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Despite high rates of mental health challenges, Asian Americans are less likely to seek out and receive school-based mental health services (SBMHSs) than their non-Asian peers. The Youth Mental Health First Aid (YMHFA) training is an 8-hr manualized public education program designed to educate adults on recognizing common mental health challenges among adolescents and intervening. However, no published research has evaluated YMHFA among Asian Americans. We culturally adapted YMHFA for Asian Americans (Asian American parents and youth workers) and used a pretest/posttest design to evaluate its effectiveness. Specifically, we (a) added one 2-hr session before the YMHFA to augment engagement with the curriculum and (b) contextualized the YMHFA curriculum content to ensure cultural sensitivity for Asian American participants. Thirty-one Asian immigrant parents (Mage = 45.55, SD = 3.6) and 24 Asian American youth workers (Mage = 23.17, SD = 3.67) participated in YMHFA. Participants' mental health literacy (MHL) and their confidence in using MHFA skills significantly increased after the training. Participants also participated in four focus groups after the training to share their experiences. Participants stated that they benefited from this training and suggested additional cultural adaptations to make the program more appropriate for Asian Americans. Culturally adapted YMHFA may be an effective way to promote MHL and engage Asian Americans in mental health services. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Background Children and young people’s (CYP) mental health is a major public health concern internationally and the recent Covid-19 pandemic has amplified these concerns. However, only a minority of CYP receive support from mental health services due to the attitudinal and structural barriers they and their families encounter. For over 20 years, report after report has consistently highlighted the shortcomings of mental health services for CYP in the United Kingdom and attempts to improve services have been largely unsuccessful. The findings reported in this paper are from a multi-stage study that aimed to develop a model of effective, high-quality service design for CYP experiencing common mental health problems. The aim of the stage reported here was to identify CYP’s, parents’ and service providers’ perceptions of the effectiveness, acceptability and accessibility of services. Methods Case studies were conducted of nine different services for CYP with common mental health problems in England and Wales. Data were collected using semi-structured interviews with 41 young people, 26 parents and 41 practitioners and were analysed using the Framework approach. Patient and Public Involvement was integrated throughout the study with a group of young co-researchers participating in data collection and analysis. Results Four key themes defined participants’ perceptions of service effectiveness, acceptability and accessibility. Firstly, open access to support with participants highlighting the importance of self-referral, support at the point of need and service availability to CYP/parents. Secondly, the development of therapeutic relationships to promote service engagement which was based on assessment of practitioner’s personal qualities, interpersonal skills and mental health expertise and underpinned by relational continuity. Thirdly, personalisation was viewed as promoting service appropriateness and effectiveness by ensuring support was tailored to the individual. Fourthly, the development of self-care skills and mental health literacy helped CYP/parents manage and improve their/their child’s mental health problems. Conclusions This study contributes to knowledge by identifying four components that are perceived to be central to providing effective, acceptable and accessible mental health services for CYP with common mental health problems irrespective of service model or provider. These components could be used as the foundations for designing and improving services.

OBJECTIVE The main goal of this study was to investigate how persons with symptoms of traumatization and other mental disorders influence daily policing work. METHOD In total, 2,228 German police officers filled out a questionnaire (28.2% female, 71.8% male). The data were assessed using Mann-Whitney U and chi-square tests. RESULTS The results show that 14.3% of the individuals police officers encountered in their daily work had been traumatized, according to police officer observations. With respect to mental health literacy, depression was the best-known disorder (M = 13.46) among police officers, and anxiety was the least known disorder (M = 10.88). According to police officers' responses, 75.5% of the persons thought to be suffering from mental health disorders or traumatization did not file a complaint because interrogation, investigations, or legal proceedings were perceived as too stressful. More than half of the participating police officers (50.4%) recommended the expansion of specialized training programs for law enforcement personnel, and more than one third recommended an increase in collaboration with professionals (39.1%), such as psychiatrists and psychologists. CONCLUSION Law enforcement officers often have contact with persons who show symptoms of traumatization or other mental disorders. Their general knowledge about mental disorders and regarding traumatization in particular is in need of expansion. The additional strain caused by legal proceedings prevents reporting of criminal incidents to the police from the respondents' viewpoint. This impediment to law enforcement needs to be addressed. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Background: In this paper, we present the protocol for a cluster-randomised trial to evaluate the implementation and effectiveness of a workplace mental health intervention in the state-wide police department of the south-eastern Australian state of Victoria. n. The primary aims of the intervention are to improve psychosocial working conditions and mental health literacy, and secondarily to improve mental health and organisational outcomes. Methods/design: The intervention was designed collaboratively with Victoria Police based on a mixed methods pilot study, and combines multi-session leadership coaching for the senior officers within stations (e.g., Sergeants, Senior Sergeants) with tailored mental health literacy training for lower and upper ranks. Intervention effectiveness will be evaluated using a two-arm cluster-randomised trial design, with 12 police stations randomly assigned to the intervention and 12 to the non-intervention/usual care control condition. Data will be collected from all police members in each station (estimated at >20 per station). Psychosocial working conditions (e.g., supervisory support, job control, job demands), mental health literacy (e.g., knowledge, confidence in assisting someone who may have a mental health problem), and mental health will be assessed using validated measures. Organisational outcomes will include organisational depression disclosure norms, organisational cynicism, and station-level sickness absence rates. The trial will be conducted following CONSORT guidelines. Identifying data will not be collected in order to protect participant privacy and to optimise participation, hence changes in primary and secondary outcomes will be assessed using a two-sample t-test comparing summary measures by arm, with weighting by cluster size. Discussion: This intervention is novel in its integration of stressor-reduction and mental health literacy-enhancing strategies. Effectiveness will be rigorously evaluated, and if positive results are observed, the intervention will be adapted across Victoria Police (total employees ~16,500) as well as possibly in other policing contexts, both nationally and internationally. Trial registration: Current Controlled Trials: ISRCTN82041334. Registered 24th July, 2014.

Background Postpartum depression is a significant public health issue. It is important to understand new mothers' awareness on depression during the postpartum period. Aim This study was aimed to understand the postpartum depression literacy of postpartum women. Methods This was a cross-sectional survey carried out among randomly selected mothers (N = 279) attending a paediatric tertiary care center. The data was collected through face-to-face interview technique using a structured questionnaire. Results Our findings revealed that merely 50.7% of the postpartum mothers had an adequate level of knowledge on postpartum depression. Postpartum depression literacy was significantly associated with participants' age (P Conclusion The findings of the present study highlight specific gaps in postpartum depression literacy which may compromise the help-seeking behaviours of postpartum mothers. The findings also suggest an urgent need to sensitize women about postpartum depression.

