By Charline Riffaud, M2 PCPI
E183823H
- Introduction
My M1-M2 thesis is about the Mental Health Literacy (MHL) of the students of Nantes University, supervised by Didier Acier. This research is part of the EUniWell-program (European University for Well-being) in which Nantes University participates, in collaboration with the Universities of Cologne, Firenze, Leiden and Semmelweis. The findings from this study will allow developing intervention programs with the objective to improve the well-being of the students at the university. In addition, this collaboration aimed at offering common avenues for the improvement of the mental health care of students within our different campuses.
2. Why did I chose this subject ?
The European dimension of this project caught my attention, as I had an experience abroad with the European Erasmus program. During my schooling, I have also benefited from exchanges with English and German pen pals. Furthermore, when I was 14, I have also hosted several German pen friends as part of a twinning between my city and German cities. These experiences have allowed me to realize that being a student in France or in another European country is not so different and we are confronted with the same problems. Thus, this European project was a natural continuation of the values I had developed during my past experiences.
During my years at the university and my numerous exchanges with students, I was able to see for myself how much students could be impacted by academic, financial, relational, organizational and psycho-social difficulties. I have also personally experienced periods of stress in the face of academic requirements as well as during exams and selection periods. Moreover, after the worldwide epidemic of Covid-19, the successive confinements and associated problems, it seemed important to me to carry out a study targeting this population which was exposed to these difficulties.
3. Variables of the study
MHL is a recent concept developed by Jorm et al. (1997) as the “knowledge and beliefs about mental disorders which aid their recognition, management or prevention”. The authors defined 7 dimensions which are : 1) the ability to recognise specific disorders or different types of psychological distress, 2) knowledge and beliefs about risk factors and causes, 3) knowledge and beliefs about self-help interventions, 4) knowledge and beliefs about professional help available, 5) attitudes which facilitate recognition and 6) appropriate help-seeking, and finally 7) knowledge of how to seek mental health information.
Particularly, my thesis investigate the level of mental health literacy and the relationship to other constructs, such as help-seeking behavior, depressive disorders and perceived stigma. “Perceived stigma” can be defined as the individual’s beliefs about what others think about people with mental illness. Depression is a common disorder and is one of the best known to the general public, along with anxiety disorders. Its prevalence is relatively high among students since the age of onset of this disorder coincides with the university period. Moreover, this term is often used, wrongly, in common language, so we can wonder about the real knowledge of this disorder. So that, it seems natural to study the relationship between depression and student MHL.
Furthermore, within the literature, much research has explored the effects of stigma in relation to mental health. However, poor interest has been shown in the field of perceived stigma, this variable having been little studied previously. Since perceived stigma depends in part on the level of knowledge of individuals, it is relevant to link the study of this variable with the MHL.
Thus, the problematic of this research is focussed around the influence of the perception of stigma related to mental illness on the MHL in students suffering from depression. How does the perception of stigma related to mental illness influence students’ MHL? What is the impact of depression on students’ MHL? Finally, is there a relationship between having depression and perceived stigma related to mental illness?
4. Methods
To evaluate these variables, I used four different scales regrouped in one questionnaire. First, socio-demographics data were collected such as gender, age, studies and mental health care related questions were asked. Then, the participants should have responded to Patient Health Questionnaire (PHQ-9), Mental Health Literacy Scale (MHLS) and The Stigma-9 Questionnaire (STIG-9).
The questionnaire was shared on the university website as well as on social networks. Participation in the study was voluntary and the consent was asked before starting the questionnaire. Therefore, the participants may terminate their participation in this study at any time without needing to provide reasons and without incurring any disadvantages resulting from this. Data were anonymized. Inclusion criteria were to give consent and to study at Nantes University.
Finally, we obtain a total of 262 responses but a lot were incomplete. Among the incomplete answers, we chose to include the participants who had not completed the socio-demographic questionnaire, but who had answered the other questionnaires. We then obtain a sample of 139 participants.
5. Results
Significant relationships were highlighted between perceived stigma and depression. The more the participants suffer from depression disorder, the more they perceive stigma related to mental health. No significant relationships were found between mental health literacy and depression. Nevertheless, one dimension of Mental Health Literacy was negatively correlated with depression disorder: the attitudes which facilitate appropriate help-seeking. The more the students suffer from depression disorder, the less they will adopt a help-seeking behavior. Finally, the relations between perceived stigma and mental health literacy were not significant anymore.
6. Discussion
To discuss the results, the scientific significance of these results is limited since the statistical power was not respected. Indeed, the number of participants necessary to have a good statistical power was not reached. Many participants left the study during the study, voluntarily and without any consequences for them. This large number of participants withdrawn from the study can raise questions about the long enough duration of the administration of the questionnaire, as well as the period chosen to distribute the questionnaire. The administration took place during the exam periods for Nantes students, which could potentially explain the low response rate to the questionnaire, due to a lack of time to answer it.
7. Bibliography
Jorm, A. F., Korten, A. E., Jacomb, P. A., Christensen, H., Rodgers, B., & Pollitt, P. (1997). “Mental health literacy” : a survey of the public’s ability to recognise mental disorders and their beliefs about the effectiveness of treatment. Medical Journal of Australia, 166(4), 182‑186. https://doi.org/10.5694/j.1326-5377.1997.tb140071.x
8. Important words
Key words: Mental Health ; Well-being ; Mental Health Literacy ; Depression disorders ; Perceived stigma ; Help-seeking behavior ; students.
| WORDS I HAVE LEARNED | |
| Avenues | Pistes (de travail) |
| Pen friend | Correspondant(e) |
| Twinning | Jumelage |
| Academic requirements | Exigences universitaires |
| Constucts | Concepts, notions |
| Depend on | Dépendre de, être en lien avec |
| Incur | Entraîner |
| Withdraw | Retirer |
| Coincide | Coïncider |