Mediating Role of Mental Help-Seeking Attitude in the Effect of Mental Health Literacy on Mental Treatment: A Structural Equation Model

Year 2025, Volume: 15 Issue: 2, 295 - 301, 30.06.2025

Sevil Albayrak , Seda Sönmez , Pınar Öke Karakaya , Elif Asık

https://doi.org/10.33808/clinexphealthsci.1510141

Abstract

Objective: This study aims to display the mediating role of mental help-seeking attitude in the effect of mental health literacy (MHL) on mental treatment.
Methods: This study conducted through a structural equation model. This research was carried out in line with the descriptive survey and relational screening model to determine the relationship between the variables. In this scope, the predictive relationship between MHL’s effect on mental treatment and the mental help-seeking attitude was examined through a structural equation model. Data were obtained from 391 individuals through the Personal Information Form, the Mental Health Literacy Scale, and the Scale of Attitudes Toward Seeking Professional Psychological Help-Short Form.
Results: It was observed that MHL affected mental help-seeking attitude. It was determined that the mental help-seeking attitude does not affect the mental treatment. While the resource-oriented sub-dimension of the Mental Health Literacy Scale had a statistically significant effect on mental treatment behavior, this effect was not observed in the knowledge-oriented and belief-oriented sub-dimensions. Mental help-seeking attitude does not play a mediating role in the effect of MHL on mental treatment.
Conclusion: It was found that the help-seeking attitude develops in line with the MHL level increase. However, an increase in the level of MHL alone does not affect mental treatment. This indicates that other factors might also impact the mental treatment towards psychological problems.

Keywords

Mental health literacy , mental help-seeking attitude , mental treatment , structural equation model

Ethical Statement

This study was approved by Ethics Committee of Kırıkkale University, Noninvasive Clinic Ethics Committee (Approval date:10.03.20233 and Number: 2022.03.06)

