Journal of Health Literacy

Journal of Health Literacy

The State of Mental Health Literacy among High School Students: A Cross-Sectional Study

Document Type : Original Article

Authors
Azam Majdi 1
Ensiyeh Norozi 2
Gholamreza Sharifzadeh 3
Abbas Javadi 4
1 Student Research Committee, Birjand University of Medical Sciences, Birjand, Iran.
2 Department of Health Education and Promotion, School of Health, Social determinants of health research center, Birjand University of Medical Sciences, Birjand, Iran.
3 Department of Epidemiology and Biostatistics, Social Determinants of Health Research Center, School of Health, Birjand University of Medical Sciences, Birjand, Iran.
4 Department of Health Education and Promotion, School of Health, Social determinants of health research center, Birjand University of Medical Sciences, Birjand, Iran
10.22038/jhl.2024.79705.1568
Abstract
Background and Objective: Mental disorders affect around 20% of children and teenagers worldwide, resulting in a decrease in academic success and progress, ultimately resulting in a decrease in their academic performance. This research aimed to determine the level of mental health literacy for high school students in eastern Iran in 2023.

Materials and Methods: This descriptive-analytical cross-sectional study was conducted on 348 high school students in Zirkuh City, Iran, using a cluster sampling method. The data was gathered by a 29-item questionnaire known as the Mental Health Literacy Scale (MHLS). Mann-Whitney U-test and Kruskal-Wallis test were utilized for data analysis at a significant level of 0.05. 

Results: The study included 348 students with a µ (SD) age of 16.27 (0.89) years. Of these, 176 (50.6%) were female. Most students (53.2%) scored low in MHL with a µ (SD) score of 79.3 (9.2). The most common source of mental health knowledge was "Internet and friends" (65.5%). The mean score of "help-seeking attitudes" was significantly higher in students of natural sciences (P<0.03) and technical sciences (P<0.02) than those in humanities. There was a significant difference in the mean score of MHL, the ability to recognize disorders, and help-seeking attitudes based on the father's occupation. The mean scores for MHL and help-seeking attitudes were higher among self-employed fathers than those involved in farming and animal husbandry occupations (P<0.001). The study found that students whose fathers were teachers had a higher ability to recognize disorders compared to the other groups (P<0.001). 

Conclusion: Based on the results of the study, the level of MHL of the students participating in the study was not favourable. Therefore, it is necessary to develop educational interventions for students and their parents with their teachers' aim.
Keywords
High Schools
Mental Health
Literacy
Students

Acknowledgements: The researcher and the accompanying research team would like to acknowledge and thank the Zirkuh Education Department, Birjand University of Medical Sciences and the Professors of the Health Faculty of Birjand University of Medical Sciences for their cooperation in the implementation of the research(Approved code :6255).


Availability of data and materials: The nameless datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.


Conflict of interest: The authors involved in the study do not have any conflicts of interest.


Consent for publication: Not applicable


Ethical approval and consent to participate: The ethics committee of Birjand University of Medical Sciences, with code IR.BUMS.REC.1402.194 approved this study. In addition, the study was performed in line with the principles of the Declaration of Helsinki. Furthermore, the questionnaires were completed anonymously and the participants were assured of the confidentiality of the information.
Furthermore, the study was performed in line with the principles of the Declaration of Helsinki. All respondents and the school principal of each school gave consent for participation after reviewing the study protocol and questionnaire items.


Funding: This research was supported by Birjand University of Medical Sciences with grant number of 6255.


Author contributions: Azam Majdi, Iman Mousaei: Data curation, Formal analysis, writing original draft. Gholam Reza Sharifzadeh: Methodology,Formal analysis, Writing: review & editing. Ensiyeh Norozi: Conceptualization, review & editing the English draft,review & editing, Formal analysis. Abbas Javadi: Conceptualization, Methodology, Project administration, Supervision, Validation, Writing: review & editing.

