Mental health literacy

Mental health literacy has three major components: recognition, knowledge, and attitudes. A conceptual framework of mental health literacy illustrates the connections between components, and each is conceptualized as an area to target for measurement or intervention.{{cite journal |last1=Jorm |first1=A. F. |title=Mental health literacy: Public knowledge and beliefs about mental disorders |journal=British Journal of Psychiatry |date=November 2000 |volume=177 |issue=5 |pages=396–401 |doi=10.1192/bjp.177.5.396 |pmid=11059991 |doi-access=free }}{{cite journal |last1=O’Connor |first1=Matt |last2=Casey |first2=Leanne |last3=Clough |first3=Bonnie |title=Measuring mental health literacy – a review of scale-based measures |journal=Journal of Mental Health |date=August 2014 |volume=23 |issue=4 |pages=197–204 |doi=10.3109/09638237.2014.910646 |pmid=24785120 |hdl=10072/61844 |hdl-access=free }} While some researchers have focused on a single component, others have focused on multiple and/or the connection between components. For example, a researcher may focus solely on improving recognition of disorders through an education program, whereas another researcher may focus on integrating all three components into one program.{{citation needed|date=August 2023}}

Recognition can be broken down into symptom or illness recognition. Symptom recognition is the ability to detect beliefs, behaviors, and other physical manifestations of mental illness, without knowing explicitly which disorder they link to. Specific illness recognition is the ability to identify the presentation of a disorder, such as major depressive disorder.{{citation needed|date=August 2023}}

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The recognition of difference between knowledge and attitudes is a crucial part of the mental health literacy framework. While some efforts have focused on promoting knowledge, other researchers have argued that changing attitudes by reducing stigma is a more prolific way of creating meaningful change in mental healthcare utilization. Overall, both approaches have benefits for improving outcomes.{{Cite journal|last1=Corrigan|first1=Patrick W.|last2=Morris|first2=Scott B.|last3=Michaels|first3=Patrick J.|last4=Rafacz|first4=Jennifer D.|last5=Rüsch|first5=Nicolas|title=Challenging the Public Stigma of Mental Illness: A Meta-Analysis of Outcome Studies|journal=Psychiatric Services|volume=63|issue=10|pages=963–973|doi=10.1176/appi.ps.201100529|pmid=23032675|year=2012}}

Public knowledge about physical disease and health are often recognized and widely accepted but knowledge about mental health literacy is comparably neglected.{{Cite journal |title=Cambridge University Press |journal=The British Journal of Psychiatry |date=November 2000 |volume=177 |issue=5 |pages=396–401 |doi=10.1192/bjp.177.5.396 |url=https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/mental-health-literacy/5563369643662EC541F33D1DD307AD35 |last1=Jorm |first1=A. F. |pmid=11059991 }} Many people cannot recognize mental health disorders or different psychological distress. If mental health literacy doesn't improve, it may continue to neglect mental health care, and feeling denied of self-help and support from community.

Knowledge is the largest component of mental health literacy, and important topics in Mental Health include:

• How to get information: the networks and systems individuals use to get information about mental disorders. This may include friends, family, educators, or broader sources, such as entertainment or social media.
• Risk factors: what factors put individuals at greatest risk for specific mental health disorders. Risk factors can be unemployment, low income, lack of education, discrimination, and violence.{{cite journal |last1=McDowell |first1=Michal J. |last2=Hughto |first2=Jaclyn M. W. |last3=Reisner |first3=Sari L. |title=Risk and protective factors for mental health morbidity in a community sample of female-to-male trans-masculine adults |journal=BMC Psychiatry |date=December 2019 |volume=19 |issue=1 |page=16 |doi=10.1186/s12888-018-2008-0 |pmid=30626372 |pmc=6327526 |doi-access=free }}
• Causes of mental disorders
• Self-treatment or self-help: what are the best individuals can do to help themselves recover without consulting with professionals, including the use of self-help books and media. Although many self- treatments are quite ineffective and even harmful due to lack of knowledge.{{cite journal |last1=Guy |first1=Sarah |last2=Sterling |first2=Bobbie Sue |last3=Walker |first3=Lorraine O. |last4=Harrison |first4=Tracie C. |title=Mental Health Literacy and Postpartum Depression: A Qualitative Description of Views of Lower Income Women |journal=Archives of Psychiatric Nursing |date=August 2014 |volume=28 |issue=4 |pages=256–262 |doi=10.1016/j.apnu.2014.04.001 |pmid=25017559 }}
• Professional help: where to get professional help and/or what professional help is available.

