignette of mania, and by the addition of several region-specific response options. Nearly 500 questionnaires were distributed to representative staff (psychiatrists, nurses and allied health) of a large psychiatric institution in Singapore, with a response rate of 81%. Psychiatrists' judgements were compared with all other hospital staff, and with Australian psychiatrists' judgements.Results: The two principal contrast groups (Singapore psychiatrists and other Singapore mental health professionals) differed slightly in terms of diagnostic accuracy. The psychiatrists differed in favouring a more professionally focused model of intervention, while both professional groups viewed traditional healers and their practices as distinctly unhelpful. Direct comparison of psychiatrist ratings generated in Singapore and in Australia revealed quite similar response profiles.Conclusions: In addition to generating data of some intrinsic importance, comparison with Australian survey data allows the potential impact of regional and cultural differences, as well as of varying psychiatric practices, to be identified. Responses identified more similarities than differences in the judgements of the psychiatrists from the two countries.