MENTAL HEALTH LITERACY AND MENTAL HEALTH STATUS AMONG ADOLESCENTS

MENTAL HEALTH LITERACY AND MENTAL HEALTH STATUS AMONG ADOLESCENTSBy Adrienne SantosMental Health Literacy and Mental Health Status in Adolescents: A Population-based Survey Journal Article by Lawrence T. Lam

Mental Health LiteracyKnowledge and beliefs about mental disorders which aid their recognition, management or prevention (Jorm et al.)CharacteristicsAbility to recognize specific disordersCauses of specific disordersTreatment for mental disordersRisk factorsStudy is aimed at whether low mental health literacy would relate to an increase of mental health problems.

Very few studies are focused on the relationship between mental health literacy and mental health status in ADOLESCENTS. Theyre mostly for older age groups. Focuses on depression.

2Mental Health Literacy and Mental Health Status in Adolescents: A Population-based Survey Lawrence T. Lam

Adequate Mental Health Literacy Level Recognition of the disorderIntention to seek help

Depression, Anxiety, Stress Scale (DASS)Depression sub scaleAssess depressive symptomsProved to give valid informationSuggested to be effective among children and adolescents

BOTH are required for a good MHL (equally)Depression sub scale

3Mental Health Literacy and Mental Health Status in Adolescents: A Population-based Survey Lawrence T. Lam

October 2013Conducted in Nanning, capital of Guanxi Province in ChinaEst. Pop: 6.7 million, 505677 adolescentsSample: Students (aged 13-17) from 12 different high schools

Questionnaire Included questions about:Recognition of disorderIntended actions/perceived barriersIntentions about first aidBeliefs about interventions and preventionStigmatizing attitudes and social distanceExposure to mental disorders

The questions in the survey were adopted from the Australian National Mental Health Literacy and Stigma Youth Survey designed by Jorm et al. to complement his MHL framework. 4Mental Health Literacy and Mental Health Status in Adolescents: A Population-based Survey Lawrence T. Lam

RESULTS98% response rate14.8% exhibit moderate to severe symptoms of depression68% displayed the intention to seek help if it were needed16.4% had an adequate literacy levelMental Health Literacy significantly associated with depression60% chance of those showing signs of moderate to severe depression having an inadequate MHL levelOnly 23.4% correctly recognized depressionInadequate mental health literacy levels are greatly associated with moderate to severe levels of depression. 23.4% - relatively low, because studies in the past found that about 50-75% of respondents would correctly pinpoint depression Possibly because the respondents of this survey were younger and have experienced less of a depressive mood compared to people in an older age group. OR is that there really is a lack of mental health education in the specific location where the study took place. This makes comparing results of mental health literacy and depression among adolescent difficult because this was the first known study regarding the specific topic. This makes the results of the study unique. 5Mental Health Literacy and Mental Health Status in Adolescents: A Population-based Survey Lawrence T. Lam

Inadequate MHL levels could imply that respondents may have had a lack of personal experience of being in a depressive mood.Adolescents in the country of study may mislabel and incorrectly identify symptoms.Adolescents may have a lack of knowledge and understanding of the symptoms they experience Or this can be due to stigmatization related to any mental disorder

Mislabel whether they are aware of it or notHappens often in the location where study took place6Mental Health Literacy and Mental Health Status in Adolescents: A Population-based Survey Lawrence T. Lam

SuggestionsEducating adolescents about mental issues and how to get help could aid in increasing mental health outcomes.Encouraging a positive attitude a positive attitude plays a large role in changing depressive behavior.The identification of the problem, as well as a positive outlook to fix it, would likely result in improved behavior and mental status.ConclusionMental health literacy is a probably factor that could be greatly affecting the mental health status of adolescents.Improving mental health literacy should be considered an essential preventive measure of mental health problems for adolescents.7Mental Health Literacy and Mental Health Status in Adolescents: A Population-based Survey Lawrence T. Lam

CommentaryNot a lot of people are aware of how important mental health is, and that could be why there are more and more people who show symptoms of depression nowadays. Mental health literacy is important. If the problem concerning the lack of it will not go away it is likely that more and more cases of mental disorders will just keep occurring.It is a fact that there are a number of people with mental disorders, and the best way to help them is simply by educating. If people are unaware of the problem, then they cant possibly know how to solve it. Awareness is the first step, and thats what mental health literacy is all about.The world has outgrown the habits of ignoring emotions and stigmatizing mental disorders. Mental disorders are real, depression is real, and accepting that fact would be the first step to change it.

