Perceived ease of managing information on mental health–development of a mental health literacy tool

Abstract Background Health literacy (HL) and mental health literacy (MHL) research have evolved separately, with HL focusing on navigating health information and MHL emphasizing knowledge on mental illnesses, help-seeking, and stigma. Since findings from HL and MHL studies are hardly comparable, we developed a tool bridging both traditions, aligning with current HL research while addressing mental health. Methods The European Health Literacy Survey Questionnaire (HLS-EU-Q47) was adapted to reflect scenarios related to mental health while preserving its model of 4 competences (access, understand, appraise, apply information) and 3 domains (mental illness treatment, prevention, well-being promotion). 12 experts reviewed the items. The resulting 24-item MHLS-GER-Q24, measuring perceived difficulty on a 4-point Likert scale, was used in a representative online survey of internet users in Germany. Confirmatory factor analysis (CFA) tested the underlying model, supplemented by exploratory factor analysis (EFA), and internal consistency was assessed with Cronbach's α. Results The MHLS-GER-Q24 showed high internal consistency (α = .96) in a survey of n = 2007. CFA did not display sufficient fit for either of the mentioned 4-factor or 3-factor solutions related to competences and domains. EFA suggests an alternative 3-factor solution, with one factor explaining ∼49% of variance. Mean score was 2.42 (1 = “very difficult” to 4 = “very easy"), and 54.3% of responses indicated dealing with mental health information was “very difficult” or “rather difficult." Conclusions While the MHLS-GER-Q24 displays high internal consistency, its presumed factor structure could not be confirmed. Also, high internal consistency suggests potential for a short version, which is being developed taking into account results from EFA. Participants found it particularly challenging to manage mental health information, suggesting the need for MHL promotion and more manageable mental health information. Key messages • The MHLS-GER-Q24 is a promising tool bridging HL and MHL research. • The scenarios on dealing with mental health information are considered difficult in 54% of responses.