Attitudes are studied in two sub-components: attitudes about mental disorders, or persons with mental disorders, and attitudes about seeking professional help or treatment. Attitudes can vary greatly by individual, and can often be difficult to measure or target with intervention. Nonetheless, a large body of research literature exists on both sub-components, though not always explicitly tied to the mental health literacy.

Recent research recognizes the varying attitudes across mental health professionals towards prognosis, long-term outcomes and likelihood of discrimination as more negative than those of the public. The attitudes of mental health professionals also differ towards interventions, but this variability is usually related to professional orientation.{{cite report |first1=Beverley |last1=Bourget |first2=Richard |last2=Chenier |date=May 2007 |title=Mental Health Literacy in Canada: Phase One Report Mental Health Literacy Project |publisher=Canadian Alliance on Mental Illness and Mental Health |url=http://en.copian.ca/library/research/mhl/mhl.pdf }}

Surveys of the public have been carried out in a number of countries to investigate mental health literacy.{{cite journal | last1 = Angermeyer | first1 = M.C. | last2 = Matschinger | first2 = H. | year = 2005 | title = Have there been any changes in the public's attitudes towards psychiatric treatment? Results from representative population surveys in Germany in the years 1990 and 2001 | journal = Acta Psychiatrica Scandinavica | volume = 111 | issue = 1| pages = 68–73 | doi=10.1111/j.1600-0447.2004.00441.x| pmid = 15636596 }}{{cite journal |last1=Jorm |first1=Anthony F |last2=Nakane |first2=Yoshibumi |last3=Christensen |first3=Helen |last4=Yoshioka |first4=Kumiko |last5=Griffiths |first5=Kathleen M |last6=Wata |first6=Yuji |title=Public beliefs about treatment and outcome of mental disorders: a comparison of Australia and Japan |journal=BMC Medicine |date=December 2005 |volume=3 |issue=1 |page=12 |doi=10.1186/1741-7015-3-12 |doi-access=free |pmid=16004615 |pmc=1177951 }}{{cite book |doi=10.1017/CBO9780511543562 |title=Unmet Need in Psychiatry |date=2000 |isbn=978-0-521-02723-6 |editor-last1=Andrews |editor-last2=Henderson |editor-first1=Gavin |editor-first2=Scott |chapter=Public knowledge of and attitudes to mental disorders: a limiting factor in the optimal use of treatment services |first1=Anthony F. |last1=Jorm |first2=Mattias |last2=Angermeyer |first3=Heinz |last3=Katschnig |pages=399–413 }}{{cite journal | last1 = Lauber | first1 = C. | last2 = Nordt | first2 = C. | last3 = Falcato | first3 = L. | last4 = Rössler | first4 = W. | year = 2003 | title = Do people recognise mental illness? Factors influencing mental health literacy | journal = European Archives of Psychiatry and Clinical Neuroscience | volume = 253 | issue = 5| pages = 248–251 | doi=10.1007/s00406-003-0439-0| pmid = 14504994 }}{{cite journal | last1 = Magliano | first1 = L. | last2 = Fiorillo | first2 = A. | last3 = De Rosa | first3 = C. | last4 = Malangone | first4 = C. | last5 = Maj | first5 = M. | year = 2004 | title = Beliefs about schizophrenia in Italy: A comparative nationwide survey of the general public, mental health professionals, and patients' relatives | journal = Canadian Journal of Psychiatry | volume = 49 | issue = 5| pages = 322–330 | doi = 10.1177/070674370404900508 | pmid = 15198469 | doi-access = free }}{{cite journal | last1 = Wang | first1 = J.L. | last2 = Adair | first2 = C. | last3 = Fick | first3 = G. | last4 = Lai | first4 = D. | last5 = Evans | first5 = B. | last6 = Perry | first6 = B.W. | last7 = Jorm | first7 = A. | last8 = Addington | first8 = D. | year = 2007 | title = Depression literacy in Alberta: Findings from a general population sample | journal = Canadian Journal of Psychiatry | volume = 52 | issue = 7| pages = 442–449 | doi=10.1177/070674370705200706| pmid = 17688008 | doi-access = free }}{{cite journal |last1=Marie |first1=Dannette |last2=Forsyth |first2=Darryl K. |last3=Miles |first3=Lynden K. |title=Categorical Ethnicity and Mental Health Literacy in New Zealand |journal=Ethnicity & Health |date=August 2004 |volume=9 |issue=3 |pages=225–252 |doi=10.1080/1355785042000250085 |pmid=15369998 }} These surveys demonstrate that the recognition of mental disorders is lacking and reveal negative beliefs about some standard psychiatric treatments, particularly medications. On the other hand, psychological, complementary and self-help methods are viewed much more positively. The public tends to prefer self-help and lifestyle interventions, opposed to medical, and psychopharmacological interventions.