References

• World Health Organization (WHO) Mental disorders. Published [2019]. Accessed [15 July 2021]. https://www.who.int/news-room/fact-sheets/detail/mental-disorders .
• Ritchie H, Roser M. Mental health. Published online at OurWorldInData.org. Published [2018]. Accessed [24 April 2023]. https://ourworldindata.org/mental-health.
• Charlson F, van Ommeren M, Flaxman A, Cornett J, Whiteford H, Saxena S. New WHO prevalence estimates of mental disorders in conflict settings: A systematic review and meta-analysis. The Lancet 2019;394(10194):240-248. https://doi.org/10.1016/S0140-6736(19)30934-1
• Taquet M, Geddes JR, Husain M, Luciano S, Harrison P. 6-month neurological and psychiatric outcomes in 236 379 survivors of COVID-19: A retrospective cohort study using electronic health records. Lancet Psychiatry 2021;8(5):416-427. https://doi.org/10.1016/S2215-0366(21)00084-5
• Önder H. Bir sürdürülebilir kalkınma hedefi olarak sağlık. Akademia Doğa ve İnsan Bilimleri Dergisi 2020;6(1):10-24. (Turkish)
• Tay JL, Tay YF, Klainin-Yobas P. Mental health literacy levels. Arch Psychiatr Nurs. 2018;32(5):757-763.
• Göktaş S, Işıklı B, Metintaş S. Ruh sağlığı okuryazarlığı. Türk Dünyası Uygulama ve Araştırma Merkezi Halk Sağlığı Dergisi 2018;3(2):68-75. (Turkish)
• Jorm AF. Mental health literacy: Empowering the community to take action for better mental health. Am Psychol. 2012;67(3):231-243. https://doi.org/10.1037/a0025957
• Kim EJ, Yu J H, Kim EY. Pathways linking mental health literacy to professional help‐seeking intentions in Korean college students. J Psychiatr Ment Health Nurs. 2020;27(4):393-405. https://doi.org/10.1111/jpm.12593
• Tokur Kesgin M, Pehlivan Ş, Uymaz P. Ruh Sağlığı Okuryazarlığı Ölçeğinin Türkçe uyarlaması: Geçerlilik ve güvenilirlik çalışması. Anadolu Psikiyatri Derg. 2020;21(2):5-13. https://doi.org/10.5455/apd.102104. (Turkish)
• Noroozi A, Khademolhosseini F, Lari H, Tahmasebi R. The mediator role of mental health literacy in the relationship between demographic variables and health-promoting behaviours. Iran J Psychiatry Behav Sci. 2018; 12(2): e12603. https://doi.org/10.5812/ijpbs.12603.
• Beasley L, Kiser R, Hoffman S. Mental health literacy, self-efficacy, and stigma among college students. Soc Work Ment Health. 2020;18(6):634-650. https://doi.org/10.1080/15332985.2020.1832643
• Al-Yateem N, Rossiter RC, Robb WF, Slewa-Younan S. Mental health literacy of school nurses in the United Arab Emirates. Int J Ment Health Syst. 2018;12(1):1-13. https://doi.org/10.1186/s13033-018-0184-4
• Bose R, Sivaprakash B, Sarkar S, Backer A, Eswaran S. An observational study to assess mental health literacy among undergraduate students from Tamil Nadu. Arch Med Health Sci. 2020;8(2): 230-235. https://doi.org/10.4103/amhs.amhs_85_20
• Gorczynski P, Sims-Schouten W, Wilson C. Evaluating mental health literacy and help-seeking behaviours in UK university students: A country wide study. J Public Ment Health. 2020;19(4):311-319. https://doi.org/10.1108/JPMH-10-2019-0086
• Reavley NJ, Jorm AF. Recognition of mental disorders and beliefs about treatment and outcome: Findings from an Australian national survey of mental health literacy and stigma. Aust N Z J Psychiatry. 2011;45(11):947-956. https://doi.org/10.3109/00048674.2011.6210
• Lee HY, Hwang J, Ball JG, Lee J, Yu Y, Albright DL. Mental health literacy affects mental health attitude: Is there a gender difference? Am J Health Behav. 2020;44(3):282-291. https://doi.org/10.5993/AJHB.44.3.1
• Marwood MR, Hearn JH. Evaluating mental health literacy in medical students in the United Kingdom. J Ment Health Train Educ Pract. 2019;14(5):339-334. https://doi.org/10.1108/JMHTEP-01-2019-0001
• McGuirk E, Frazer P. The impact of the campus climate and mental health literacy on students’ wellbeing. J Ment Health Train Educ Pract. 2021;16(3):245-256. https://doi.org/10.1108/JMHTEP-12-2020-0088
• Devraj R, Gupchup GV, Henson D. Mental health literacy of pharmacy students compared to nursing and medical students. Innov Pharm. 2019;10(4):1-13. https://doi.org/10.24926/iip.v10i4.2091
• Liu W, Gerdtz MF, Liu TQ. A survey of psychiatrists’ and registered nurses’ levels of mental health literacy in a Chinese general hospital. Int Nurs Rev. 2011;58:361-369. https://doi.org/10.1111/j.1466-7657.2011.00883.x
• Hao Y, Wu Q, Luo X, Chen S, Qi C, Long J, Xiong Y, Liao Y, Liu T. Mental health literacy of non-mental health nurses: A mental health survey in four general hospitals in Hunan Province, China. Front Psychiatry 2020;11(507969):1-10. https://doi.org/10.3389/fpsyt.2020.507969
• Liu W, Li YM, Peng Y. Mental health literacy: A cross‐cultural study of American and Chinese bachelor of nursing students. J Psychiatr Ment Health Nurs. 2018;25(2): 96-107. https://doi.org/10.1111/jpm.12442
• Jorm AF. Mental health literacy- public knowledge and beliefs about mental disorders. Br J Psychiatry. 2000;177(5):396-401. https://doi.org/10.1192/bjp.177.5.396
• Özel Y, Duzcu T. Ruh sağlığı okuryazarlığı. Akademik Sosyal Araştırmalar Dergisi. 2018;6(77):380-387. (Turkish)
• Topkaya N, Kağnıcı Y. Psikolojik yardım alma niyeti: Bir model testi. Türk Psikoloji Dergisi. 2012;27(69):101-117. (Turkish)
• Gorczynski P, Sims-Schouten W, Hill D, Wilson JC. Examining mental health literacy, help seeking behaviors, and mental health outcomes in UK university students. J Ment Health Train Educ Pract. 2017;12(2):111-120. https://doi.org/10.1108/JMHTEP-05-2016-0027
• Yelpaze İ, Ceyhan AA. The prediction of personality, culture and coping strategies on university students’ psychological help seeking attitudes. TURJE. 2020;9(2):134-153.
• McMillan JH, Schumacher S. Research in Education: Evidence-Based Inquiry. Pearson. Boston: 2010.
• Hoyle RH. Structural Equation Modeling: Concepts, Issues, and Applications. London Sage London: 1995.
• Jung H, von Sternberg K, Davis K. Expanding a measure of mental health literacy: Development and validation of a multicomponent mental health literacy measure. Psychiatry Res. 2016;243:278-286. https://doi.org/10.1016/j.psychres.2016.06.034
• Göktaş S, Işıklı B, Önsüz MF, Yenilmez Ç, Metintaş S. Ruh Sağlığı Okuryazarlığı Ölçeği’nin (Rsoy Ölçeği) Türkçe geçerlilik ve güvenilirliğinin değerlendirilmesi. Konuralp Tıp Dergisi. 2019;11(3):424-431. (Turkish)
• Türküm AS. Developing a scale of attitudes toward seeking psychological help: Validity and reliability analyses. Int J Adv Couns. 2004;26(3):321-329.
• Gunzler D, Chen T, Wu P, Zhang H. Introduction to mediation analysis with structural equation modeling. Shanghai Arch Psychiatry. 2013;25(6):390. https://doi.org/10.3969/j.issn.1002-0829.2013.06.009
• MacKinnon DP, Fairchild AJ, Fritz MS. Mediation analysis. Annu Rev Psychol. 2007;58:593.
• Hooper D, Coughlan J, Mullen MR. Structural equation modelling: Guidelines for determining model fit. EJBRM. 2008;6(1):53-60.
• Waldmann T, Staiger T, Oexle N, Rüsch N. Mental health literacy and help-seeking among unemployed people with mental health problems. J Ment Health. 2020;29(3):270-276. https://doi.org/10.1080/09638237.2019.1581342
• Schnyder N, Michel C, Panczak R, Ochsenbein S, Schimmelmann BG, Schultze-Lutter F. The interplay of etiological knowledge and mental illness stigma on healthcare utilisation in the community: A structural equation model. Eur Psychiatry 2018;51:48-56. https://doi.org/10.1016/j.eurpsy.2017.12.027
• Arthur YA, Boardman GH, Morgan AJ, McCann TV. Effectiveness of a problem-solving, story-bridge mental health literacy programme in improving Ghanaian community leaders’ attitudes towards people with mental illness: a cluster randomized controlled trial. Issues Ment Health Nurs. 2021;42(4):332-345. https://doi.org/10.1080/01612840.2020.1799273
• Wu Q, Luo X, Chen S, Qi C, Yang WFZ, Liao Y, Wang X, Tang J, Tang Y, Liu T. Stigmatizing attitudes towards mental disorders among non-mental health professionals in six general hospitals in Hunan Province. Front Psychiatry 2020;10:946. https://doi.org/10.3389/fpsyt.2019.00946