 

Open Access Policy: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. To view a copy of this licence, visit https://creativecommons.org/licenses/by/4.0/

  1. SR M. Healthy man and its role in the spiritual health and mental health from the viewpoints of Rene Descartes and Allamah Tabatabaei based on the interpretative attitude of Almizan. J Adv Med Biomed Res. 2014;22(90):33-44)(persian).
  2. ALIZADEH Z RM, FEIZI A, AFSHAR H, HASSANZADE KASHTALI A, ADIBI P. INVESTIGATION OF PSYCHOLOGICAL DISORDERS PROFILE (ANXIETY, DEPRESSION AND PSYCHOLOGICAL DISTRESS) IN ADULT POPULATION OF ISFAHAN PROVINCE. JOURNAL OF TORBAT HEYDARIYEH UNIVERSITY OF MEDICAL SCIENCES. 2016;3(4).
  3. Khadem H MM, Yousefi A, Hashemabad BG. The relationship between spiritual health and mental health in students of Ferdowsi University of Mashhad. Medical History Journal. 2016;7(25):33-50(Persian).
  4. Renani MTS NF, Fathimard F. Relationship between Self-efficacy and Mental Health with Health Literacy in Patients with Diabetes in Kazerun City, Fars, Iran. Journal of Community Health Research. 2020.
  5. NOORBALA AA nF, yahyavi dizej J, anvari S, mahmood pour azari M. Burden of Mental Disorders. A Study of the Middle East Countries for the Period 2000-2017. JOURNAL OF MEDICAL COUNCIL OF IRI. 2020;38(1).
  6. Ganasen K PS, Hugo C, Stein D, Emsley R, Seedat S. Mental health literacy: focus on developing countries. African Journal of Psychiatry. 2008;11(1):23-8. https://doi.org/10.4314/ajpsy.v11i1.30251 PMid:19582321
  7. RAEISOON MR MM, DASTJERDI R, SHARIFZADEH GR. PREVALENCE OF MENTAL DISORDERS IN BIRJAND-2010. JOURNAL OF BIRJAND UNIVERSITY OF MEDICAL SCIENCES. 2012;19(1).
  8. Furnham A, Annis J, Cleridou K. Gender differences in the mental health literacy of young people. 2014;26(2):283-92.
  9. KAVEH MH SD, EFTEKHAR ARDEBILI H, SHAHMOHAMMADI D, RAHIMI A, BOU ALHARI J. ORGANIZING MENTAL HEALTH SERVICES IN SCHOOLS: ASSESSING TEACHERS' ROLES. JOURNAL OF SCHOOL OF PUBLIC HEALTH AND INSTITUTE OF PUBLIC HEALTH RESEARCH. 2003;1(4):(pershian).
  10. Campos L DP DA, Veiga E, Dias CC, Palha F. Is It Possible to "Find Space for Mental Health" in Young People? Effectiveness of a School-Based Mental Health Literacy Promotion Program. Int J Environ Res Public Health. 2018;15(7):1426. https://doi.org/10.3390/ijerph15071426 PMid:29986444 PMCid:PMC6069495
  11. Mirsalimi F GF, Montazeri A, Noroozi A. Postpartum depression literacy among pregnant women. Payesh (Health Monitor). 2019;18(5):525-33.
  12. Foulkes L, Andrews JL. Are mental health awareness efforts contributing to the rise in reported mental health problems? A call to test the prevalence inflation hypothesis. New Ideas in Psychology. 2023;69:101010. https://doi.org/10.1016/j.newideapsych.2023.101010
  13. Özparlak A, Karakaya D, Özer Z. The association of mental health literacy with mental well-being and help-seeking in young people: A systematic review and meta-analysis. Journal of pediatric nursing. 2023;73:e243-e50.
  14. Kutcher S WY, Gilberds H, Ubuguyu O, Njau T, Brown A, et al. A school mental health literacy curriculum resource training approach: effects on Tanzanian teachers' mental health knowledge, stigma and help-seeking efficacy. International Journal of Mental Health Systems. 2016;10(1):1-9. https://doi.org/10.1186/s13033-016-0082-6 PMid:27493684 PMCid:PMC4973111
  15. Tehrani H OS. The effect of an education intervention on mental health literacy among middle school female students. Journal of Health Literacy. 2021;5(4):41-7.
  16. NT NTQ. Mental health literacy: knowledge of depression among undergraduate students in Hanoi, Vietnam. Int J Ment Heal Syst. 2018;12(1):19. https://doi.org/10.1186/s13033-018-0195-1 PMid:29760770 PMCid:PMC5937829