Implications surrounding public attitudes towards mental disorders include negative Stereotypes, Prejudice, or Stigma. As a result, this can influence help-seeking behavior or failure to seek treatment. In Canada, a national survey found that young adult males tend to manage their problems individually and are less likely to seek formal help.{{Cite journal|last1=Marcus|first1=Madalyn|last2=Westra|first2=Henny|date=April 2012|title=Mental Health Literacy in Canadian Young Adults: Results of a National Survey|journal=Canadian Journal of Community Mental Health|volume=31|issue=1|pages=1–15|doi=10.7870/cjcmh-2012-0002 |doi-access=free}} Media influence plays a huge role in perpetuating negative mindsets towards mental illness, such as prescribing menacing qualities. A recent study highlights how the majority of participants note the media as the primary source of their beliefs about mental illness being associated with violence, and how this attitude is more prevalent towards serious mental illnesses. Fear and perceptions of danger related to mental illness have increased over the past few decades, largely due to serious mental illness such as schizophrenia being associated as potentially violent and harmful to others. These beliefs and attitudes are potential barriers to seeking individual professional help, and being supportive of others.

Additionally, the negative stigma against mental health may impede the ability of some to get help. When a caregiver avoids seeking mental health treatment due to fear of the stigma surrounding the label of a mental illness, it is seen as affiliate stigma.{{Cite journal |last1=Ben-Zeev |first1=Dror |last2=Young |first2=Michael A. |last3=Corrigan |first3=Patrick W. |date=October 2010 |title=DSM-V and the stigma of mental illness |journal=Journal of Mental Health |language=en |volume=19 |issue=4 |pages=318–327 |doi=10.3109/09638237.2010.492484 |pmid=20636112 }} This phenomenon is exacerbated in scenarios where children who present with signs of mental illness have parents who hold negative beliefs about mental illness. Studies found that individuals that have a negative impression of mental health labels might refuse seeking treatment for themselves or their children in order to avoid mental illness label.{{Cite journal |last1=Sayal |first1=Kapil |last2=Tischler |first2=Victoria |last3=Coope |first3=Caroline |last4=Robotham |first4=Sarah |last5=Ashworth |first5=Mark |last6=Day |first6=Crispin |last7=Tylee |first7=Andre |last8=Simonoff |first8=Emily |date=December 2010 |title=Parental help-seeking in primary care for child and adolescent mental health concerns: qualitative study |journal=British Journal of Psychiatry |volume=197 |issue=6 |pages=476–481 |doi=10.1192/bjp.bp.110.081448 |pmid=21119154 |doi-access=free }} A study in 2015 found that affiliate stigma decreases a parent's willingness to pursue mental health treatment for their children, which can lead to decreases in overall well-being for children.{{Cite journal |last1=Chang |first1=Chih-Cheng |last2=Su |first2=Jian-An |last3=Tsai |first3=Ching-Shu |last4=Yen |first4=Cheng-Fang |last5=Liu |first5=Jiun-Horng |last6=Lin |first6=Chung-Ying |date=June 2015 |title=Rasch analysis suggested three unidimensional domains for Affiliate Stigma Scale: additional psychometric evaluation |url=https://linkinghub.elsevier.com/retrieve/pii/S0895435615000499 |journal=Journal of Clinical Epidemiology |language=en |volume=68 |issue=6 |pages=674–683 |doi=10.1016/j.jclinepi.2015.01.018|pmid=25748074 |url-access=subscription }} It is also found that suicide is the third leading cause of death for ages 15 to 19.{{Cite web |title=Are we focused on the wrong solutions to mental illness? |url=https://standtogether.org/stories/health-care/are-we-too-focused-on-the-wrong-things-when-it-comes-to-solutions-to-mental-health?msclkid=ac60a1bc37891a800e66c6ec3fa66b4a&utm_source=bing&utm_medium=cpc&utm_campaign=STTOTGR_IN_2024_PRG-PUB_BING_50SCROLL_STBP-STMAIN-HC-NB-BROAD&utm_term=Mental%20Wellness&utm_content=ARTL_HIGHCOST-MENTALHEALTH-OCCUPATIONS-859133_V1_TXT |access-date=2024-12-05 |website=standtogether.org}} This same study found that some parents fear that general practitioners will judge them as bad parents if their children are diagnosed with ADHD. A case study from a supplement to the 2001 US Surgeon General’s report on mental health in America shows an example of low mental health literacy and/or fear of the stigma of mental illness: "An was a 30-year-old bilingual, Vietnamese male who was placed in involuntary psychiatric hold for psychotic disorganization. After neighbors found him screaming and smelling of urine and feces, they called the police, who escorted him to a psychiatric emergency room… His parents had a poor understanding of schizophrenia and were extremely distrustful of mental health providers. They thought that his psychosis was caused by mental weakness and poor tolerance of the recent heat wave…These misconceptions and differences in beliefs caused the parents to avoid the use of mental health services".{{cite book |title=Mental Health: Culture, Race, and Ethnicity: A Supplement to Mental Health: A Report of the Surgeon General |date=2001 |publisher=Substance Abuse and Mental Health Services Administration |url=https://www.ncbi.nlm.nih.gov/books/NBK44243/ |doi=10.13016/jela-ckxw |doi-access=free |hdl=1903/22834 |hdl-access=free |page=118 |last1=Satcher |first1=David |series=Publications and Reports of the Surgeon General |pmid=20669516 }} Affiliate stigma and lack of mental health literacy can cause harm in those suffering from mental illness.