Background: Mental Health Literacy (MHL) has become a focus of research in recent decades, as a prerequisite for early identification and intervention for mental health problems. Although several instruments have been developed for assessing MHL, there is a need for brief and psychometrically sound measures to capture important aspects of MHL in large and diverse adult samples. The present study aimed to: (1) provide a revised and shorter version of a previously validated questionnaire for assessing MHL; and (2) examine the psychometric properties of the MHLq-SVa in student samples from six different countries (China, India, Indonesia, Portugal, Thailand, and United States). Methods: The study involved 2180 senior school and undergraduate students, aged between 17 and 25 years old, from China, India, Indonesia, Portugal, Thailand, and the United States. Participants responded to the Mental Health Literacy Questionnaire for young adults (MHLq-ya), in their native language, following its translation and adaptation for each culture. The MHLq-ya comprises 29 items, organized into four dimensions: Knowledge of mental health problems; Erroneous beliefs/stereotypes; First-aid skills and help-seeking behavior; Self-help strategies. Confirmatory factor analyses and internal consistency analyses were performed on the combined data. Results: Data from the different countries supported a shorter version of the questionnaire (MHLq-SVa), composed of 16 items that fit with previously defined dimensions. Internal consistency and between-factor correlations further supported the adequacy of the instrument’s psychometric properties. Conclusion: The study provided preliminary support for the construct validity and reliability of the MHLq-SVa as a measure for assessing MHL in young adults from six different countries and languages. Future studies are needed to further validate the measure and undertake multicultural comparisons of MHL in diverse samples from around the globe.

Hazaras, mostly aged

Background This study aims to know the seeking help behavior (including seeking help or not, first choice, influential factors and barriers in seeking help) of individuals with SZ (Schizophrenia) in Hunan province of China. Methods The participants are from a larger epidemiological study of severe mental disorders in Hunan province of China. Self-made questionnaires were used to collect relative information. Results (1) Of the 367 participants, 68.9% (253/367) sought help; of those, 64.6% (n=163) pursued professional psychiatric services and 30.8% (n=78) pursued non-medical options (i.e., relatives, praying to Buddha) as the most common first choices. (2) The help-seeking behavior ratio (seeking help individuals/total sample size) is significantly lower in the illiterate group than in other education levels. Those with a family history of mental disorders tend to have a higher help-seeking behavior ratio. And the first choice of help is largely related to education level. (3) Frequent reasons behind not seeking help include fear of stigmatization (72.9%), poor mental health literacy (64.5%), concerns over cost (50.6%), and limited access to medical services (47.0%). Conclusions About one third of the individuals do not seek help. Individuals with SZ tend to choose psychiatric hospital and relatives as their first choice. A family history of mental disorders and higher education levels are meaningfully associated with help-seeking behavior, and individuals with more education tend to seek for professional help first. The primary reasons for not seeking help include fear of stigmatization, lack of awareness about mental illness, concerns over cost, etcTrial registration This study is approved by ‘the ethics committee of the Brain Hospital of Hunan Province’,the committee’s reference numberis ‘Z2019045’.

Background Suicide is a major public health issue among Indigenous Sámi in Nordic countries, and efforts to prevent suicide in the Sámi context are increasing. However, there is no literature on suicide prevention initiatives among Sámi. The aim of the study was to map suicide prevention initiatives targeting Sámi in Norway, Sweden, and Finland during 2005–2019. Method Initiatives were identified and described through utilizing networks among stakeholders in the field of suicide prevention among Sámi, acquiring documentation of initiatives and utilizing the authors first-hand experiences. The described initiatives were analyzed inspired by the “What is the problem represented to be?” (WPR)-approach. Results Seventeen initiatives targeting Sámi were identified during 2005–2019, including nine in Sweden, five in Norway, one in Finland and two international initiatives. Analysis with the WPR-approach yielded 40 problematizations regarding how to prevent suicide among Sámi, pertaining to shortcomings on individual (5), relational (15), community/cultural (3), societal (14) and health systems levels (3). All initiatives were adapted to the Sámi context, varying from tailor-made, culture-specific approaches to targeting Sámi with universal approaches. The most common approaches were the gatekeeper and mental health literacy training programs. The initiatives generally lacked thorough evaluation components. Conclusion We argue that the dominant rationales for suicide prevention were addressing shortcomings on individual and relational levels, and raising awareness in the general public. This threatens obscuring other, critical, approaches, such as broadening perspectives in prevention planning, improving health systems for Sámi, and promoting cultural empowerment among Sámi. Nevertheless, the study confirms considerable efforts have been invested into suicide prevention among Sámi during the last 15 years, and future initiatives might include a broader set of prevention rationales. To improve evaluation and identify the most promising practices, increased support regarding development of plans and implementation of evaluation components is needed.

Background There is an increasing need for Mental Health Promotion (MHP) among adolescents, especially in developing countries with limited resources and rapid socio-demographic transition. With the growing burden of mental health problems among adolescents (suicide, depression) and their preferences to seek help from their peers, improving Mental Health Literacy (MHL) and behaviours for First Aid in Mental Health (MH-FA) becomes crucial to promote their mental health. Methods Schools are ideal settings for reaching the vulnerable adolescents. The proposed study evaluates the effectiveness of a classroom-based teacher-led integrated school mental health intervention called SUMS (MHP + MHL + MH-FA). The study will involve a pragmatic, cluster-randomised waitlist-controlled design to evaluate the effectiveness of SUMS intervention using schools as unit-of-randomisation. The study will be conducted in Srinivaspura taluka (Sub-district) of Kolar district (administrative unit of health) of Karnataka in collaboration with a multi-disciplinary expert team from NIMHANS (National Institute of Mental Health And Neuro Sciences), Bangalore-India and Department of Education, Government of Karnataka, India. A total of 8 schools (400 students studying in 6–8 grade) from Srinivaspura taluka will be randomised into intervention and waitlist control group. The intervention group will receive SUMS intervention through 10–15 h of classroom sessions. The primary outcome is the improvement in positive mental health literacy, as measured by the Mental Health-Promoting Knowledge (MHPK-10) scale. Changes in MH-FA knowledge and intentions, Mental health stigma, help-seeking and resilience are assessed as secondary outcomes. Data will be collected at baseline, 6-weeks, 6-months and 12-months post-intervention. The waitlist-control schools will receive the interventions at the end of the 12-month follow-up assessment in intervention-schools. Discussion This is the first study to integrate Mental Health Literacy with Mental Health Promotion and behaviours for First Aid in Mental Health to promote mental health well-being among adolescent school children in India. With a need to build a more substantial evidence base on School Mental Health Promotion approaches in developing countries, the study findings will have implications for implementing and operationalising Health and Wellness Ambassador initiative in India. Trial registration Clinical Trials Registry - India, CTRI/2019/07/020394. Registered prospectively on 29 July 2019. (ctri.nic.in/Clinicaltrials/pmaindet2.php?trialid=35724&EncHid=&userName=sums).

