Mental Health Literacy Research Articles

Canadian undergraduate students’ mental health literacy and its influence on psychological distress and help-seeking behaviour

Psychological distress (PD) among Canadian undergraduate students continues to be a prevalent issue. Developing an enhanced understanding of the relationship between mental health literacy (MHL), PD and help-seeking behavior (HSB) can provide researchers, educators, and clinicians with additional insight as to what knowledge should be taught and reiterated to undergraduate students that will support their mental health. While many studies across the globe have consistently reported significant positive relationships between MHL and HSB, there remains mixed findings regarding the relationship between MHL and PD. The purpose of this study was to explore Canadian undergraduate students’ degree of MHL, and the influence it has on their levels of PD and HSB. While previous Canadian studies have explored students’ MHL, this is the first Canadian study that has examined the relationships between MHL, PD and HSB. A total of 335 participants completed an online survey. More than half of the students reportedly experienced heightened levels anxiety, depression, and stress. The results suggested that Canadian undergraduate students demonstrate adequate levels of MHL and that some attributes of MHL have significant relationships with PD and HSB. Further research is warranted to strengthen our understanding of the influence of MHL on PD and HSB.

Impact of Mental Health Literacy on Mental Health and Renal Function in Dialysis Patients: A Cross-Sectional Study

Aim: This article aims to assess Mental Health Literacy (MHL) in dialysis patients and examine their impact on anxiety, depression and physical health. Material and Method: The study was conducted in the Hemodialysis Unit of Karaman Training and Research Hospital between March and June 2024. A total of 87 patients who met the inclusion criteria and agreed to participate were included in the study. Data were collected using a semi-structured sociodemographic form, Mental Health Literacy Scale, Hamilton Depression Scale and Hamilton Anxiety Scale. Biochemical parameters were obtained from electronic patient records. Results: The frequency of depression was 45%. There was no significant difference in MHL points among individuals with and without depression. Furthermore, no correlation was found between MHL and duration of disease or dialysis. A significant relationship was found between Total and Resource subscale scores of MHL and estimated glomerular filtration rate (eGFR). Conclusion: The frequency of depression was higher in dialysis patients than in the general population. Albeit no significant difference in MHL was observed between patients diagnosed with depression and those without, the significant relationship between MHL and eGFR suggests that interventions to increase MHL may have positive effects on disease progression.

Pathways to suicide for children and youth in Guyana: A life charts analysis

Background: Suicide is the third leading cause of death among youth aged 15 to 29 years old globally. Guyana has the highest rate of youth suicide in the world, yet only limited research exists. Aim: The aim of this study is to identify key features of the suicide pathway for Guyanese children and youth and to distinguish meaningful subgroups. Method: The psychological autopsy (PA) method was used to generate life charts for 15 Guyanese children and youth (10–29 years) who died by suicide. Nineteen close contacts of these individuals were interviewed about the life events of the decedent between 6 months and 5 years after their death. Semi-structured interviews lasting 30 to 150 min took place between November 2021 and January 2022. The interview data were converted into life charts and these were reviewed to uncover meaningful subgroups of suicide pathways. Results: Three groups with distinct suicide pathways were identified: hard life (46%), mental illness (20%) and interpersonal stress (20%). There were also two male youths for whom the suicidal antecedents and pathways were unclear. Interpersonal stress, alcohol, exposure to suicide and family history of suicide were common factors identified across groups. Conclusions: The findings emphasise the role of both acute and protracted interpersonal stress for child and youth suicide in Guyana. The structure and dynamics of Indo-Guyanese families are discussed. Interventions recommended include enhancing child and youth community engagement, improving mental health and suicide literacy, alcohol restriction, increasing access to support services, and reducing stigma.

Predictors of depression among caregivers of patients with severe mental illness in Northwest Ethiopia, 2023: an explanatory sequential mixed-method study.