  17. Huang D YL PB. Understanding the public's profile of mental health literacy in China: a nationwide study. BMC Psychiatry. 2019;19(1):20. https://doi.org/10.1186/s12888-018-1980-8 PMid:30642305 PMCid:PMC6332702
  18. Aluh DO OM OV. Cross-sectional survey of mental health literacy among undergraduate students of the University of Nigeria. BMJ Open. 2019;9(9).
  19. Sayarifard A GL MA, Eftekhar M, Badpa M, Rajabi F. Assessing mental health literacy: what medical sciences students' know about depression. Med J Islam Repub Iran. 2015;29:161.
  20. SEPEHRMANESH Z AA, YAVARI P, SAEI R. ASSESSING THE MENTAL HEALTH OF ADOLESCENTS IN KASHAN, 2004. IRANIAN JOURNAL OF EPIDEMIOLOGY. 2008;4(2).
  21. SHAKIBAEI Z TR, NOROOZI A. DETERMINANT FACTORS OF MENTAL HEALTH BASED ON SOCIAL COGNITIVE THEORY AMONG HIGH SCHOOL GIRL STUDENTS OF BUSHEHR. STUDENTS MENTAL HEALTH. 2014.
  22. TAVAKOL M FH. SOCIOLOGICAL STUDY OF MENTAL DISORDERS: A CASE STUDY IN ARAK. JOURNAL OF BIOETHICS. 2018;7(26).
  23. Abster A KZ, Hashemi T, Beyrami M. Teenager's Psychopathology and Personality Traits of Parents: An Analysis on the Role of Personality of Parents on Mental Health of Children. Journal of Modern Psychological Researches. 2012;7(27):1-22.
  24. Jafari A NM, Momeniyan V, Barsalani FR, Tehrani H. Mental health literacy and quality of life in Iran: a cross-sectional study. BMC psychiatry. 2021;21(1):1-11. https://doi.org/10.1186/s12888-021-03507-5 PMid:34641793 PMCid:PMC8507341
  25. O'Connor M, Casey L. The Mental Health Literacy Scale (MHLS): A new scale-based measure of mental health literacy. Psychiatry research. 2015;229(1-2):511-6.
  26. Noroozi A, Khademolhosseini F, Lari H, Tahmasebi R. The Mediator Role of Mental Health Literacy in the Relationship Between Demographic Variables and Health-Promoting Behaviours. 2018;12(2):e12603.
  27. Shojaei Baghini M SBS, Naseri Booriabadi T. Health Literacy of Kerman Province Educational Staff. Journal of Health Literacy. 2020;4(4):64-9.
  28. Kim YS, Lee HY, Lee MH, Simms T, Park BH. Mental health literacy in korean older adults: A cross-sectional survey. Journal of psychiatric and mental health nursing. 2017;24(7):523-33. https://doi.org/10.1111/jpm.12395 PMid:28474412
  29. Rickwood DJ DF, Wilson CJ. When and how do young people seek professional help for mental health problems? 2007;187(57):535-9.
  30. Ghadirian L SA. Depression literacy in urban and suburban residents of Tehran, the Capital of Iran; recognition, help seeking and stigmatizing attitude and the predicting factors. Int J Prev Med. 2019;10(1):134. https://doi.org/10.4103/ijpvm.IJPVM_166_18 PMid:31516675 PMCid:PMC6710924
  31. Mahmoodi SMH, Ahmadzad-Asl M, Eslami M, Abdi M, Hosseini Kahnamoui Y, Rasoulian M. Mental Health Literacy and Mental Health Information-Seeking Behavior in Iranian University Students. Frontiers in psychiatry. 2022;13:893534. https://doi.org/10.3389/fpsyt.2022.893534 PMid:35770063 PMCid:PMC9234209
  32. Christensen H, Griffiths K. The Internet and Mental Health Literacy. The Australian and New Zealand journal of psychiatry. 2001;34:975-9. https://doi.org/10.1080/000486700272 PMid:11127628
  33. Yeo G, Reich SM, Liaw NA, Chia EYM. The Effect of Digital Mental Health Literacy Interventions on Mental Health: Systematic Review and Meta-Analysis. Journal of medical Internet research. 2024;26:e51268.
  34. Chan FHF, Lin X, Griva K, Subramaniam M, Ćelić I, Tudor Car L. Information needs and sources of information among people with depression and anxiety: a scoping review. BMC psychiatry. 2022;22(1):502. https://doi.org/10.1186/s12888-022-04146-0 PMid:35896995 PMCid:PMC9326147