Background Medical students are prone to mental disorders, such as depression and anxiety, and their psychological burden is mainly related to their highly demanding studies. Interventions are needed to improve medical students’ mental health literacy (MHL) and wellbeing. This study assessed the digital Transitions, a MHL program for medical students that covered blended life skills and mindfulness activities. Methodology This was a one group, quasi-experimental pretest-posttest study. The study population was 374 first-year students who started attending the medical faculty at the University of Turku, Finland, in 2018-2019. Transitions was provided as an elective course and 220 students chose to attend and 182 agreed to participate in our research. Transitions included two 60-minute lectures, four weeks apart, with online self-learning material in between. The content focused on life and academic skills, stress management, positive mental health, mental health problems and disorders. It included mindfulness audiotapes. Mental health knowledge, stigma and help-seeking questionnaires were used to measure MHL. The Perceived Stress Scale and General Health Questionnaire measured the students’ stress and health, respectively. A single group design, with repeated measurements of analysis of variance, was used to analyze the differences in the mean outcome scores for the 158 students who completed all three stages: the pre-test (before the first lecture), the post-test (after the second lecture) and the two-month follow-up evaluation. Results The students’ mean scores for mental health knowledge improved (-1.6, 95% Cl -1.9 to -1.3, P

Background Australian policy reports recommended schools to be leveraged to better support student mental health, with a focus on regional and rural areas where students have poorer mental health outcomes. In designing solutions to address this systemic gap, decision-makers require an understanding of the barriers and facilitators experienced by regional and rural schools. However, current literature has focused on metropolitan schools and neglected to explore facilitators. Objective To review the evidence on barriers and facilitators in delivering student mental health support experienced by regional and rural schools in Organisation for Economic Co-operation and Development nations. Design A mixed-methods systematic review of peer-reviewed and grey literature. Findings The search identified 4819 studies. A full-text review by 2 reviewers resulted in 5 papers, which met the inclusion criteria and were assessed using methodological appraisal. One study used qualitative data, 2 studies used quantitative data, and 2 studies were a mixed-methods design. Discussion While there was a paucity of studies, this review draws together the most up-to-date research. The barriers and facilitators were categorised into 3 themes: access to services and resources; mental health literacy of staff and parents; and communication and collaboration between stakeholders. Conclusion This review presents a comprehensive synthesis of the literature and highlights opportunities to leverage rural and regional schools to support student mental health, focusing on the quality of communication and collaboration, and increasing access to services and resources, and mental health literacy. Research should explore the unique advantages of rural and regional areas to inform policy, including a focus on strengths.

Problem One in seven children, aged 3-17, have a mental health diagnosis with suicide being the second leading cause of death in the United States in persons aged 10-24. Adolescents are at high risk for mental health disorders, substance use, and risky behaviors, yet most adolescents never receive treatment. Research is needed to answer the question, "What are adolescents' perceived barriers and facilitators to engaging in mental health treatment?" Methods A four-step qualitative meta-synthesis design included: A structured research question and search strategy, data immersion through quality appraisal, thematic synthesis of primary research studies, and reciprocal translation of derived themes. Findings Eight studies met inclusion criteria. Autonomy was the primary theme that emerged. Meta-synthesis produced five subthemes: (a) choice as integral to engagement, (b) stigma as barrier to engagement, (c) quality of the therapeutic relationship as integral to engagement, (d) systemic influences as both barrier and facilitator to engagement, and (e) mental health literacy as crucial factor in decision to engage. Conclusion Adolescents require autonomy to engage in mental health treatment. Improving treatment engagement in adolescents requires interventions that address their ability to be autonomous.

Background Despite of literature available on mental health-related stigma interventions, little is reported about the operational challenges faced during the planning, implementation and evaluation phases. Methods The Systematic Medical Appraisal, Referral and Treatment Mental Health Project was implemented in 42 villages of the West Godavari district in India. Andersen’s Behavioural Model for Health Services Use was adopted to understand the factors influencing anti-stigma campaign delivery and the strategies identified to overcome these challenges. Results The challenges faced during the planning and implementation phase included distance and time taken for travel by the field staff, inadequate mental health services and infrastructure within communities, engagement of community with the field staff and community’s poor mental health literacy and knowledge. Strategies used to overcome these challenges were regular engagement with community stakeholders, understanding mental health literacy levels and seeking inputs from the community regarding campaign design, organizing live drama shows at community’s preferred time and place and screening of recorded drama video clips where lives shows were difficult. The evaluation phase posed challenges such as non-availability of key stakeholders and inadequate time and funding to evaluate the entire study population. Conclusion The reported findings can help in planning and scaling up of the anti-stigma campaign in large trials in similar settings.

BackgroundMental health is one of the effective factors in the quality of life of people. The aim of the present study was to determine the status of mental health literacy (MHL) and its relationship with the quality of life across the Iranian general population.MethodsIn this cross-sectional study, a multi-stage sampling method was used to survey 1070 participants from the city of Gonabad (Iran). The data collection tools were demographics section, mental health literacy scale (MHLS), and quality of life (SF-12) questionnaires. The data was analyzed by SPSS software version 24 using Independent sample t- test, One- way ANOVA, Pearson correlation, and logistic regression.ResultsThe mean and standard deviation of the total scores of MHL and quality of life were 113.54 (10.34) and 35.26 (6.42), respectively. The results revealed that there was a significant positive correlation between MHL and the quality of life (p p p p ConclusionBased on the results of this study, there was a correlation between health literacy and quality of life, and more attention should be paid to MHL. Thus, appropriate programs should be designed and implemented to enhance the level of MHL.

The purpose of this study was to investigate the attitudes toward eating disorders in native German adolescents (Germans), adolescents with Turkish migration background in Germany (Immigrants), and native Turkish adolescents (Turks).A total of 507 adolescents (Adolescents living in Germany were more likely to recognize the vignette as an eating disorder than Turks. Immigrants were more similar to Germans in mental health literacy of eating disorders than Turks. However, in terms of stigmatizing attitudes, immigrants blamed more than Germans, Turks being intermediate on this variable. In Turks, higher desirability of eating disorder-related behaviors was associated with an increased acquaintance with bulimic symptoms and decreased evaluations of impairment. Higher mental health literacy was associated with less blame in Germans.Migration background was associated with increased mental health literacy of eating disorders but did not result in reduced stigma. Differences in attitudes toward eating disorders indicate the need for differential interventions across the groups.

Mental health literacy is an important determinant of mental health help-seeking and is associated with improved mental health. There is evidence that mental health literacy may be lower amongst some migrant communities in Australia. The present study conducted the first cross-sectional survey of mental health literacy in Sri Lankan Australians between April and October 2020. Participants (N = 404) were presented with a culturally-tailored vignette describing an individual with symptoms of major depressive disorder, with correct recognition determined by the coding of an open text response to the question ‘what’s wrong with Mr Silva?’. Binomial linear regression modelling was conducted to identify predictors of the correct recognition of depression. Approximately 74% of participants recognised the presented symptoms as depression, though multiple other labels were also used by the respondents. The results also suggested that younger age and having a prior diagnosis of depression were significant predictors of recognising depression in the vignette. In the first study of Sri Lankan migrants’ mental health literacy in an Australian context, the rates of depression recognition were comparable to those found in the general Australian population. Further research is urgently required to replicate and extend the present findings and ultimately support the development of tailored interventions aimed at improving mental health literacy across the diverse Sri Lankan Australian community.