Severe mental illness results in an enormous social and economic burden on affected individuals, their families, and communities, especially in developing countries, such as Ethiopia. The aim of this study was to assess the level of depression among caregivers of patients with severe mental illness in Debre Tabor Town, Northwest Ethiopia in 2023. This institution-based explanatory mixed study was conducted at Debre Tabor Compressive Specialized Hospitals between September 30 to October 30, 2023. A systematic random sampling technique was used to select 260 study participants, and a public health questionnaire was used to assess depression. Epicollect5 was used to collect data, which were then exported to the SPSS-25 for analysis. Variables with a p-value <0.25 were considered candidates for the multivariate logistic regression analysis. The odds ratios with a 95% confidence interval were used to determine the strength of the association. An in-depth interview was conducted with 11 participants, selected using purposive sampling. The prevalence of depression was 31.3% (95% CI = 29.7-38.6). The multivariate analysis showed that being female (AOD = 2.43, CI = 1.42-7.23), divorced/widowed (AOD = 1.8, CI = 1.32-6.34), poor social support (AOD = 2.2, CI = 1.9-5.87), and perceived stigma (AOD = 2.33, CI = 0.24-13.22) were positively associated with depression. The qualitative results suggest that being female, illiterate, severity of the illness, poor social support, and stigma were factors for depression. The prevalence of depression was high among caregivers of patients with severe mental illness. Female sex, being divorced or widowed, being illiterate, poor social support, and perceived stigma were the contributing factors. This implies that a greater focus on caregivers and the government increases mental health literacy and mental health community services.

A Cannabis Crossroads: The Impact of Risk Interpretation on Cannabis-Related Behaviors Among Canadian Youth

Attitudes toward cannabis in Canada are continually shifting, leaving youth vulnerable as they navigate the pre- to post-legalization context. Using the Youth Risk Interpretation (Y-RIF) conceptual framework, our research aimed to explore youth’s interpretation of cannabis-related risks and gather insight into how this dynamic contextual shift influences their decisions. A qualitative study used a series of virtual focus groups with youth ( N = 38; M = 15) living in urban and rural areas of Newfoundland and Labrador that were facilitated by young adults in 2021. An inductive thematic analysis approach was used to code all transcripts, and the identification of themes was informed by the Y-RIF. Our thematic analysis highlights the multitude of contextual factors (e.g., developmental, social, cultural, neurocognitive, geographical, and structural) that influence youths’ perceptions of cannabis-related risks, which in turn impact their cannabis-related decisions. Youths’ exposure to various circumstances, coupled with their internalization of contextual factors, interplay with cognitive processes, personal preferences, and agency. Consequently, this influenced how youth interpreted the risks associated with cannabis and their behaviors. Understanding youths’ risk perception and underlying factors that contribute to unsafe decisions will inform targeted substance use and mental health literacy efforts for youth.

Predicting Pornography Use Based on Mental Health and Quality of Communication with Parents.

Pornography, encompassing explicit images, videos, audio, and written content, has adverse impacts on individuals' well-being. We aimed to explore the relationship between mental health and communication quality with parents and the use of pornography, considering the moderating effect of gender. Quantitative data collection and descriptive-correlation analysis were employed. The study included university students in Tehran, Iran during the 2021-2022 academic year. Through purposive sampling, 210 participants completed an online questionnaire on Porsline. The survey assessed pornography use, quality of communication with parents, and general health. SPSS 23 software facilitated correlation and hierarchical regression analysis. Gender significantly influenced pornography use (β=0.557). Anxiety symptoms (β=0.45) and social dysfunction (β=0.351) had significant positive effects on pornography use. Moreover, quality of relationships with parents, both mother (β=-0.47) and father (β=-0.27), exhibited negative associations with pornography use (P=0.01). High quality relationships with parents, lower anxiety and social dysfunction could potentially decrease the likelihood of pornography use on the internet. It is recommended that educational efforts and cultural interventions focus on protecting young adults from the negative effects of pornography use. Such interventions may include psychoeducational training on effective communication skills, mental health literacy, and stress management skills.