  35. Furnham A, Annis J, Cleridou K. Gender differences in the mental health literacy of young people. International journal of adolescent medicine and health. 2014;26(2):283-92. https://doi.org/10.1515/ijamh-2013-0301 PMid:23843570
  36. Hadjimina E, Furnham A. Influence of age and gender on mental health literacy of anxiety disorders. Psychiatry research. 2017;251:8-13. https://doi.org/10.1016/j.psychres.2017.01.089 PMid:28189082
  37. Li J ZM, Zhao L, Li WQ, Mu JL, Zhang ZH. Evaluation of attitudes and knowledge toward mental disorders in a sample of the Chinese population using a web-based approach. BMC Psychiatry. 2018;18(1):367. https://doi.org/10.1186/s12888-018-1949-7 PMid:30453932 PMCid:PMC6245628
  38. Ibrahim N AN, Shahar S, Wee L-H, Ismail R, Khairuddin R, et al. Do depression literacy, mental illness beliefs and stigma influence mental health help-seeking attitude? A cross-sectional study of secondary school and university students from B40 households in Malaysia. BMC Public Health. 2019;19(4):544. https://doi.org/10.1186/s12889-019-6862-6 PMid:31196033 PMCid:PMC6565530
  39. Anbesaw T, Asmamaw A, Adamu K, Tsegaw M. Mental health literacy and its associated factors among traditional healers toward mental illness in Northeast, Ethiopia: A mixed approach study. PLOS ONE. 2024;19(2):e0298406.
  40. Sokolová L. Mental health literacy and seeking for professional help among secondary school students in Slovakia: a brief report. Front Public Health. 2024;12(2296-2565 (Electronic)):1333216.
  41. Xu Z, Huang F, Kösters M, Staiger T, Becker T, Thornicroft G, et al. Effectiveness of interventions to promote help-seeking for mental health problems: systematic review and meta-analysis. Psychol Med. 2018;48(16):2658-67. https://doi.org/10.1017/S0033291718001265 PMid:29852885
  42. Sharma M, Banerjee B, Garg S. Assessment of Mental Health Literacy in School-going Adolescents. Journal of Indian Association for Child and Adolescent Mental Health. 2017;13:263-83. https://doi.org/10.1177/0973134220170403
  43. Cheng HL, Wang C, McDermott RC, Kridel M, Rislin JL. Self‐stigma, mental health literacy, and attitudes toward seeking psychological help. Journal of Counseling & Development. 2018;96(1):64-74. https://doi.org/10.1002/jcad.12178
  44. Simkiss NA-O, Gray NA-O, Kemp AA-O, Dunne C, Snowden RA-OX. A randomised controlled trial evaluating the Guide Cymru mental health literacy intervention programme in year 9 (age 13-14) school pupils in Wales. BMC Public Health. 2023;23(1):1062. https://doi.org/10.1186/s12889-023-15922-2 PMid:37277757 PMCid:PMC10239719
  45. Bonabi H, Müller M Fau - Ajdacic-Gross V, Ajdacic-Gross V Fau - Eisele J, Eisele J Fau - Rodgers S, Rodgers S Fau - Seifritz E, Seifritz E Fau - Rössler W, et al. Mental Health Literacy, Attitudes to Help Seeking, and Perceived Need as Predictors of Mental Health Service Use: A Longitudinal Study. J Nerv Ment Dis. 2015;204(4):321-4. https://doi.org/10.1097/NMD.0000000000000488 PMid:27015396
  46. Kutcher S, Bagnell A, Wei Y. Mental Health Literacy in Secondary Schools: A Canadian Approach. Child and Adolescent Psychiatric Clinics of North America. 2015;24(2):233-44. https://doi.org/10.1016/j.chc.2014.11.007 PMid:25773321
  47. Tehrani H, Olyani S, Salimi M. The Effect of an Education Intervention on Mental Health Literacy among Middle School Female Students. Journal of Health Literacy. 2021;5(4):41-7.
  48. Ojio Y, Yonehara H, Taneichi S, Yamasaki S, Ando S, Togo F, et al. Effects of school-based mental health literacy education for secondary school students to be delivered by school teachers: A preliminary study. Psychiatry and clinical neurosciences. 2015;69.