This study aimed to examine the psychometric properties of the Multicomponent Mental Health Literacy Scale (MMHLS) among Chinese elite athletes. Particularly, the factorial validity, convergent validity, discriminant validity, concurrent validity, internal-consistency reliability, and test-retest reliability of the MMHLS were examined. A total of 320 participants were recruited from the Guangdong provincial sports training center in China. Data collection was conducted between 30 June and 31 July 2020 using electronic questionnaires. Confirmatory factor analysis (CFA), Rasch analysis, correlation analysis and independent-sample t-tests were conducted using Mplus 8.3 and ConQuest 2.0. The CFA results supported the factorial validity of the three-dimensional MMHLS, consisting of knowledge-oriented MHL, beliefs-oriented MHL, and resource-oriented MHL. Cronbach’s alpha and composite reliability coefficients supported the internal-consistency reliability of the MMHLS. Moreover, the convergent and discriminant validities were supported for the subdimension of MHL-Knowledge, MHL-Beliefs, and MHL-Resources. Concurrent validity was demonstrated through correlations between MMHLS, help-seeking attitudes, and stigma. Rasch analysis provided further evidence of the psychometric quality of the instrument in terms of its dimensionality, item fit statistics, and rating scale effectiveness. Finally, test–retest reliability was 0.66 after one month. In conclusion, the 24-item three-dimensional MMHLS was verified to be a reliable and valid measurement of mental health literacy in Chinese elite athletes.

Mental illness significantly impacts agricultural producers, whose occupation puts them at increased risk for compromised mental health and related disorders. Help-seeking intention, which can be mediated by variables such as social identity, social capital, and self-stigma, can lead to improved mental health outcomes. This cross-sectional study aimed to describe the intention of agricultural producers to seek mental health assistance and determine whether these three variables are associated with help-seeking intention. Researchers administered a cross-sectional survey of agricultural producers from two regions in 32 Texas counties. Researchers surveyed a sample of Texas agricultural producers (n = 429) to understand their social identity, social capital, and degree of self-stigma, and their intent to seek help for personal or emotional problems and for suicide ideation. Researchers identified a relationship between social identity and social capital, which indicated that social identity is moderately associated with greater levels of social capital. The multiple linear regression analyses confirmed that social capital and self-stigma are significant predictors of producers’ help-seeking intention for both help-seeking types. These results signify the importance of efforts to increase social capital, increase mental health literacy and tailor training to address self-stigma and enhance positive help-seeking behavior among agricultural producers.

Objective Mental illness is a common medical condition to onset during adolescence. Young people who leave for postsecondary life are at an especially challenging period of lifetime when many will leave home and familiar environments for prolonged periods of time. These new circumstances may put young people at risk of developing mental health problems or disorders or exacerbate existing mental disorders. Alternatively, some young people may misinterpret the normal negative emotional states occurring as a result of these new challenges as a mental disorder requiring professional intervention. We conducted a quasiexperimental cohort study to investigate the effectiveness of a mental health literacy intervention Transitions with blended life skills to address these challenges for first-year postsecondary students. Methods Students ( n = 2,397) from five Canadian postsecondary institutions were assigned to the intervention or the control group and were administered a survey at baseline, postintervention, and at 2-month follow-up (September 2017 to February 2018). We applied generalized linear mixed effects (PROC Mixed procedure) to test the between-group difference in the post—pre/follow-up—pre and to determine the predicted least-square mean values. Results The findings showed that students who were exposed to the Transitions intervention significantly improved their mental health knowledge, decreased stigma against mental illness, improved help-seeking attitudes and behaviours, and decreased perceived stress when compared to students who had not been exposed to the intervention. However, we did not identify significant changes in general health. This may be due to the relatively short follow-up time (2 months) to determine participants’ general health status. Conclusions Transitions delivered to first-year postsecondary students may be a beneficial intervention to help young people adjust to their new postsecondary life and improve their mental health.

Background: There has been a noticeable increase in the number of studies concerned with mental health literacy (MHL), specifically among students. Still, very few studies have examined MHL among students of non-Western minority groups. Aims: This study examined MHL among Arab students in Israel based on Jorm’s conceptual framework. Methods: Twenty-eight Arab students in Israel took part in semi-structured, in-depth interviews. Most were single and Muslim, in their second year of studies, and most reported low socioeconomic status. The data were analyzed thematically, guided by the Jorm’s six MHL dimensions. Results: Different levels of literacy were found in the various MHL dimensions. The participants identified severe mental disorders more easily than mood disorders; reported a variety of possible causes of mental disorders; were well aware of available professional help (apart for rehabilitative services); identified significant barriers to mental health help seeking, as Arabs; and reported the internet as a major source of information about mental health problems and their treatment Conclusions: The participants’ MHL appeared to be associated with their unique sociocultural characteristics. This study stresses the need to raise MHL among Arab students in Israel, and in particular to promote positive attitudes to seeking professional help. It also highlights the need to develop culturally adapted mental health interventions for the Arab population in Israel.

Agricultural producers have worse mental health than the general population, and often have limited access to mental health providers. Educational programs can strengthen knowledge of mental health including warning signs of stress and suicide, as well as assist individuals in developing communication skills and help-seeking behaviors. Cooperative Extension, the nation's academic outreach unit provided by land-grant universities, has a long history of providing agricultural education programs in the United States; this article describes the expansion of such programs to include mental health education for farmers and agricultural stakeholders in Michigan. Evaluation results of two programs developed by Michigan State University Extension demonstrate the programs are effective in improving understanding of agricultural economic trends, impacts of stress on the body, and warning signs of suicide among agricultural producers and stakeholders. Community-based education increases the capacity for mental health literacy programs to reach distressed farmers.

BACKGROUND: Lack of mental health literacy among rehabilitation professionals and employers in the return-to-work of persons with mental health problems resulted in the development of a three-day group training program, the Support to Employers from rehabilitation Actors about Mental health (SEAM) intervention. OBJECTIVE: To evaluate the impact of SEAM on rehabilitation professionals’ knowledge and beliefs, attitudes, and supporting behaviors towards people with mental health problems and employers as part of the return-to-work process. METHODS: In this longitudinal study, 94 rehabilitation professionals were included. Data were collected prior to (T1), immediately after (T2) and 6 months after SEAM training (T3) using knowledge and attitude scales and a questionnaire on supporting behaviors. SEAM includes training in Mental Health First Aid, presentations and discussions on current research on work and mental health, and strategies and communication guidelines to use when meeting service users and employers as part of the return-to-work of persons with mental health problems. SEAM also includes a homepage with targeted employer information. Data were analyzed using non-parametric statistics. RESULTS: SEAM significantly increased rehabilitation professionals’ knowledge of mental health (T1-T2: z = –2.037, p = 0.042; T2-T3: z = –5.093, p = 0.001), and improved their attitudes towards persons with mental health problems (T1-T2: z = 4.984, p = 0.001). Professionals (50–60%) also estimated that they had increased their use of supporting strategies towards service users and employers. CONCLUSIONS: The study suggests that SEAM can increase mental health literacy among rehabilitation professionals and lead to a greater focus on service users’ resources and work ability, as well as on employers’ support needs.