Advances have been made in science, and were doing relatively well at curing physical diseases, and with that stability there it might be time to put more focus into mental health. Obviously, there are psychiatrists and psychologists who do that, however mental health literacy is a different story. I dont believe that they are too young; Im quite sure that children aged 13-17 more or less understand whats going on around them

8Finding Space to Mental Health Promoting mental health in adolescents: Pilot study Journal Article by L. Campos, P. Dias & F. Palha

FocusExecuted due do the lack of methodical health education proposals regarding mental health in Portugal.Pilot studyQualitative study to create a Mental Health Literacy QuestionnaireMental Health Promotion Intervention

Study is aimed at promoting mental health literacy among young people in a school-based environment.

Luisa Campos, Pedro Dias and Filipa Palha3 phases: pilot study, intervention, follow upThe reason for the pilot intervention is to study how relevant mental health literacy is to the target groupDemographics and psychographics taken into account

9Sample: 70 students aged 12-14 years old attending a private secondary school in Portugal

Questionnaire 3 sections:KnowledgePrevalence and characteristics of mental health problemsRisk factorsSymptoms of mental disordersImpact and stereotypes concerning mental health problemsFirst Aid Skills & Help SeekingIssues about informal and formal help seekingFirst Aid skillsSelf-help StrategiesQuestions related to behaviorsAttitudes that promote health

Finding Space to Mental Health Promoting mental health in adolescents: Pilot study L. Campos, P. Dias & F. Palha

Depression, Generalized Anxiety Disorder, Anorexia, Schizophrenia, and Substance-related disorder 10Finding Space to Mental Health Promoting mental health in adolescents: Pilot study L. Campos, P. Dias & F. Palha

Mental Health Promotion InterventionTwo 90-minute sessions executed with a one-week intervalFirst sessionExploration of students knowledge and beliefs about physical and mental health and illnessExploration of mental health problems signsImpact and risk factorsIdentification of symptoms and signs of mental disordersPromotion of non-stigmatized behaviors towards mental disordersSecond session (Goals)Explore beliefs related to mental disordersRaise awareness of the students regarding mental health problems and their impactIdentify formal and informal help-seeking optionsPromote First Aid skills towards people with mental health problemsAddress self-help strategies

Both sessions were interactive and made use of group dynamics, videos, and music, using a strategy designed specifically for the target group 11Finding Space to Mental Health Promoting mental health in adolescents: Pilot study L. Campos, P. Dias & F. Palha

RESULTSParticipants scored relatively high scores in all three sections of the Mental Health Literacy questionnaire during the pre-testCould be due to private school setting & high rate of employment of caregiversGreater mental health literacy is associated to fewer stereotypes of mental disordersYounger peoples greater capability to know and find help and supportDevelopment of more suitable mental health promoting behaviorsIncreased capacity to learn more about mental health Greater motivation to help

Students had relevant information gapsSome students had difficulty in differentiating between some physical and mental disabilities.The results also show that for young people stereotypes are not completely established and are less negative as compared to adults many students made the mistake of classifying Downs Syndrome, Cerebral Palsy and Parkinsons Disease as mental health problems

12Finding Space to Mental Health Promoting mental health in adolescents: Pilot study L. Campos, P. Dias & F. Palha

CommentaryIt is important for the younger generations to be educated on mental health literacy because the future of the world lies in the hands of the youth.Interventions should eventually branch out to public schoolsIt is more likely that adolescents in poorer classes would have more mental health problems because of household issuesIt is more likely that they would have less adequate mental health literacy Mental health literacy should be a part of every schools program, especially here in the Philippines, where corruption is rampant and better leaders are much needed.

To people whose caregivers arent very well off

13Evaluating Mental Health Literacy and Adolescent Depression: What do teenagers know? Journal Article by J. McCarthy, M. Bruno, T. Fernandez

FocusPilot study about mental health literacy as it relates to depression in adolescents.Depression often goes undiagnosed and untreated in adolescence however it can extend into adulthoodThe DSM-IV states that the diagnostic characteristics and duration are similar to adult depressionSymptoms like being in a depressed mood or losing pleasure/interestDepressed mood can manifest as an irritable mood in adolescents

The main goal of doing the study was to observe the level of adolescents mental health literacy specific to adolescent depression.The authors focused on depression in adolescents because it is particularly significant, as it often goes

14Sample: Students from 8 sections of Indiana University of Pennsylvanias psychology and anthropology classesQuestionnaire Friend In NeedEnumerates 5 vignettes/situations of adolescents experiencing different hardships Calls for both close and open-ended answers from the participants

Replication of previous study of Burns and Rapee in AustraliaGives insight into older adolescents views in the assessment, recovery period, and health-seeking behavior involving depression.