Along with schizophrenia, PTSD is also a highly stigmatized mental disorder that is often misunderstood, especially among the military community. Studies have found that there are various barriers to treatment that prevent many veterans from seeking treatment for PTSD and other mental disorders{{Cite journal |last1=Elbogen |first1=Eric B. |last2=Wagner |first2=H. Ryan |last3=Johnson |first3=Sally C. |last4=Kinneer |first4=Patricia |last5=Kang |first5=Han |last6=Vasterling |first6=Jennifer J. |last7=Timko |first7=Christine |last8=Beckham |first8=Jean C. |date=February 2013 |title=Are Iraq and Afghanistan Veterans Using Mental Health Services? New Data From a National Random-Sample Survey |journal=Psychiatric Services |language=en |volume=64 |issue=2 |pages=134–141 |doi=10.1176/appi.ps.004792011 |pmc=3622866 |pmid=23475498}}{{Cite journal |last1=Erbes |first1=Christopher |last2=Westermeyer |first2=Joseph |last3=Engdahl |first3=Brian |last4=Johnsen |first4=Erica |date=April 2007 |title=Post-Traumatic Stress Disorder and Service Utilization in a Sample of Service Members from Iraq and Afghanistan |journal=Military Medicine |language=en |volume=172 |issue=4 |pages=359–363 |doi=10.7205/MILMED.172.4.359 |pmid=17484303 |doi-access=free }} such as concerns that others will see them as "crazy", beliefs that treatment is ineffective or is simply not worth it, and beliefs that those with mental health problems cannot be relied upon.{{cite journal |last1=Hoge |first1=Charles W. |last2=Auchterlonie |first2=Jennifer L. |last3=Milliken |first3=Charles S. |title=Mental Health Problems, Use of Mental Health Services, and Attrition From Military Service After Returning From Deployment to Iraq or Afghanistan |journal=JAMA |date=March 2006 |volume=295 |issue=9 |pages=1023–1032 |doi=10.1001/jama.295.9.1023 |pmid=16507803 }} These beliefs about mental health and mental health treatment is more prevalent in the military community due to the culture of the military that places a strong emphasis on emotional toughness, self-control and stoicism.{{Cite journal |last1=Krill Williston |first1=Sarah |last2=Roemer |first2=Lizabeth |last3=Vogt |first3=Dawne S |date=June 2019 |title=Cultural and service factors related to mental health beliefs among post-9/11 veterans |journal=International Journal of Social Psychiatry |language=en |volume=65 |issue=4 |pages=313–321 |doi=10.1177/0020764019842327 |pmid=30995148 }} Though these values are useful in combat scenarios, they can serve as barriers to seeking treatment and treatment adherence.{{cite book |doi=10.1037/e514742018-001 |title=Cognitive Processing Therapy Veteran/Military Version: Therapist's manual |date=2008 |last1=Resick |first1=Patricia A. |last2=Monson |first2=Candice M. |last3=Chard |first3=Kathleen M. |url=https://www.apa.org/ptsd-guideline/treatments/cognitive-processing-therapist.pdf }}{{pn|date=December 2024}}

