Measuring Mental Health Literacy : Adaptation and Validation of the Portuguese Version of the Mental Health Literacy Scale (MHLS)

Abstract

Understanding mental health literacy is essential for promoting empowerment and proactivity in patients, reducing stigma, and increasing population awareness. The constitutive dimensions of mental health literacy are still being researched, and instruments’ research can shed light on the involved processes. The Mental Health Literacy Scale (MHLS) is a self-report measure of mental health literacy. This study aimed to adapt the MHLS to Portuguese and evaluate mental health literacy in a broad sample. A broad sample of 337 individuals participated in the adaptation. Besides filling out the MHLS, the participants were invited to fill out a general lifestyle measure. The global results reveal a good internal consistency of the MHLS. A three-factor structure (i.e., attitudes towards mental illness, knowledge about mental illness, and the ability to recognize symptoms) explained 35% of the total variance. Despite not finding an association with the general lifestyle measure, the MHLS scored higher in women and individuals with higher schooling, as expected. The results reinforce the role of MHLS as a useful measure of mental health literacy. The identified structure is discussed in light of the current understanding and implications of this essential process.

Portuguese Version of the Stigma Scale: Preliminary Psychometric Characteristics

“…14,31,33 Therefore, patients that have a higher level of mental health literacy and a more positive attitude regarding seeking professional help are the ones that do it the most. 30,36 Therefore, patients that are already followed in regular appointments because of their psychiatric problems, such as those who participated in the present study, probably know that they cannot solve the problems by themselves and that they need the help of healthcare professionals. As the appointments are in public institutions and Portugal has a high governmental financial participation in healthcare costs, it seems less likely that low HSB is associated with financial problems.…”

“…34,35 It has also been shown that seeking help one time changes the way each patient perceives help-seeking behavior. 31 The high representativeness of women in the sample may also contribute to the lack of association between stigma and HSB, as women reveal less stigma-related barriers to help-seeking 10 and higher mental health literacy, 36 both of which may promote adjusted help-seeking behaviors. There is also high representativeness of graduates and post-graduates in the sample and education is associated with reduced stigma and high levels of mental health literacy, 10 namely a high level of knowledge about mental health, awareness, and health-seeking attitudes.…”

“…There is also high representativeness of graduates and post-graduates in the sample and education is associated with reduced stigma and high levels of mental health literacy, 10 namely a high level of knowledge about mental health, awareness, and health-seeking attitudes. 36 Besides stigma, there are many predictive factors of help-seeking behavior such as the normalization of mental health problems, knowing they are not the only ones with these kind of problems, having friends that also have psychiatric problems, the knowledge that the appointments are confidential, the lower caregiver stigma, the respect and non-judgment of healthcare professionals, higher physical dysfunction and the belief that the doctor will help. 10,30 Regarding the factors that negatively influence the HSB besides stigma, there are, for example, the desire to solve the problem by themselves, the patients' belief that they do not need help, a feeling of embarrassment to talk about their problems, the patients' concerns about hospitalization and the treatments available, poor knowledge about the available services and how to contact them, difficulties in taking time off work and having financial problems.…”

Translation, Adaptation and Assessment of the Psychometric Properties of the Mental Health Knowledge Questionnaire in a Sample of Higher Education Students in Portugal

“…The Mental Health Literacy Scale (MHLS) [ 14 ] presents a three-factor structure (attitudes towards mental illness; knowledge about mental illness; and ability to recognize symptoms), which explains 35% of the total variance (a value lower than the MHKQ). On the other hand, the internal reliability of the factors tends to be better than in the MHKQ (ranging from 0.66 and 0.89).…”

“…Most assessment tools on mental health literacy usually focus on knowledge about mental disorders. For example, the Mental Health Literacy Scale [ 13 ], which was validated for the Portuguese population in 2021 [ 14 ], is entirely focused, for instance, on the recognition of mental disorders, knowledge of their risk factors and causes, knowledge of self-treatments, or knowledge of available professional help. However, the assessment tool Mental Health Knowledge Questionnaire (MHKQ) does not concretely focus on mental disorders.…”