Objectives This study aimed to investigate associations between eating disorder mental health literacy (EDMHL), defense style, eating disorder (ED) symptom severity, psychological distress and mental-health-related quality of life (MHRQoL) and the likelihood of formal and informal healthcare use (HCU) across multiple time points. Methods A community sample of 445 young women with ED symptoms were followed over 7 years. Questionnaires were distributed via email and postal mail across multiple time points; this study includes data from years 2 (baseline in this study), 4 and 9. The inclusion criteria was provision of HCU data at year 2. Results ED symptom severity at baseline was significantly associated with greater HCU two and seven years later. Accurate identification of an ED by participants (i.e. EDMHL) at baseline was associated with greater HCU seven years later. Defense style, psychological distress, MHRQoL and other aspects of EDMHL were not significantly associated with HCU over time. Conclusions Individuals with more severe ED symptoms, and with greater EDMHL, may be more likely to seek help over time. However, individuals with EDs may not seek help directly for poorer MHRQoL and higher levels of psychological distress. This reinforces the importance of ED screening, particularly in primary care settings.

Background Half of mental health disorders begin before the age of 14, highlighting the importance of prevention and early-intervention in childhood. Schools have been identified globally by policymakers as a platform to support good child mental health; however, the majority of the research is focused on secondary schools, with primary schools receiving very little attention by comparison. The limited available evidence on mental health initiatives in primary schools is hindered by a lack of rigorous evaluation. This quasi-experimental cluster study aims to examine the implementation and effectiveness of a Mental Health and Wellbeing Co-ordinator role designed to build mental health capacity within primary schools. Methods This is a primary (ages 5–12) school-based cluster quasi-experimental study in Victoria, Australia. Before baseline data collection, 16 schools selected by the state education department will be allocated to intervention, and another 16 matched schools will continue as ‘Business as Usual’. In intervention schools, a mental health and well-being coordinator will be recruited and trained, and three additional school staff will also be selected to receive components of the mental health training. Surveys will be completed by consenting staff (at 2-, 5-, 10- and 17-months post allocation) and by consenting parents/carers (at 3-, 10- and 17-months post allocation) in both intervention and business as usual schools. The primary objective is to assess the change in teacher’s confidence to support student mental health and wellbeing using the School Mental Health Self-Efficacy Teacher Survey. Secondary objectives are to assess the indirect impact on systemic factors (level of support, prioritisation of child mental health), parent and teachers’ mental health literacy (stigma, knowledge), care access (school engagement with community-based services), and student mental health outcomes. Implementation outcomes (feasibility, acceptability, and fidelity) and costs will also be evaluated. Discussion The current study will examine the implementation and effectiveness of having a trained Mental Health and Wellbeing Coordinator within primary schools. If the intervention increases teachers’ confidence to support student mental health and wellbeing and builds the capacity of primary schools it will improve student mental health provision and inform large-scale mental health service reform. Trial registration The trial was retrospectively registered in the Australian New Zealand Clinical Trials Registry (ANZCTR) on July 6, 2021. The registration number is ACTRN12621000873820.

Introduction Depression represents a major disease burden in Colombia. To better understand opportunities to improve access to mental healthcare in Colombia, a research team at Javeriana University conducted formative qualitative research to explore stakeholders’ experiences with the integration of mental healthcare into the primary care system. Methods The research team conducted 16 focus groups and 4 in-depth interviews with patients, providers, health administrators and representatives of community organisations at five primary care clinics in Colombia, and used thematic analysis to study the data. Results Themes were organised into barriers and facilitators at the level of patients, providers, organisations and facilities. Barriers to the treatment of depression included stigma, lack of mental health literacy at the patient and provider level, weak links between care levels, and continued need for mental health prioritization at the national level. Facilitators to the management of depression in primary care included patient support systems, strong patient-provider relationships, the targeting of depression interventions and national depression guidelines. Discussion This study elucidates the barriers to depression care in Colombia, and highlights action items for further integrating depression care into the primary care setting.

Research on Mental Health Literacy (MHL) has been growing internationally. However, the beliefs and knowledge of Ghanaians about specific mental disorders have yet to be explored. This vignette study was conducted to explore the relationships between religiosity, education, stigmatization and MHL among Ghanaians using a sample of laypeople (N = 409). The adapted questionnaire presented two vignettes (depression and schizophrenia) about a hypothetical person. The results revealed that more participants were able to recognize depression (47.4%) than schizophrenia (15.9%). Religiosity was not significantly associated with recognition of mental disorders but was positively associated with both social and personal stigma for depression, and negatively associated with personal and perceived stigma for schizophrenia. Moreover, education was found to be positively associated with disorder recognition, and negatively with perceived stigma. Finally, perceived stigma was positively associated with disorder recognition, whereas personal stigma for schizophrenia related negatively to recognition of mental disorders. In conclusion, education but not religiosity predicted identification accuracy, but both predictors were associated with various forms of stigma. Findings from this study have implications for MHL and anti-stigma campaigns in Ghana and other developing countries in the region. Peter Adu et al, Mental health literacy in Ghana: Implications for religiosity, education and stigmatization, Transcultural Psychiatry (58, 4) pp. . Copyright © 2021. DOI: 10.1177/13634615211022177. Users who receive access to an article through a repository are reminded that the article is protected by copyright and reuse is restricted to non-commercial and no derivative uses. Users may also download and save a local copy of an article accessed in an institutional repository for the user's personal reference. For permission to reuse an article, please follow our Process for Requesting Permission. Deposited by shareyourpaper.org and openaccessbutton.org. We've taken reasonable steps to ensure this content doesn't violate copyright. However, if you think it does you can request a takedown by emailing help@openaccessbutton.org.

Mental health literacy (MHL) promotes mental health among youths. We aimed to evaluate the effectiveness of the newly developed HOPE intervention in improving depression literacy, anxiety literacy, psychological well-being, and reducing personal stigma and stress levels amongst young adults at a university in Singapore. After two pilot studies, we conducted a randomised controlled trial (RCT) and recruited 174 participants aged 18–24 years old through social media platforms. The HOPE intervention group received four online sessions over two weeks and the control group received online inspirational quotes. Study outcomes were measured with self-reported questionnaires and they were assessed at baseline, post-intervention, and two-month follow-up (ClinicalTrials.gov: NCT04266119). Compared with the control arm, the intervention group was associated with increased depression and anxiety literacy levels at post-intervention and two-month follow-up. In addition, personal stigma for depression was reduced at the post-intervention juncture. However, there were no statistically significant changes in the ratings of psychological well-being and stress levels between the two groups. Longitudinal studies with larger sample sizes are warranted to replicate and extend the extant findings.

Background Individuals with psychiatric disorders are often unwilling to seek help or often follow treatment regimens, fearing public stigma. This study identified the sociodemographic correlates of public stigma while accounting for mental health literacy and life satisfaction. Methods This study analysed data for 1514 individuals who participated in a population-based random telephone survey conducted in 2018. Sociodemographic characteristics included gender, age, education level, and occupation. Data on public stigma, mental health literacy, and life satisfaction were also collected. Multiple linear regression was conducted to examine the effects of sociodemographic characteristics on public stigma. A moderation analysis was performed to investigate the role of age and education in the relationship between mental health literacy and public stigma. Results Sociodemographic characteristics, such as female gender, older age, lower education, and occupation (particularly retired and homemakers), were associated with a higher public stigma. The association between public stigma and mental health literacy was the most significant among individuals aged 50 years and above with lower education levels. Conclusions This study showed that certain population subgroups, based on their sociodemographic profile, have a higher stigma about mental illnesses. Understanding the differential effects of sociodemographic factors on public stigma is imperative to developing effective anti-stigma campaigns.