Researchers have measured aspects of mental health literacy in several ways.{{Cite journal|last1=Wei|first1=Yifeng|last2=McGrath|first2=Patrick J.|last3=Hayden|first3=Jill|last4=Kutcher|first4=Stan|date=2015-01-01|title=Mental health literacy measures evaluating knowledge, attitudes and help-seeking: a scoping review|journal=BMC Psychiatry|volume=15|pages=291|doi=10.1186/s12888-015-0681-9 |pmc=4650294|pmid=26576680 |doi-access=free }} Popular methodologies include vignette studies and achievement tests. Vignette studies measure mental health literacy by providing a brief, detailed story of an individual (or individuals) with a mental health problem, and ask participants questions to identify what problem the individual is experiencing, and at times, additional questions about how the individual can help themselves.

Achievement tests measure mental health literacy on a continuum, such that higher scores on a test indicate greater overall knowledge or understanding of a concept. Achievement tests can be formatted using multiple-choice, true/false, or other quantitative scales.{{citation needed|date=August 2023}}

Various scales have been created to measure the various components of mental health literacy, though not all are validated. Mental health literacy has been measured across several populations, varying in age range, culture, and profession. Most studies have focused on adult and young adult populations, though improving literacy in children has been a focus of prevention efforts.

Parental label avoidance can be measured by the Self-Stigma of Seeking Help Scale (SSOSH).{{Cite journal |last1=Vogel |first1=D. L. |last2=Wade |first2=N. G. |first3=Haake |last3=S. |title=Measuring the self-stigma associated with seeking psychological help |url=https://selfstigma.psych.iastate.edu/wp-content/uploads/sites/204/2016/02/SSOSH_0.pdf |journal=Journal of Counseling Psychology |date=2006 |volume=53 | issue=3 |pages=325–337 |doi=10.1037/0022-0167.53.3.325 }}

Family empowerment is measured by the Family Empowerment Scale (FES).{{Cite journal |last=Singh |first=Nirbhay N. |date=March 1995 |title=In search of unity: Some thoughts on family-professional relationships in service delivery systems |journal=Journal of Child and Family Studies |volume=4 |issue=1 |pages=3–18 |doi=10.1007/BF02233951 }}

The three levels of development{{cite journal |last1=O’Connor |first1=Matt |last2=Casey |first2=Leanne |title=The Mental Health Literacy Scale (MHLS): A new scale-based measure of mental health literacy |journal=Psychiatry Research |date=September 2015 |volume=229 |issue=1–2 |pages=511–516 |doi=10.1016/j.psychres.2015.05.064 |pmid=26228163 |hdl=10072/125127 |hdl-access=free }}

• Measure development
• Seven attributes of MHL were developed using clinical psychology
• Clinical results reveal insufficient level of knowledge in the field to enable differentiation of risk factors for mental illness and the causes.
• Item testing
• Items are generated of the attributes by the research team and clinical panel
• psychometrics and methodology quality
• Results for the ability to recognize mental disorders

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Low literacy within a population is a relevant concern, since at the most basic level, mental health literacy is linked to general literacy. Without this foundation, the beneficial effects of mental health literacy are challenging for those who face difficulties with reading and writing. Increased measures to increase literacy rates must be employed to empower and encourage the self-help components of mental health literacy.{{citation needed|date=August 2023}}

Populations can be diverse, which means barriers, such as cultural and social contexts, must be addressed. Within and across cultures, social, economic and political factors profoundly influence mental health.{{cite journal |last1=Edmonds |first1=David Matthew |last2=Zayts-Spence |first2=Olga |last3=Fortune |first3=Zoe |last4=Chan |first4=Angus |last5=Chou |first5=Jason Shang Guan |date=2024-03-04 |title=A scoping review to map the research on the mental health of students and graduates during their university-to-work transitions |journal=BMJ Open |volume=14 |issue=3 |pages=e076729 |doi=10.1136/bmjopen-2023-076729 |pmid=38443080 |doi-access=free|pmc=11146370 }} There are numerous environmental and socioeconomic determinants of mental health and mental illness, just as there are for physical health and physical illness. Social determinants of physical health including poverty, education and social support also serve as influencers. In order to encompass mental health literacy and diverse perspectives, further research in these areas are needed.