Evaluating Mental Health Literacy and Adolescent Depression: What do teenagers know? J. McCarthy, M. Bruno, T. Fernandez

appropriate to the topic of study as well as the ages of interest There has been a increasing interest in mental health literacy because of the prevalence of mental disorders and how they impact society. However, few studies have been conducted on adolescent populations and mental health literacy 15RESULTSHigh level of recognition of adolescent depressionOver 50% and 75% of respondents correctly identified 2 depressed-based situations as being depressed, wherein in the previous study of Burns and Rapee in Australia the findings of correctly identifying these situations were 34% and 68%, respectively.Participants were able to detect whether a problem was severe or not, and whether the fictional people given to them in situations were showing signs of genuine depression.American sample performed somewhat better when compared to the Australian study of Burns and Rapee More concern was observed from the participants of the present studyEvaluating Mental Health Literacy and Adolescent Depression: What do teenagers know? J. McCarthy, M. Bruno, T. Fernandez

The findings showed that the sample had a significant level of literacy.Since this was the first study in America concerning mental health literacy in adolescents, these findings were moderately surprising because there was nothing else to compare them to.

16Participants in the study were accurate in their detection, concern, and estimated time of recovery.Suggests they had previous knowledge based either on Their classroom educationTheir accumulated experience themselves As seen in peersNo significant difference found regarding gender and mental health literacy.Results warrant further explanation of the relationships between youth and parents during adolescence.

ConclusionFurther research is needed. Future mental health literacy studies could have larger sample sizes, and in-depth investigations of adolescents of various racial/ethnic differences within the sample.Evaluating Mental Health Literacy and Adolescent Depression: What do teenagers know? J. McCarthy, M. Bruno, T. Fernandez

Previously, Burns and Rapee found that girls clearly demonstrated higher mental literacy. This suggests that there is a possibility that adolescent men of the U.S. are more knowledgeable and have a higher mental literacy than anticipated.Though their developmental period can be manifest by a turbulent relationship between them, there could be insight in providing communication skills to support such relationships. If adolescents were more open with sharing information with their parents, it could speed up the process of getting help. Teenage depression is a pressing matter in adolescent mental health, and the domain of mental health literacy in regard to this disorder is an important one that calls for additional research 17CommentaryPilot study shows how critical an adolescents knowledge about his/her mental health can be.Necessary that adolescents in general should be aware of their mental health because it can lead to self understanding, development of social skills, and resiliency.Adolescents experiencing depression are able to empathize and associate with others undergoing depression (whether they know them or not) based on an experiential levelStudy gave importance to proper treatment of an individual undergoing mental health problemsSupport and awareness are whats important for an adolescent experiencing depression, especially in the adolescents own home.

Evaluating Mental Health Literacy and Adolescent Depression: What do teenagers know? J. McCarthy, M. Bruno, T. Fernandez

social skills (forms of communication with others) find that the study gave importance to the treatment of an individual as this also affects the adolescents mental health literacy 18Child Mental Health in the PhilippinesJournal Article by Consuelo Cagande

Little research has been conducted on adolescent mental health in the Philippines as compared to other developing countries.In the WHO Seven Nation Collaborative Study, it was found that 16% of Filipino children had mental disorders.

The Philippines mental health system is still in its early stages of formation, and it is struggling to increase awareness of the causes of mental disorders, as well as meet the health demands of both a young as well as aging population.The few studies that exist are just case studies, literature reviews, intervention research (particularly disaster mental health studies), and surveys on Filipino immigrants in other countries. Little research has been made therefore there is little to work with. 19Study in the 1970s conducted in Lubao city reported that 18.6%-29% of children consulting a health center were found to have psychiatric problems.UPs Psychiatric Foundation conducted a population survey for mental disorders in rural provinces.Top 5 most predominant childhood psychiatric conditionsEnuresis (9.3%), speech and language disorder (3.9%), mental subnormality (3.7%), adaption reaction (2.4%), neurotic disorder (1.1%)Emigrated Filipinos had second highest occurrences of depressive symptoms among all Asian ethnic groups.Child Mental Health in the Philippines Consuelo Cagande

in a study conducted with a sample of Filipinos who emigrated to the United States, it was found that the Filipinos had the second highest occurrences of depressive symptoms among all Asian ethnic groups 20Most Filipinos in their native and adoptive countries severely underutilize mental health services compared to other Asian populations.Higher risk of depression for a Filipino American sample in comparison to White American sample.Possible barriers Fil-Ams may face in relation to stigmaDealing with established family hierarchyProtection of family reputationFatalism and religiosityCommunication barriersLack of culturally component practitioners who speak the patients language.