Adaptation of mental health first aid guidelines for eating disorders for Iran

BackgroundThis study aimed to adapt mental health first aid guidelines to support individuals with or at risk of developing eating disorders in Iran. This adaptation seeks to enhance the support available for the Iranian population dealing with these disorders.MethodsWe employed the Delphi expert consensus method, utilizing two panels: health professionals (n = 37 in the first round; n = 29 in the second) and individuals with lived experience (n = 20 in the first round; n = 18 in the second). The health professionals panel was selected from the graduates of various eating disorders associated scientific fields who had a history of providing services to or conducting research on people with eating disorders, and the lived experience panel had a history of eating disorders themselves or in their family. The panel of individuals with lived experience included those who had personal or familial histories of eating disorders. Efforts were made to ensure cultural, gender, and age diversity in the selection of panel members. Panellists rated the importance of each item for inclusion in the guidelines for Iran based on the English-language Mental Health First Aid guidelines for eating disorders. Items deemed essential by at least 80% of both panels were included in the final guideline. Additionally, panel members were invited to suggest any missing items.ResultsA total of 57 participants took part in the first round of the survey, and 47 participated in the second round. In the first round, 204 items across 11 categories were assessed, with 174 items endorsed by the panels. Thirteen items were re-scored in the second round, and 17 items were rejected. Participants suggested 11 new items in the first round. In the second round, 18 out of 24 items were endorsed, while six were rejected. Ultimately, 192 items were incorporated into the Iranian guidelines.ConclusionsThe adaptation process considered Iran's social and cultural characteristics, including the stigma associated with mental health disorders, religious beliefs and rituals such as fasting, linguistic differences between English and Farsi, distrust of strangers, the influence of friends and family, differences in food access, and low mental health literacy. We recommend piloting the adapted guidelines in high schools, universities, and non-governmental organizations to evaluate their feasibility and effectiveness in real-world settings. Furthermore, it is essential to establish mechanisms for feedback, update content based on the latest evidence, and collaborate with the media to promote educational programs and public participation.

Mobile mental health application use, and app feature preferences among individuals with mental disorders in Ethiopia: A cross-sectional survey

BackgroundMobile health applications have been shown to assist in the treatment of mental illnesses, yet their potential remains underutilized. As supportive care, mental health applications use may be useful tools in improving mental health literacy and treatment outcomes, but patients’ use of and interest in using these apps have not been studied in low-income countries like Ethiopia. This study explores the determinants of patients’ mental health app use interests and app feature preferences. MethodsA cross-sectional study was conducted with 419 outpatient individuals with mental health disorders at Amanuel Mental Specialized Hospital, Ethiopia, between October and November 2023, using a convenience sampling method. Patients’ self-reported mental health app use, interests, attitudes, and app feature preferences were collected. A multivariate logistic regression model was used to identify the associated factors. ResultsOverall prevalence of not interested, somewhat interested, interested, and extremely interested in mental health app use was 5.3 %, 16.9 %, 27.7 %, and 50.1 % respectively. The proportion of current mental health apps use was low (21.2 %). Current mental health app use is associated with living in an urban area (AOR = 6.69, CI: 3.19–14) and having a higher education level (4.12 (2.02–8.04). Furthermore, app features such as psychoeducation, symptom tracking, and self-management techniques ranked as the most preferred app features. ConclusionsMost study participants were interested in using mental health apps, but only about one in four were using mental health apps. This suggests promise for their utility in the Ethiopian context. App developers and policymakers should consider rural residents’, lower educational levels, and patient app preferences when developing these applications.

College students’ utilization of the Internet to search for mental health information: Effects on mental health literacy, stigma, and help-seeking

Objective The current study examined how college students search online for mental health information and the impact of these searches on mental health literacy, stigma, and help-seeking. Method Undergraduate participants (N = 270; Fall 2015 to Spring 2019) were randomly assigned to search online for information about coping with anxiety for themselves or a friend (experimental activity), or to utilize Google Maps to answer navigational questions (control). Results Participants who conducted an online search demonstrated greater mental health literacy including optimism about psychotherapy, and lower levels of certain types of stigma, but lower willingness to seek/recommend professional help. Participants were more likely to recommend professional help for a friend compared to themselves. Conclusions Online searches for mental health information have the potential to increase mental health literacy. Universities can harness the Internet to reduce help-seeking barriers but should also address when it is appropriate to engage in self-help versus seek professional help.

