Mental health literacy: a focus on daily life context for population health measurement

Abstract

BackgroundA core purpose of mental health literacy is to enable everyone from all walks of life to manage and maintain wellbeing in daily life. However, mental health literacy in daily life context is not adequately captured by existing measures due to a prevailing focus on ‘mental disorder literacy’. We developed three measures of mental health literacy in terms of knowledge, and attitudes that may evoke the use of this knowledge, of signs and actions in everyday life when mental health is affected by depression, anxiety and stress. Construct validation was performed to examine the suitability of these measures for population health surveillance. MethodsIn October 2019 Public Health England, funded by the UK government, launched a digital resource, Every Mind Matters, aimed at improving mental health literacy in the general population and empowering action around daily life stress and anxiety, mood, and sleep. Baseline data for evaluating Every Mind Matters was collected via an online survey of the general public (n = 3262 adults). For construct validation, we investigated dimensionality and hypotheses of logical associations with mental health literacy. ResultsStructural validation results lend credence to our claim that the primary influence on item responses to the three measures is mental health literacy. These responses show logical associations with knowledge about sleep hygiene, attitudes indicative of stigma towards mental health, and some indirect experience with mental health difficulties. Item response theory information plots showed that total scale scores are sensitive to a wide range of individual differences in mental health literacy. This means the three knowledge and attitudes measures can be administered to a diverse group of people for early screening purposes or to evaluate the impact of public mental health interventions.Conclusions To monitor societal changes in mental health literacy, population surveillance will need measures that tap into lay knowledge and attitudes about mental health in the context of everyday life using non-technical language of the general public. More contextually informed data are needed to construct sound measurement for steering empirical debates about mental health literacy in societies with high- and low-resource healthcare systems.

The Every Mind Matters campaign in England: changes in mental health literacy over 30 months and associations between campaign awareness and outcomes

“…Both the MHL-REC and MHL-ACT have been evaluated for construct validity. 14 Mental health vigilance was measured using the Mental Health Vigilance scale (MHL-VIG). 14 The MHL-VIG comprises 12 items on attitudes about maintaining mental health.…”

“…14 Mental health vigilance was measured using the Mental Health Vigilance scale (MHL-VIG). 14 The MHL-VIG comprises 12 items on attitudes about maintaining mental health. The response options are 'strongly disagree', 'disagree', 'neutral', 'agree', and 'strong agree'.…”

“…Symptom management of stress, depression and anxiety was measured by the Mental Health Literacy – Knowledge for Management (MHL-ACT) scale. 14 The MHL-REC consists of three identical sets of nine items and asks the participants to identify whether these experiences were a symptom of stress, depression, anxiety. Respondents could choose an answer for each condition or the option “none of these”.…”

“…1 Mental health vigilance fits into Kutcher’s definition of MHL as vigilance leads to the use of relevant knowledge in the maintenance of every day mental health and wellbeing. 14…”

Views and experiences of Every Mind Matters, Public Health England’s adult mental health literacy campaign: a qualitative interview study

“…1 Measurement: Development of three new measures of mental health literacy (recognition, action, vigilance) (11) suitable for the content of EMM and use in general population samples. 2 Change in outcomes over time and their relationship to EMM awareness or use: Quantitative analysis of data from repeated bespoke surveys of nationally representative samples before and since the launch of EMM using the above measures and others based on the Kutcher definition of mental health literacy (12).…”