Child Mental Health in the Philippines Consuelo Cagandefatalism and religiosity (such as trusting fate to Divine will, or lacking self trust when it comes to ones capacity to make changes), communication barriers such as language problems or somatization of complaints, and lack of culturally competent practitioners who can speak the patients language. 21Child Mental Health in the Philippines Consuelo CagandeChallenges in the admittance to appropriate mental health care5% of the health budget is spent on mental health46 outpatient mental health facilities, 28% allocated for adolescents4 facilities for day-treatment, 7% of patients are adolescents19 community-based psychiatric inpatient units, 1% beds reserved for adolescents15 community-residential facilities, 3% of beds for adolescents2 mental hospitals, 2% of beds for adolescents

These numbers have not increased in 5 years. For every 100,000 of the general population of children and adolescents, only 27 area able to use these services. 22Child Mental Health in the Philippines Consuelo CagandeNMHP identified problems to be focused onMental disordersSubstance abuseDisaster and crisis managementWomen, children and other vulnerable groups

NMHP indicated support to shift from mental hospital-based psychiatric treatment to community-based mental health care.Proposes emergence of acute psychiatric units and outpatient clinics in all 72 government hospitalsBudgetary constraints have only allowed 10 hospitals to open outpatient clinics

National mental health program23Child Mental Health in the Philippines Consuelo Cagande1982 Perceptions of mental illness among Filipinos that act as a barrier to seeking mental health care are:Perceived ridicule encourages hesitance to accept having a mental illness and treatmentSeeking alternative care (family and peer groups, dependence on religion)Cost (prioritization of other needs)Knowledge of mental health services (limited awareness of services)Belief systems (mental illness seen as projecting a weak spirit)Limitation of services (lack of culturally relevant services for diverse populations within the nation, language barriers)Possibility that traditional culture values of authority figures as well as strong family unit may be root cause of the lack of a recognized mental health system. Along with stigma, the observance of traditional practices and healing methods remains a formidable barrier to the needed provision of care.

24Child Mental Health in the Philippines Consuelo Cagande

Key to developing community-based programs in the Philippines is the involvement of groups with patients and their respective families. Family ties are a prominent part of the culture.Manpower and experience are lacking in overcrowded psychiatric inpatient units and outpatient clinics.Not known how many psychiatrists/psychologists have training in adolescent mental health screening.Possible MeasuresTraining of family medicine physicians, pediatricians and nurses on how to screen and treat mental illness among adolescents.Involvement of patients and their family members is vital to developing community-based programs.Seeking assistance from established mental health experts around the world to create a child psychiatric residency program could help promote a more effective workforce. (Can be done online)

which is crucial to lessening shame and stigma and encouraging good mental health. The integration of pediatric and psychiatric care would offer a more comprehensive service to adolescents and their families Though all of these models of access to care would be ideal, any of these approaches can aid in further destigmatizing mental illness and promote good mental health and literacy as a part of routine health care for the Filipino youth 25Child Mental Health in the Philippines Consuelo Cagande

CommentaryThis study should be an eye opener for not just the government, but also the church, schools, community and the family.Through observation, Filipino adolescents tend to go through a quarter life crisis due to identity issues in early schooling and religious formation coupled with familial expectations and culture.Beyond mental health facilities, the Filipino family must learn to reach out and give support (with patience and acceptance) to change and identity of the adolescent.Proper and genuine support will always play the biggest role in the positive mental health of the Filipino adolescent because of the natural kindness and empathy that the Filipino possesses.26Depression in rural adolescents: relationships with gender and availability of mental health services Article by Black G, Roberts RM, Li-Leng T.

