It is likely that someone you know will be diagnosed with a mental health disorder sometime in their life. Mental health literacy can be a powerful tool to support them (and take care of your own mental health). If people instantly recognized when they began to have a problem and sought appropriate treatment, some mental health conditions might be more consequential than a seasonal flu, yet not of grave severity or duration. But studies have shown that that isn’t how things tend to happen.
Low recognition of mental health disorders
Obviously, to treat a problem you must know that there’s a problem. The seminal study of Jorm and associates used a representative sample of Australians, showing them a vignette of a person suffering from either depression or schizophrenia: two common mental health disorders. While most subjects recognized that there was a mental health problem, the label “depression” was only used by 39% of the sample; only 27% of the study participants recognized schizophrenia. Jorm (2000) refers to other studies which had similar findings.
We can question whether getting a label right is important. Jorm also cites research showing that G.P.s often miss mental health disorders in their patients. They are, however, much more able to detect disorders when the patients themselves present their symptoms as reflecting a psychological problem (Kessler et al, 1999, in Jorm, 2000). Patients, of course, can’t do this if they don’t recognize that they have a problem!
Divergence between the lay public and the professionals
But let’s say you had recognized that your partner was ailing because of having some sort of mental health problem, and let’s say you even labelled it correctly, as depression. What then? As we suggested above, your action(s) to resolve/heal the condition would be largely dependent on whatever conceptual model you might be holding in your head to explain phenomena such as mental health conditions. This, in turn, would affect the choice of treatment that you and your partner might opt for, how well you both might comply with a given treatment (such as taking anti-depressant medication regularly), and how stigmatized (or not) you might feel by being identified as a person (or a partner of a person) with a mental illness.
When academics have examined mental health literacy, they have typically found the public to have a poor understanding of mental health, which has impeded their help-seeking and meant that they do not receive treatment 50% to 80% of the time (Furnham and Swami, 2020). Moreover, some studies have shown that most people do not share the same opinions as mental health professionals about various aspects of mental health, including whom they should consult for help and explanations for the causes of mental health disorders.
The consequences of poor mental health understanding
Where does all this lack of mental health literacy leave us? A high prevalence of mental health disorders coupled with low recognition of the problem leads to no or possibly inappropriate help-seeking. The resultant low rate of treatment means untreated individuals are likely to get worse, or at least they do not get better.
Noting that 70 – 75% of adult mental health problems and mental disorders start to manifest during adolescence or early adulthood, Wei and colleagues have cited consequences of untreated mental health problems in adolescents and young adults: poor vocational achievements, problematic interpersonal and family functioning, and reduced life expectancy due to associated medical conditions, such as diabetes, heart diseases and stroke, respiratory conditions, and suicide. Yet worldwide research shows that between 70% and 80% of young people and adults do not receive the care that they need (Wei, McGrath, Hayden, and Kutcher, 2015).
With specific reference to the divergence between the views of the public and those of mental health professionals about what constitutes appropriate treatment, we can note that negative beliefs about medication, for example, might yield low to no compliance with medication regimens. Negative views about certain professionals (say, psychiatrists) could result in the individual with the mental health concern simply not turning up for needed treatment. Beyond that, widely different views from professionals may mean that a close and influential contact of a person needing help – say, you, in the above scenario of a depressed partner – could end up not recommending a potentially helpful treatment, which the unwell person might then miss out on.
Finally, the Australian Institute of Health and Welfare, in their snapshot look at health literacy (2020), notes that people with low health literacy are more likely to have worse health outcomes overall and adverse health behaviors, such as lower engagement with health services (including preventive ones, such as cancer screening), higher hospital re-admission rates, poorer understanding of medication instructions (so using prescribed drugs improperly), and lower ability to manage self-care (AIHW, 2020).
Reflection Exercise: What’s your level of mental health literacy?
Griffith University in Australia has developed the Mental Health Literacy Scale (MHLS) (2015), a 35-item measure which assesses all attributes of mental health literacy. You can click here to access it to gain an understanding of your knowledge of various aspects of mental health (O’Connor & Casey, 2015).
- Australian Institute of Health and Welfare (AIHW) 2017, National Drug Strategy Household Survey 2016: Detailed Findings, AIHW, viewed 17 February 2020, https://www.aihw.gov.au/reports/illicit-use-of-drugs/ndshs-2016-detailed/contents/table-of-contents
- Furnham, A., & Swami, V. (2020). Mental Health Literacy: A Review of What It Is and Why It Matters | International Perspectives in Psychology (hogrefe.com)
- Jorm, A.F., Korten, A.E., Jacomb, P.A., et al. (1997). “Mental health literacy”: a survey of the public’s ability to recognize mental disorders and their beliefs about the effectiveness of treatment. Medical Journal of Australia, 166, 182-186.
- Jorm, A. F. (2000). Mental health literacy: Public knowledge and beliefs about mental disorders. British Journal of Psychiatry (2000), 177, 396-401.
- Kessler, R.C., Chiu, W.T., Demler, O., Merikangas, K.R., & Walters, E.E. (2005). Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62, 617-627.
- O’Connor, M., & Casey, L. (2015). The Mental Health Literacy Scale (MHLS): A new scale-based measure of mental health literacy. Psychiatry Research. DOI: https://doi.org/10.1016/j.psychres.2015.05.064
- Swami, V., Furnham, A., Kannan, K., & Sinniah, D. (2008). Lay beliefs about schizophrenia and its treatment in Kota Kinabalu, Malaysia. International Journal of Social Psychology, 54, 164-179.
- Wei Y., McGrath, P.J., Hayden, J., & Kutcher, S. (2015). Mental health literacy measures evaluating knowledge, attitudes and help-seeking: A scoping review. BMC Psychiatry, 2015 Nov 17;15:291. doi: 10.1186/s12888-015-0681-9.