COVID-19 social control measures (e.g. physical distancing and lockdowns) can have both immediate (social isolation, loneliness, anxiety, stress) and long-term effects (depression, post-traumatic stress disorder) on individuals’ mental health. This may be particularly true of adolescents living with HIV (ALHIV) and their caregivers – populations already overburdened by intersecting stressors (e.g. psychosocial, biomedical, familial, economic, social, or environmental). Addressing the adverse mental health sequelae of COVID-19 among ALHIV requires a multi-dimensional approach that at once (a) economically empowers ALHIV and their households and (b) trains, mentors, and supervises community members as lay mental health services providers. Mental health literacy programming can also be implemented to increase mental health knowledge, reduce stigma, and improve service use among ALHIV. Schools and HIV care clinics offer ideal environments for increasing mental health literacy and improving access to mental health services.

Background: Mental Health Literacy (MHL) is the ability to recognize mental disorders, along with knowledge of professional help available, effective self-help strategies, skills to give support to others, and knowledge of how to prevent mental disorders. Adequate MHL is linked to better health-seeking behavior and management of mental illness. Aim: To assess the MHL related to depression and anxiety among adolescents of age 15 to 19 years residing in Delhi Methods: A survey was conducted among adolescents in southeast Delhi. MHL was assessed using sex-matched vignettes of Common Mental Disorders (CMDs) like depression and anxiety. MHL was assessed under domains of identifications of disorders, help-seeking behavior, knowledge about prevention, and stigmatizing attitude toward the respective illness. Statistical analysis was done in STATA and percentage of participants with adequate MHL in various domains was calculated, and difference between various groups was examined using chi-square test. Results: A total of 491 adolescents participated (response rate of 87.2%) of whom a 50.3% were girls and 57.8% were 15 to 17 years of age. Only 50 (10.2%) participants identified depression vignette as that of depression and 51 (10.4%) identified vignette of anxiety disorder as the same. No statistically significant gender differential in MHL was seen ( p value = .8). The stigmatizing attitude, assessed by asking a series of questions suggesting stigma toward the particular illness, was observed among almost all participants (depression -99.4%, and anxiety disorders -96.1%). 18.3% and 18.7% of participants reported correct knowledge about the prevention of depression and anxiety respectively. Four hundred and twenty-two (86%) identified the need to seek help for symptoms reported in vignettes. Of these, 234 (55%) preferred parents, and 62 (14.7%) look after friends for any help. Conclusion: Adolescents residing in Delhi reported poor MHL for Common Mental Disorders. High stigma and poor help-seeking behavior was also observed among the participants toward CMDs

In Japan, the number of patients with mental illness is increasing; therefore, the need for national measures, such as suicide prevention measures and measures against alcohol health disorders, and multiple social concerns and needs, such as depression and dementia problems, are increasing. As such, measures for mental health are emphasized. Mental health is a common issue; however, there is still prejudice regarding mental illness, and its understanding and awareness by local residents and medical staff need to be improved. The author introduced a medication self-management module in the psychiatric ward to improve medication adherence, and constructed a program for mental health literacy education in the faculty of pharmacy. This paper outlines these studies.

Safety isolation protocols in response to the COVID-19 (coronavirus disease 2019) pandemic have had the unintended consequence of social isolation for adolescents, youth who have a developmental need for autonomy and peer connection. Social isolation alone can lead to various psychological effects such as anxiety, stress, low mood, fear, frustration, and boredom. School nurses serve a vital role in addressing stress among adolescents by initiating early interventions, ensuring positive school experiences for students, and providing support surrounding the development of mental health disorders. Through implementation of NASN’s Framework for 21st Century School Nursing Practice, school nurses address stress among high school students during the COVID-19 pandemic. Innovative interventions can include recognizing signs and symptoms of stress on physical and emotional health, advocating for mental health literacy curriculums, social prescribing, incorporating anticipatory guidance related to health promotion lifestyle practices into each school health encounter, and creating a virtual school health office to reach students while COVID-19 safety isolation continues.

Conceptual frameworks for school-based, preventive interventions recognise that educators’ capacity is, in part, dependent on school-level characteristics. This study aimed to (i) examine the factor structure and internal consistency of the Mental Health Literacy and Capacity Survey for Educators (MHLCSE); (ii) assess responses in relation to supporting students’ mental health; (iii) describe schools’ mental health provision in terms of designated roles, training offered, and perceived barriers; (iv) investigate variance in MHLCSE outcomes explained by schools; and, (v) explore school-level predictors of educators’ perceived MHL and capacity after controlling for individual-level characteristics. A multi-level, cross-sectional design involving 710 educators across 248 schools in England was used, and secondary analyses of baseline data collected as part of the Education for Wellbeing Programme were conducted. Mental health provision data was available for 206 schools, of which 95% offered training to some staff, and 71% had a designated mental health lead. Secondary schools offered significantly more training than primary schools. Significant barriers included lack of capacity in Child and Adolescent Mental Health Services (CAMHS) and within school, and communication challenges between agencies. The amount of training offered by schools significantly predicted educators’ awareness and knowledge of mental health issues, treatments and services, legislation and processes for supporting students’ mental health and comfort providing active support, with increased training predicting higher scores. However, little variance was explained by schools (1.7–12.1%) and school-level variables (0.7–1.2%). Results are discussed in relation to current mental health and education policy in England.

Objective: Mental health awareness (MHA) campaigns have been shown to be successful in improving mental health literacy, decreasing stigma, and generating public discussion. However, there is a dearth of evidence regarding the effects of these campaigns on behavioral outcomes such as suicides. Therefore, the objective of this article is to characterize the association between the event and suicide in Canada’s most populous province and the content of suicide-related tweets referencing a Canadian MHA campaign (Bell Let’s Talk Day [BLTD]). Methods: Suicide counts during the week of BTLD were compared to a control window (2011 to 2016) to test for associations between the BLTD event and suicide. Suicide tweets geolocated to Ontario, posted in 2016 with the BLTD hashtag were coded for specific putatively harmful and protective content. Results: There was no associated change in suicide counts. Tweets ( n = 3,763) mainly included content related to general comments about suicide death (68%) and suicide being a problem (42.8%) with little putatively helpful content such as stories of resilience (0.6%) and messages of hope (2.2%). Conclusions: In Ontario, this national mental health media campaign was associated with a high volume of suicide-related tweets but not necessarily including content expected to diminish suicide rates. Campaigns like BLTD should strongly consider greater attention to suicide-related messaging that promotes help-seeking and resilience. This may help to further decrease stigmatization, and potentially, reduce suicide rates.