FocusStudies have shown increasing evidence that indicate the prevalence of depression is similar in urban and rural areas.It is generally perceived that the causes associated with compromised mental health in rural areas include deprivation and lack of accessThis research studies the relationship between depression and possible determinants of mental health among rural adolescents. Factors identified were degree of remoteness, gender, socioeconomic status, and perception of rural community characteristics (long waiting lists & lack of mental health professionals)Access to proper mental health care services

27Sample: 531 Year 9-12 students from 23 different schools, with 55.7% being female and 98.5% being born in Australia.

QuestionnaireIncluded questions on demographics6-item Kutcher Adolescent Depression Scale (KADS-6)Designed to analyze symptoms consistent with DSM-IV diagnosis of major depressive disorderEstablished to have high sensitivity, good specificity, good test-retest reliability.Degree of remoteness measured through home postcodesA section required respondents to choose possible reasons for the difficulty in seeking mental health care in rural areasCauses investigated: mental healthcare professionals, long waiting listsDepression in rural adolescents: relationships with gender and availability of mental health services by Black G, Roberts RM, Li-Leng T.

28Results showed that 18.1% of the participants displayed positive for major depressive disorder on the KADS.Item on the KADS that measured depressed mood showed that 28.7% of participants responded that they experienced low mood, sadness, or depression much of the time.11.6% most of the time1.1% all of the timeResponses to KADS question regarding suicide and self-harm (Thoughts, plans, actions about suicide/self-harm)12.4% reporting occasional thoughts4.0% reporting frequent thoughts3.6% reporting suicidal/self-harming plans or actions

Depression in rural adolescents: relationships with gender and availability of mental health services by Black G, Roberts RM, Li-Leng T.

29Depression remains an issue of significant concern among South Australian rural adolescents, esp. with remote areas having fewer established mental health professionals and mental health services.Study found that females were more likely to screen as depressed on the KADS compared to males (23% F, 11.8% M)Consistent with most studies on adolescent depression which suggests females may be more prone to depressionResults are consistent with other research that has shown that it is not the rurality that affects the development of adolescent depression, but it may be that community characteristics or stressors such as life events and relationships are triggers.

Depression in rural adolescents: relationships with gender and availability of mental health services by Black G, Roberts RM, Li-Leng T.

Sawyer et al found that the males from the rural areas experience higher rates of depression than females 30Poor mental health literacy is another factor.Indicates that continuous health initiatives are needed to improve mental health of rural South Australian adolescents.Improvement of mental health literacy is an important area to targetOther areas to target: availability of mental health services, promoting help-seeking behavior for those with mental health problems, promoting awareness of available mental health services within the region.Depression in rural adolescents: relationships with gender and availability of mental health services by Black G, Roberts RM, Li-Leng T.

31CommentaryStudy is further evidence of the association of lack of mental health awareness and knowledge with an increase in depression Men seem to be more suppressive of their condition while women are more expressiveFocus of most rural communities is how to better the livelihood of the whole community rather than just the individual, which then may cause instability within adolescents since in most rural communities theyre pressured by their families to stay and help out with the work.Increasing knowledge on mental health is important, especially in less developed areas and tightly knit traditional communities.Depression in adolescents can be lessened with an educated and supportive community. Depression in rural adolescents: relationships with gender and availability of mental health services by Black G, Roberts RM, Li-Leng T.

this is probably the case because of how in rural areas gender differences and roles are still prevalent among families and communities not just in Southern Australia but also around the world and at times their livelihood depends on how quick they can produce for those in the urban sectors Rural areas seem to have a lack of mental health care and awareness because the rate of development that they experience is slow compared to their urban counterparts.

32BibliographyBlack G, Roberts RM, Li-Leng T. Depression in rural adolescents: relationships with gender and availability of mental health services. Rural and Remote Health 12: 2092. (Online) 2012. Available: http://www.rrh.org.auCagande, C. 2013. Child Mental Health in the Philippines. Adolescent Psychiatry 3(1): 11- 13.Lawrence, L. 2014. Mental health literacy and mental health status in adolescents: a population based survey. Child and Adolescent Psychiatry and Mental Health 8(26): 1-8.Luisa, C. Pedro, D. Filipa, P. 2014. Finding Space to Mental Health Promoting mental health in adolescents: Pilot study. Faculty of Education and Psychology Catholic University of Portugal. 32(1): 23-29McCarthy, J. Bruno, M. Fernandes, T. 2011. Evaluating Mental Health Literacy and Adolescent Depression: What Do Teenagers Know?. The Professional Counselor: Research and Practice 1(2): 133-142.