Men’s experiences of HeadsUpGuys: A strength-based case study

Objective: Suicide is one of the leading causes of death of men. This article reports on men’s experiences of using an e-mental health resource, HeadsUpGuys, which was designed to support men’s management and recovery from depression and suicidality. Design: Survey methodology was used to report men’s experiences of using the website. Constructs of interest included mental health literacy, stigma, attitudes, taking action, help-seeking and satisfaction with the resource. Survey items were developed specifically for the study. Setting: The survey was conducted online. Methods: Participants were recruited via the HeadsUpGuys website ( headsupguys.org ) and invited to participate in the survey if they were (a) male, (b) visiting the site for help with their own health, (c) 18 years of age or older and (d) able to read English. Results: A total of 443 men participated in the study. A high proportion indicated that visiting HeadsUpGuys helped improve their knowledge of suicidality among men and better recognise symptoms of male depression. The majority reported a reduction in their stigmatising beliefs about depression and suicidality among men. An increased sense of hope for recovery was reported by many participants. The majority of men also reported feeling inspired to take action towards recovery and having a better understanding of the steps they needed to take. Furthermore, a high proportion indicated they were more likely to seek help from both peers and professionals after visiting the site. Most men reported being satisfied with the HeadsUpGuys resource and would recommend it to others. Conclusion: A tailored mental health resource for men has the capacity to facilitate important shifts in constructs that play a critical role in shaping help-seeking behaviours among men. Considering the dearth of free public health resources to support men’s mental health, the HeadsUpGuys programme not only helps to fill this gap, but also provides an example of effective engagement of men to guide the development of other tailored programmes.

A National Snapshot of Training and Technical Assistance Needs Within the Mental Health Workforce.

This report summarizes results from a national survey that aimed to assess the training and technical assistance needs of individuals who work in mental health. A survey was distributed to mental health workers by 10 regional centers of a large, nationwide, federally funded training and technical assistance network during January-October 2021. A total of 2,321 individuals from 58 states and territories responded to the survey. The three training and technical assistance needs they indicated most frequently were equitable and culturally responsive services, co-occurring mental and substance use disorders, and mental health awareness and literacy. The survey findings reflect the continued need to address inequities in mental health services, particularly for communities of color. In addition, a cluster of topics (i.e., mental health awareness and literacy, trauma-informed care, crisis services, grief, and provider well-being) stemmed from the COVID-19 pandemic and its effects on the nation's mental health.

The relationship between mental health literacy and community attitudes towards mental illness: is myths about schizophrenia a mediator?

The relationship between mental health literacy and community attitudes towards mental illness: is myths about schizophrenia a mediator?

Lifetime trauma, mental well-being, alcohol and help-seeking; the phenomenological experience of veterans residing in Northern Ireland

BackgroundVeteran residents in Northern Ireland (NI) are an under-researched population. Little is known about their experiences of trauma and mental health management. The overall mental well-being of veterans living in NI may be poorer than other veteran populations, due to the challenges presented by the unique landscape. Understanding their experiences is crucial for providing appropriate, targeted support.MethodSix male veterans, who had received a mental health diagnosis, living in NI and all aged > 40 years participated. Semi-structured interviews, using open-ended questions, were conducted over the telephone. Interpretative phenomenological analysis was used to explore their experiences.ResultsTwo experiential themes were identified each containing three experiential statements. Statements for ‘an extreme lack of’ included: lack of mental health literacy/awareness; lack of expectations of official support; lack of a sense of perceived appreciation. Statements for ‘an extreme abundance of’ included: exacerbated exposure to a range of extreme environments; high levels of ruled-based living; high levels of engaging with informal/local level support.ConclusionsSeveral experiential statements aligned with existing literature, including having poor mental health literacy and problem recognition, and heavily utilising social support versus formal help-seeking. Some novel findings included bouncing between extreme positive and negative environments which could be as detrimental to mental health as experiencing conflict trauma. Heavy alcohol use was just another rule soldiers followed. Positive help-seeking experiences failed to improve poor opinions of support organisations. Finally, poor self-perceptions connected to military status are pertinent in NI, which seems to fuel self-marginalisation and distrust. A combination of factors likely contributes to many veterans living in NI having poorer mental well-being. Novel findings would benefit from further exploration as understanding how NI veterans interpret their experiences is key to providing adequate healthcare.