Recognizing uncommon mental disorders is another hurdle that can disrupt mental health literacy within the public. Recent research shows that most studies are limited to identifying depression, generalized anxiety, and schizophrenia. In a recent Canadian study, most participants demonstrated good mental health literacy in regards to most mental health disorders, but a poor understanding of panic disorder.{{cite journal |last1=Gallagher |first1=Catherine E. |last2=Watt |first2=Margo C. |title=Mental health literacy in a sample of Canadian adults |journal=Canadian Journal of Behavioural Science |date=July 2019 |volume=51 |issue=3 |pages=171–180 |id={{ProQuest|2249964816}} |doi=10.1037/cbs0000129 }} An increased awareness surrounding underrepresented or more uncommon mental disorders is needed to widen public knowledge.{{citation needed|date=August 2023}}

A concluding limitation is the lack of research on child mental health literacy, as the majority of studies focus on adults and adolescents. If caregivers are not educated on recognizing and supporting mental disorders, this could create confusion and result in delayed treatment or wrongful prognosis for dependents. A child mental health literacy (CMHL) initiative could be implemented to target all adults in the general population, as well as parents, teachers, health professionals and/or children themselves.{{cite journal |last1=Tully |first1=Lucy A |last2=Hawes |first2=David J |last3=Doyle |first3=Frances L |last4=Sawyer |first4=Michael G |last5=Dadds |first5=Mark R |title=A national child mental health literacy initiative is needed to reduce childhood mental health disorders |journal=Australian & New Zealand Journal of Psychiatry |date=April 2019 |volume=53 |issue=4 |pages=286–290 |doi=10.1177/0004867418821440 |pmid=30654614 }}

A number of approaches have been tried and suggested to improve mental health literacy, many of which have evidence of effectiveness. These include:

1. Whole of community campaigns. Examples are beyondblue{{cite journal | last1 = Jorm | first1 = A.F. | last2 = Christensen | first2 = H. | last3 = Griffiths | first3 = K.M. | year = 2005 | title = The impact of beyondblue: the national depression initiative on the Australian public's recognition of depression and beliefs about treatments | journal = Australian and New Zealand Journal of Psychiatry | volume = 39 | issue = 4| pages = 248–254 | doi=10.1080/j.1440-1614.2005.01561.x| pmid = 15777361 }} and the Compass Strategy{{cite journal | last1 = Wright | first1 = A. | last2 = McGorry | first2 = P.D. | last3 = Harris | first3 = M.G. | last4 = Jorm | first4 = A.F. | last5 = Pennell | first5 = K. | year = 2006 | title = Development and evaluation of a youth mental health community awareness campaign: The Compass Strategy | journal = BMC Public Health | volume = 6 | page = 215 | doi=10.1186/1471-2458-6-215| pmid = 16923195 | pmc = 1564138 | doi-access = free }} in Australia, the Defeat Depression Campaign{{cite journal | last1 = Paykel | first1 = E.S. | last2 = Hart | first2 = D. | last3 = Priest | first3 = R.G. | year = 1998 | title = Changes in public attitudes to depression during the Defeat Depression Campaign | journal = British Journal of Psychiatry | volume = 173 | issue = 6| pages = 519–522 | doi=10.1192/bjp.173.6.519| pmid = 9926082 }} in the United Kingdom, and the Nuremberg Alliance Against Depression{{cite journal | last1 = Hegerl | first1 = U. | last2 = Althaus | first2 = D. | last3 = Stefanek | first3 = J. | year = 2003 | title = Public attitudes towards treatment of depression: Effects of an information campaign | journal = Pharmacopsychiatry | volume = 36 | issue = 6| pages = 288–291 | doi=10.1055/s-2003-45115| pmid = 14663652 }} in Germany.
2. School-based interventions. These include MindMattersMindMatters Evaluation Consortium (2000). Report of the MindMatters (National Mental Health in Schools Project) Evaluation Project, vols 1-4. Newcastle: Hunter Institute of Mental Health.{{vs|date=December 2024}}{{pn|date=December 2024}} and Mental Illness Education{{cite journal | last1 = Rickwood | first1 = D. | last2 = Cavanagh | first2 = S. | last3 = Curtis | first3 = L. | last4 = Sakrouge | first4 = R. | year = 2004 | title = Educating young people about mental health and illness: Evaluating a school-based programme | journal = International Journal of Health Promotion | volume = 6 | issue = 4| pages = 23–32 | doi=10.1080/14623730.2004.9721941 }} in Australia, and the Mental Health & High School Curriculum Guide in Canada{{cite journal | last1 = Kutcher | first1 = S. | last2 = Wei | first2 = Y. | last3 = McLuckie | first3 = A. | last4 = Bullock | first4 = L. | year = 2013 | title = Educator mental health literacy: a programme evaluation of the teacher training education on the mental health & high school curriculum guide | journal = Advances in School Mental Health Promotion | volume = 6 | issue = 2 | pages = 83–92 | doi=10.1080/1754730X.2013.784615 }}
3. Individual training programs. These include mental health first aid training{{cite journal | last1 = Kitchener | first1 = B.A. | last2 = Jorm | first2 = A.F. | year = 2006 | title = Mental Health First Aid training: review of evaluation studies | journal = Australian and New Zealand Journal of Psychiatry | volume = 40 | issue = 1| pages = 6–8 | doi=10.1080/j.1440-1614.2006.01735.x| pmid = 16403032 | hdl = 1885/23864 | hdl-access = free }} and training in suicide prevention skills.{{cite journal |last1=Pearce |first1=Katie |last2=Rickwood |first2=Debra |last3=Beaton |first3=Susan |title=Preliminary evaluation of a university-based suicide intervention project: impact on participants |journal=Australian e-Journal for the Advancement of Mental Health |date=January 2003 |volume=2 |issue=1 |pages=25–35 |doi=10.5172/jamh.2.1.25 }} Initiatives that encourage empowerment and choice would also be beneficial, such as web-based self-directed therapy.
4. Websites and books aimed at the public. There is evidence that both websites and books can improve mental health literacy.{{cite journal | last1 = Christensen | first1 = H. | last2 = Griffiths | first2 = K.M. | last3 = Jorm | first3 = A.F. | year = 2004 | title = Delivering interventions for depression by using the internet: randomised controlled trial | journal = British Medical Journal | volume = 328 | issue = 7434| page = 265 | doi=10.1136/bmj.37945.566632.ee| pmid = 14742346 | pmc = 324455 }}{{cite journal | last1 = Jorm | first1 = A.F. | last2 = Griffiths | first2 = K.M. | last3 = Christensen | first3 = H. | last4 = Korten | first4 = A.E. | last5 = Parslow | first5 = R.A. | last6 = Rodgers | first6 = B. | year = 2003 | title = Providing information about the effectiveness of treatment options to depressed people in the community: A randomized controlled trial of effects on mental health literacy, help-seeking and symptoms | journal = Psychological Medicine | volume = 33 | issue = 6| pages = 1071–1087 | doi=10.1017/s0033291703008079| pmid = 12946091 }} However, the quality of information on websites can sometimes be low.{{cite journal | last1 = Griffiths | first1 = K.M. | last2 = Christensen | first2 = H. | year = 2002 | title = The quality and accessibility of Australian depression sites on the World Wide Web | journal = Medical Journal of Australia | volume = 176 | issue = 10| pages = S97–S104 | doi = 10.5694/j.1326-5377.2002.tb04509.x | pmid = 12065004 }}
5. Rapport between mental health professionals and clients. By creating a partnership, professionals can promote competence, informed choice, and comprehensible knowledge for all levels of understanding, such as translating research findings into simpler language.

