A systematic literature review of existing conceptualisation and measurement of mental health literacy in adolescent research: current challenges and inconsistencies

Abstract

Background With an increased political interest in school-based mental health education, the dominant understanding and measurement of mental health literacy (MHL) in adolescent research should be critically appraised. This systematic literature review aimed to investigate the conceptualisation and measurement of MHL in adolescent research and the extent of methodological homogeneity in the field for meta-analyses. Methods Databases (PsycINFO, EMBASE, MEDLINE, ASSIA and ERIC) and grey literature were searched (1997–2017). Included articles used the term ‘mental health literacy’ and presented self-report data for at least one MHL domain with an adolescent sample (10–19 years). Definitions, methodological and contextual data were extracted and synthesised. Results Ninety-one articles were identified. There was evidence of conceptual confusion, methodological inconsistency and a lack of measures developed and psychometrically tested with adolescents. The most commonly assessed domains were mental illness stigma and help-seeking beliefs; however, frequency of assessment varied by definition usage and study design. Recognition and knowledge of mental illnesses were assessed more frequently than help-seeking knowledge. A mental-ill health approach continues to dominate the field, with few articles assessing knowledge of mental health promotion. Conclusions MHL research with adolescent samples is increasing. Results suggest that a better understanding of what MHL means for this population is needed in order to develop reliable, valid and feasible adolescent measures, and explore mechanisms for change in improving adolescent mental health. We recommend a move away from ‘mental disorder literacy’ and towards critical ‘mental health literacy’. Future MHL research should apply integrated, culturally sensitive models of health literacy that account for life stage and acknowledge the interaction between individuals’ ability and social and contextual demands.

The Wellness Quest: A health literacy and self‐advocacy tool developed by youth for youth mental health

“…Interventions that help youth be actively involved in their care show improved quality of life and satisfaction, which in turn may promote better service engagement 35 . Improving mental health literacy may improve service utilization and mental health 8,36,37 . Young people also express the unmet need for developmentally appropriate, relevant and accurate information to enable them to make informed decisions about their mental health 38,39 .…”

“…35 Improving mental health literacy may improve service utilization and mental health. 8,36,37 Young people also express the unmet need for developmentally appropriate, relevant and accurate information to enable them to make informed decisions about their mental health. 38,39 Tools such as the Wellness Quest are specifically designed to promote help-seeking in youth, not only by increasing awareness of services available to young people, but also by providing information on barriers to help-seeking.…”

Measurement Schmeasurement: Questionable Measurement Practices and How to Avoid Them

“…A lack of conceptual clarity for a construct is the first step toward measurement heterogeneity, measurement flexibility, and the profusion of untested measures. For example, in their review of the literature on mental-health literacy, Mansfield, Patalay, and Humphrey (2020) identified “conceptual confusion, methodological inconsistency and a lack of measures developed and psychometrically tested” (p. 11).…”

Sadness and Other Health Complaints among Swedish Adolescents: A Cross-Sectional Study

“…The knowledge generated here can also be useful in preventive work. Research in the field is focusing primarily on mental illness, while mental health promotion among adolescents has not been studied to the same extent [ 47 ]. When interpreting sadness and other health complaints through embodiment, existential aspects are highlighted.…”