Level and predictors of mental health literacy among secondary school students in Nakhon Pathom Province, Thailand

Mental health literacy (MHL) is one of the most important factors in resolving mental health disorders for adolescents. This cross-sectional study examines the level of MHL among secondary school students and seeks to determine its predictors. A multi-stage sampling technique was used to recruit a sample of 404 students with a mean age of 14.89 years (SD = 1.66) attending an autonomous secondary school in Nakhon Pathom province, Thailand in the first semester of the 2023 academic year. The research instruments were two self-reporting questionnaires, namely the General Health Questionnaire (GHQ – Thai version) and the Mental Health Literacy Survey. Content validity was reviewed by three experts and the Index of Consistency (IOC) was 0.97, with Cronbach’s alpha reliabilities of 0.94 (GHQ), and 0.75 (MHL). Descriptive statistics including chi-square test and binary logistic regression were used to analyze the data. The mean score of MHL was 28.96 (SD = 3.58), indicating adequate MHL within this sample. Academic performance (OR 1.834, 95%Cl 1.139-2.954), studying at the senior high school level (OR 1.559, 95%Cl 1.005-2.418), and experiencing psychological distress (OR .535, 95%Cl .321- .892) were all predictors of adequate MHL. These findings suggest that school administrations and healthcare providers should develop a program to ensure junior-level students attain cognitive abilities and an adequate MHL level to prevent future mental illness.

Strengthening the mental health literacy and self-efficacy of school counsellors using “MDAS” module: A pilot project in Malaysia

Mental health difficulties affect children and adolescents pervasively. School counsellors serve as frontliners to support the students in need, but often face challenges from the complexity of their cases. This study aims to develop a training module named MDAS (Mental Health disorder, Developmental disorders, Attachment and Self-compassionate) program to improve the school counsellors’ mental health knowledge and counselling self-efficacy. The Module was adapted from Child and Adolescent Mental Health Training Module for Specialist 2009 (Second Edition). The study adopted a one group pre-test/post-test design to assess 28 school counsellors at 0-month and 4-month after the training. The scales used were Counselling Self-Efficacy scale (COSE), Mental Health Literacy Scale (MHLS) and Self-Compassionate Scale – Short Form (SCS-SF). Post-training, there were significant increment of COSE and MHLS scores ( p &lt; .001 and p &lt; .046) with Cohen’s d of 1.01 and 0.58. Four of the COSE subscales (micro skills, counselling process, cultural competence and dealing with difficult clients’ behaviour) significantly increased after MDAS training ( p &lt; .001, p = .006, p = .001 and p = .01). In addition to increasing the counselling capacity of school counsellors, our training module can serve as a promising platform for mental health professionals and counsellors.

Mental health awareness, stigma, and help-seeking attitudes among Albanian university students in the Western Balkans: a qualitative study.

The significance of mental health and its impact on overall well-being is increasingly acknowledged across various sectors, including higher education. However, despite this growing recognition, the stigma associated with mental health issues and related help-seeking, particularly within certain cultural groups and socio-economic contexts, continues to pose a formidable barrier to effective care, especially among university students. Addressing these challenges, this study explores the intricate interplay of factors affecting mental health awareness and stigma, including help-seeking behaviors among Albanian university students in three Western Balkan countries: Kosovo, North Macedonia, and Albania. By dissecting these multi-layered influences, this study aims to develop targeted interventions to enhance mental well-being and dismantle barriers to care in these regions. This qualitative study involved 60 Albanian university students from Kosovo, North Macedonia, and Albania, using focus groups to gather data. The discussions were structured around the socio-ecological model, facilitating a comprehensive exploration of the individual, interpersonal, organizational, and societal factors influencing mental health awareness, stigma, and help-seeking behaviors. Findings from the study indicate a moderate awareness of mental health issues among students. Familial and cultural stigma among Albanians in the Balkans hinder open discussions and access to professional help. There is a notable lack of support from higher education institutions, with only 20% of students reporting that their mental health needs are met. These needs include affordable and confidential counseling, empathetic faculty interactions, and a supportive campus environment. Additionally, there is a lack of continuous and professional help within the community. Societal attitudes deeply rooted in Albanian cultural norms and traditional beliefs perpetuate stigma, limiting effective health care and help-seeking behavior. The results emphasize the need for a culturally sensitive and holistic approach to mental health interventions that integrates strategies across multiple levels of the socio-ecological model. Enhancing mental health literacy, reducing stigma, and advocating for supportive legislation and policies in the Western Balkan region are critical. Moreover, the study highlights the urgent necessity for universities in particular to improve their mental health services, which will significantly enhance both the academic success and personal development of students.