Background Less than 20% of youth who experience mental health difficulties access and receive appropriate treatment. This is exacerbated by barriers such as stigma, confidentiality concerns and lack of mental health literacy. A youth team developed the Wellness Quest: a health literacy tool to enable help-seeking youth to advocate for themselves. Objective To evaluate the content, presentation and utility of the Wellness Quest tool among youth. Participants Participants aged 14 to 26. Methods A youth research team conducted five focus groups and one online survey to evaluate the Wellness Quest tool. Thematic analysis was used to analyse the qualitative data, and descriptive statistics were used to explore the survey results. Main results Overall evaluations of the Wellness Quest were positive: participants felt it would be useful during their mental health help-seeking journey. Participants expressed the need for information about services for specific populations, such as Indigenous, immigrants, refugees and 2SLGBTQ + youth. They expressed that the tool should be available in complementary online and print versions. Discussion Improving mental health literacy may improve mental health by enabling youth and those who support them to recognize and respond to signs of distress and understanding where and how to get help. The Wellness Quest tool may equip youth with the knowledge to make informed decisions and advocate for their own mental health, thereby facilitating help-seeking among youth. Patient or public contribution Youth as service users led all stages of the project, from designing and conducting the study and analysing the data to writing the manuscript.

Mental health disorders account for a heavy disease burden in Uganda. In order to provide culturally appropriate mental health prevention and treatment approaches, it is necessary to understand how mental health is conceptualized in the population. Three focus group discussions (FGDs) and 31 in-depth interviews (IDIs) were conducted with men and women aged 14 to 62 years residing in rural, urban, and semi-urban low-income communities in central and western Uganda to explore perceptions and knowledge of mental health. Interpretive thematic analysis was undertaken; results were organized through the lens of the mental health literacy framework. Environmental and societal stressors were identified as primary underlying causes of poor mental health. While participants recognized symptoms of poor mental health, gaps in mental health literacy also emerged. Mental health resources are needed in this setting and additional qualitative work assessing knowledge and attitudes toward mental health care seeking behavior can inform the development of acceptable integrated services.

We conducted a cluster randomized trial of a workplace mental health intervention in an Australian police department. The intervention was co-designed and co-implemented with the police department. Intervention elements included tailored mental health literacy training for all members of participating police stations, and a leadership development and coaching program for station leaders. This study presents the results of a mixed-methods implementation evaluation of the trial.Descriptive quantitative analyses characterized the extent of participation in intervention activities, complemented by a qualitative descriptive analysis of transcripts of 60 semistructured interviews with 53 persons and research team field notes.Participation rates in the multicomponent leadership development activities were highly variable, ranging from10% to approximately 60% across stations. Approximately 50% of leaders and50% of troops completed the mental health literacy training component of the intervention. Barriers to implementation included rostering challenges, high staff turnover and changes, competing work commitments, staff shortages, limited internal personnel resources to deliver the mental health literacy training, organizational cynicism, confidentiality concerns, and limited communication about the intervention by station command or station champions. Facilitators of participation were also identified, including perceived need for and benefits of the intervention, engagement at various levels, the research team's ability to create buy-in and manage stakeholder relationships, and the use of external, credible leadership development coaches.Implementation fell far short of expectations. The identified barriers and facilitators should be considered in the design and implementation of similar workplace mental health interventions.

Background Preventative interventions may be effective in reducing and preventing symptoms of mental ill health in children and young people. However, there is a paucity of research in this area that explores the views of young people. This paper reports on a qualitative study to inform the future development of attractive and appropriate early and preventative school-based mental health interventions. Methods Semi-structured interviews were conducted with a purposive sample of 12 young people aged 14–17 in North East England. Interviews were audio-recorded, transcribed, anonymised and analysed following a thematic approach. Results Four key themes were identified, relevant to those providing, designing and commissioning early and preventative mental health interventions in schools: ‘mental health literacy’, ‘risk factors for wellbeing decline’, ‘experience of school-based support’ and ‘recommendations for future support’. Conclusions Young people have varying levels of mental health literacy, but are able to identify academic stress, bullying and the transition from primary to secondary school as leading causes of worry. Young people want more regular and in-depth mental health education, tailored levels of support in school and improved training for teachers.

Over the past 25 years, a remarkable change has occurred in Australia, whereby the public have become much more like psychiatrists in their thinking. This is seen both in the everyday use of psychiatric concepts and in beliefs about appropriate treatment. This article examines evidence for this change, discusses what might have produced it, asks whether it has benefited the mental health of Australians and considers what further changes in thinking might be needed.

This study aimed to assess adolescents′ Mental Health Literacy (MHL) level, Positive Mental Health (PMH) level, the association between sociodemographic variables and the MHL and PMH levels, and the relationship between adolescent′s MHL and PMH levels. A quantitative, cross-sectional, correlational study was conducted with a convenience sample of 260 adolescents studying in the 5th to 12th years of school. The Mental Health Knowledge Questionnaire, the Mental Health-Promoting Knowledge, and the Positive Mental Health Questionnaire were used for data collection. Most of the adolescents were female (55.8%) with a mean age of 14.07 years. The participants showed good levels of MHL (MHKQ). The participants showed good levels of MHL (MHKQ 𝘹¯ = 60.03; MHPK-10 𝘹¯ = 4.49) and high levels of PMH (𝘹¯ = 128.25). The adolescents with higher levels of MHL were the oldest, in a higher year of school, female, those whose mothers are employed, those who have healthy eating habits, and those who have a better body image self-perception. Adolescents in a lower year of school, with adequate sleep habits, who spend fewer hours a day in front of a screen or online, and who have a better self-perception of mental and physical health and body image were the ones with higher PMH levels. These findings suggest the need to implement experimental or quasi-experimental studies to ascertain the effectiveness of interventions that promote adolescents′ positive mental health literacy.

Mental health literacy (MHL) plays an important role in public health. Improving MHL can promote mental health at the individual and public levels. To date, no published studies have assessed the effectiveness of MHL curriculum interventions among undergraduate public health students. The participants in this study were undergraduate public health students (n = 48) who were enrolled in an 18-week MHL curriculum for 100 min per week. MHL was assessed using the Mental Health Literacy Scale for Healthcare Students. A paired sample t-test was performed to examine the immediate and delayed effects of the MHL curriculum. The total MHL score significantly improved, and a moderate effect size was found directly after the intervention and six weeks later. There were significant differences in the recognition of mental illness (p < 0.01), help-seeking efficacy (p < 0.05), and help-seeking attitude (p < 0.05) in the five components of MHL between pre- and post-test. Furthermore, significant improvements were obtained for the maintenance of positive mental health (p < 0.05) and reduction of mental illness stigma (p < 0.001) between the pre-test and follow-up. Our findings provide evidence for the development and implementation of an MHL curriculum for public health education.