Children often must rely on their families in order to access mental health services leading to parents receiving an increasing amount of attention from mental health professionals in order to educate them on mental health. The status of family empowerment (FE) is composed of two dimensions: (a) levels of empowerment (family, knowledge, system and community) and (b) the manor that empowerment is expressed (such as attitudes, knowledge and behaviors).{{cite journal |last1=Koren |first1=Paul E. |last2=DeChillo |first2=Neal |last3=Friesen |first3=Barbara J. |title=Measuring empowerment in families whose children have emotional disabilities: A brief questionnaire |journal=Rehabilitation Psychology |date=1992 |volume=37 |issue=4 |pages=305–321 |doi=10.1037/h0079106 }} Studies have shown that FE is positively associated with healthy child functioning.{{Cite journal |last1=Resendez |first1=Miriam G. |last2=Quist |first2=Ryan M. |last3=Matshazi |first3=Dumiso G. M. |date=2000-12-01 |title=A Longitudinal Analysis of Family Empowerment and Client Outcomes |journal=Journal of Child and Family Studies |language=en |volume=9 |issue=4 |pages=449–460 |doi=10.1023/A:1009483425999 }}{{cite book |doi=10.1093/med/9780198828761.003.0010 |date=2018 |last1=Onwumere |first1=Juliana |last2=Kuipers |first2=Elizabeth |chapter=Psychosis and the family: the role of family interventions |pages=109–127 |isbn=978-0-19-882876-1 |editor-last1=Howes |editor-first1=Oliver |title=Treatment Response and Resistance in Schizophrenia }} FE also deals with an individual's belief in their ability to execute behaviors necessary to produce specific performance attainments, also called self-efficacy,{{Cite web |title=Teaching Tip:Self-Efficacy |url=https://www.apa.org/pi/aids/resources/education/self-efficacy |access-date=2022-12-02 |website=APA.org}} specifically regarding attaining knowledge of mental health. A study conducted in 2022 found that increased parent self-efficacy regarding mental health is positively correlated with child well-being outcomes.{{Cite journal |last1=Kosyluk |first1=Kristin |last2=Kenneally |first2=Ryan G. |last3=Tran |first3=Jennifer T. |last4=Cheong |first4=Yuk Fai |last5=Bolton |first5=Cassidy |last6=Conner |first6=Kyaien |date=November 2022 |title=Overcoming stigma as a barrier to children's mental health care: The role of empowerment and mental health literacy |journal=Stigma and Health |language=en |volume=7 |issue=4 |pages=432–442 |doi=10.1037/sah0000402 |doi-access=free }}

Schools can teach mental health in core classes or include it in required health education. These mental health lessons can teach practice skills and have an environment for students to share their mental health journeys. According to CDC,{{cite web |title=Increase Students' Mental Health Literacy |url=https://www.cdc.gov/healthyyouth/mental-health-action-guide/increase-students-mental-health-literacy.html |website=CDC |date=8 February 2024 }} teaching mental health can reduce stigma and improve student knowledge and attitude towards mental health, as well as ask for support. They can do this by teaching that mental health can be treatable, learn how to reduce and explain why we feel what we feel, as well as support students in need of help.

Mental health literacy has also found its uses in the realm of sports. Sports social workers are promoting mental health literacy of athletes through various means. Social workers are engaging in research, education, policy development, advocating for individuals, organizing communities, and through direct practice.{{cite journal |last1=Moore |first1=Matt A |last2=Gorczynski |first2=Paul |last3=Miller Aron |first3=Cindy |title=Mental Health Literacy in Sport: The Role of the Social Work Profession |journal=Social Work |date=20 June 2022 |volume=67 |issue=3 |pages=298–300 |doi=10.1093/sw/swac022 |pmid=35554606 }}

Inclusion with Health Literacy

According to a literature review published in the Canadian Journal of Psychiatry,{{cite journal |last1=Kutcher |first1=Stan |last2=Wei |first2=Yifeng |last3=Coniglio |first3=Connie |title=Mental Health Literacy: Past, Present, and Future |journal=The Canadian Journal of Psychiatry |date=March 2016 |volume=61 |issue=3 |pages=154–158 |doi=10.1177/0706743715616609 |pmid=27254090 |pmc=4813415 }} mental health literacy help improve health outcomes for people. Recognizing and continuing to work for future direction and development should be considered for mental health literacy. This means mental health literacy interventions should be better informed along with health literacy. For example, no examples of mental health literacy were integrated in a recent publication of Canadian health literacy.

• Mental health first aid
• Psychological literacy

{{reflist|2}}

• {{cite journal |last1=Jorm |first1=A. F. |title=Mental health literacy: Public knowledge and beliefs about mental disorders |journal=British Journal of Psychiatry |date=November 2000 |volume=177 |issue=5 |pages=396–401 |doi=10.1192/bjp.177.5.396 |pmid=11059991 }}
• {{cite journal |last1=Chua |first1=Kia-Chong |last2=Hahn |first2=Jane Sungmin |last3=Farrell |first3=Suzanne |last4=Jolly |first4=Anita |last5=Khangura |first5=Randip |last6=Henderson |first6=Claire |title=Mental health literacy: A focus on daily life context for population health measurement |journal=SSM - Mental Health |date=December 2022 |volume=2 |pages=100118 |doi=10.1016/j.ssmmh.2022.100118 }}

{{Literacy}}

Category:Mental disorders

Category:Health education