‘Mental health is a mystery’: patient perspectives on treatment engagement in the referral process to specialty geriatric mental health services

Objectives Raue and Sirey proposed a theoretical treatment engagement model for older adults outlining steps from identifying mental health problems, referral to specialty care, and involvement in treatment. Using this model as a guide, the current study aimed to explore patient perspectives of their experience in the process of referral and first meeting with geriatric mental health services. Furthermore, the current study aimed to identify opportunities to enhance patient engagement in these beginning steps of the treatment engagement process. Method Thirteen geriatric outpatients (7 psychology, 6 psychiatry) presenting with concerns of anxiety, depression, and/or stress were interviewed. Interviews were analyzed using the framework method. Results Themes emerged as suggested by Raue and Sirey’s model, including attitudes toward treatment (e.g. stigma), treatment expectations, and treatment preferences. In addition, new themes emerged related to modifiable individual factors (the patient as a passive recipient of care, mental health literacy, and ageism) as well as social influences on treatment engagement. Participants primarily noted opportunities for psychoeducation as a potential treatment engagement intervention to implement within the current referral system. Conclusions This is the first study to examine the applicability of Raue and Sirey’s theoretical engagement model in a clinical sample. Findings both support and expand the model and offer several recommendations for improving treatment engagement for older patients.

Defining mental health literacy: a systematic literature review and educational inspiration

PurposeThis paper aims to explore how the term “mental health literacy” (MHL) is defined and understand the implications for public mental health and educational interventions.Design/methodology/approachAn extensive search was conducted by searching PubMed, ERIC, PsycINFO, Scopus and Web of Science. Keywords such as “mental health literacy” and “definition” were used. The publication year ranges from 1997 to 2023.FindingsIn total, 17 papers met the inclusion criteria. Three distinct themes characterise the definitions of MHL: cognitive understanding; affective empowerment; and behavioural change. In the mental health educational context, inspiration, transformation and practice can be viewed as three stages for curriculum development.Research limitations/implicationsDespite conducting a systematic literature review, there remains the possibility that certain relevant studies may not have been identified. Specifically, the selection criteria prioritise papers that explicitly addressed MHL.Practical implicationsTraditional educational approaches prioritise knowledge dissemination and attitude change; integrating MHL into mental health well-being curriculum advocates for action-oriented intervention to address mental health challenges.Social implicationsUnderstanding different definitions and concepts in a field can be valuable for consolidating shared understandings, highlighting tensions and contradictions, and enhancing communication among researchers. Ironically, perhaps, the process also highlights the provisional nature of these definitions.Originality/valueThe exploration of MHL with three themes of definitions sheds light on the understanding of this concept. Three core themes in MHL definitions guide future curriculum development. This study underscores the importance of prioritise action-oriented intervention in mental health education, emphasising the need to move beyond knowledge dissemination towards transformative practices that promote holistic mental well-being.

Mental Health Literacy Among Urban and Rural Residents of Guangdong Province, China.

The study aims to understanding the mental health literacy level of urban and rural residents in Guangdong Province, the first major province in China, and its influencing factors is crucial. A multi-stage stratified equal-volume random sampling method was adopted in October-December 2022 to select permanent residents aged 18 years and above in Guangdong Province for the questionnaire survey, which consisted of a general demographic information questionnaire and a national mental health literacy questionnaire. Rao-Scott χ²-test with correction based on sampling design, independent samples t-test and binary multivariate logistic regression analysis were performed. A total of 51744 individuals completed the questionnaire, including 31822 urban residents and 19200 rural residents. The rate of achievement of mental health literacy was 13.6% among urban residents, which was significantly higher compared to the rate of 8.6% among rural residents. Logistic regression analysis showed that female, higher education, being mental worker, being a retiree, having a higher monthly household income, maintaining a regular diet, and using electronic products for 2-6hours per day were protective factors for mental health literacy attainment in urban residents, while having chronic diseases, being a smoker and having a history of drinking were identified as risk factors in urban residents. Among in rural residents, married, younger, higher education, being mental worker and using electronic products for 2-6hours per day, maintaining a regular diet, and engaging in regular exercise were protective factors for achieving mental health literacy, while previous smoking was a risk factor. The study revealed a low level of mental health literacy among urban and rural residents of Guangdong Province, with a significant disparity between the two areas. These findings highlight the need for continuing efforts to increase the dissemination of mental health knowledge in rural communities and improve levels of mental health literacy.

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.