Empirical evidence describes the negative outcomes people with mental health disorders experience due to societal stigma. The aim of this study was to examine the role of gender and rural-urban living in perceptions about mental illness. Participants completed the Day’s Mental Illness Stigma Scale, a nationally validated instrument for measuring stigma. Directors of Chambers of Commerce in North Dakota distributed the electronic survey to their members. Additionally, distribution occurred through use of social media and other snowball sampling approaches. Analysis of data gathered from 749 participants occurred through examination of the difference in perceptions based on geography and gender. The zip codes of residence were sorted to distinguish between rural and urban participants. Application of weighting measures ensured closer alignment with the general population characteristics. Findings indicate that for the majority of the seven stigma measures the Day’s Mental Illness Stigma Scale examines, the coefficient of rural–gender interactions was positive and highly significant with higher levels of stigma in rural areas. Females exhibited lower stigma perceptions than males. However, women living in rural areas held higher degrees of stigma compared to urban residing females. Implications of the study include the need to advance mental health literacy campaigns for males and people residing in rural communities. Additional empirical studies that examine the role of geography and gender in understanding stigma toward people with mental health disorders will result in improved treatment outcomes due to increased and focused educational efforts.

The upsurge in the number of people affected by the COVID-19 is likely to lead to increased rates of emotional trauma and mental illnesses. This article systematically reviewed the available data on the benefits of interventions to reduce adverse mental health sequelae of infectious disease outbreaks, and to offer guidance for mental health service responses to infectious disease pandemic. PubMed, Web of Science, Embase, PsycINFO, WHO Global Research Database on infectious disease, and the preprint server medRxiv were searched. Of 4278 reports identified, 32 were included in this review. Most articles of psychological interventions were implemented to address the impact of COVID-19 pandemic, followed by Ebola, SARS, and MERS for multiple vulnerable populations. Increasing mental health literacy of the public is vital to prevent the mental health crisis under the COVID-19 pandemic. Group-based cognitive behavioral therapy, psychological first aid, community-based psychosocial arts program, and other culturally adapted interventions were reported as being effective against the mental health impacts of COVID-19, Ebola, and SARS. Culturally-adapted, cost-effective, and accessible strategies integrated into the public health emergency response and established medical systems at the local and national levels are likely to be an effective option to enhance mental health response capacity for the current and for future infectious disease outbreaks. Tele-mental healthcare services were key central components of stepped care for both infectious disease outbreak management and routine support; however, the usefulness and limitations of remote health delivery should also be recognized.

OBJECTIVES Mental Health First Aid (MHFA) is designed to help the general public acquire the knowledge and skills needed to respond to a person in a mental health emergency and offer support to someone in emotional distress. Through the PA Foundation's Mental Health Outreach Fellowship, 16 physician assistants (PAs) were selected to become MHFA instructors and teach the course to members of their local communities over 1 year. METHODS MHFA course evaluations, completed by course participants, were reviewed to determine the effectiveness of the PA fellows as instructors. RESULTS The fellows' mean evaluation instructor presentation score was 4.82 and the mean course content score was 4.75. The national mean for instructor presentation was 4.72 for presentation and 4.66 for course content. The maximum possible score in each category was a 5. CONCLUSIONS The PAs selected for the Mental Health Outreach Fellowship were effective MHFA instructors. Benefits to having a PA serve as the instructor include positively affecting communities by increasing the public's mental health literacy, reducing the stigma associated with mental illness, increasing visibility and promotion of the PA profession, and enhancement of a PA's individual career through education and service.

Purpose In the recent years, it was possible to observe two trends: First, there has been a trend to greater mental health literacy, in particular towards a biological model of schizophrenia. Secondly, an increase in public acceptance of professional help and psychiatric treatment has been observed in western countries. This indicates that the societal idea about mental illness and how it can be treated has changed. However, no changes or even changes to the worse occurred regarding the attitudes towards those suffering from the illness, particularly concerning schizophrenia. Thus, the question arises as to whether similar trends can also be found in Austria. Methods We use data from two representative population surveys in Austria, conducted 1998 (n = 1042) and 2018 (n = 1010) using face-to-face interviews, the same sampling procedure, interview mode, and interview schedule. Results The data show that today Austrians tend to opt less frequently for genetic factors and chronic stress as causes of schizophrenia than 20 years ago. There were only slight changes regarding intended first help-seeking actions except for a stronger endorsement of lay help. The believe in an effective treatment of schizophrenia has increased significantly and there was a marked trend towards preference of medication over psychotherapy. Social acceptance of people with schizophrenia has increased, but also the ascription of violence. Conclusion In summary, the evolution of attitudes and beliefs concerning schizophrenia in Austria shows a rather inconsistent pattern and differs to some extent from what has been observed in other western countries. This is important to know when planning awareness-raising or stigma-reducing initiatives.

Objectives: The prevalence rates for mental health (MH) problems in cancer patients is high, although reduced uptake of services may be influenced by mental health literacy (MHL). The objective of this study was to investigate the MHL for depression and panic disorder (PD), including treatment preferences in Australian adults who had been diagnosed and treated for cancer, and whether MHL and treatment preferences was influenced by sex, age, and individuals' lived MH experience. Method: A total of 421 cancer survivors (n = 378 females) completed a self-report survey. Participants were asked to specify whether they had a lived experience with anxiety and/or depression, and to indicate treatment preferences for managing cancer-related distress. Two vignettes were administered to assess MHL for depression and PD. Results: The MHL accuracy for depression was higher than PD. Accuracy rates were higher for females with a lived experience with anxiety and/or depression; although the accuracy rate for PD was significantly lower in males. A high proportion of individuals preferred exercise and in-person counselling to manage depression and PD. Internet-based therapies were not strongly preferred for managing MH problems. Conclusions: The MHL for depression and PD is moderate for adult cancer survivors, with higher levels indicated for individuals with a personal lived experience with anxiety and/or depression. Public health campaigns for enhancing MHL should broaden to include individuals experiencing comorbid physical health conditions. Health providers also need to take into account client preferences for evidence-based therapies.

Background: Having a proper approach to depression requires having sufficient depressive literacy in the affected person. Aims: This study aimed to evaluate the level of depression literacy among hospital staff affiliated to Isfahan University of Medical Sciences (IUMS) and to reveal the risk factors and knowledge gaps. Methods: This was a cross-sectional study with 760 participants from university hospital staff at IUMS who were selected by a census method from April 2018 to December 2018. The data regarding depression signs and symptoms, anti-depressant drugs safety, non-medical treatment efficacy, etc. were collected using the Depression Literacy Questionnaire (D-Lit-22) and were analysed by SPSS-20, using the Pearson correlation coefficient, independent Samples t-test and analysis of variance (ANOVA) ( p ⩽ .05). Results: The mean age of participants was 35.33 ± 8.00 years old and 77.6% of them were female. The mean of the total score of depression literacy was 11.62 ± 3.53. Depression Literacy score was significantly higher in those with higher education levels, female gender and clinical staff ( p < .001). The inability to distinguish depression from other mental disorders as well as having wrong beliefs about suitable treatment approaches were the most considerable gaps in depression literacy. Conclusion: Male gender, low level of academic education and working in non-medical wards are the main factors associated with lower depression literacy in our studied sample. The poor differentiation of depression and wrong beliefs in depression treatment modalities were the largest gaps which require more educational programmes.