Research Article Analysis

Title of the Study: Mental Health Literacy in Healthcare Students: An Expansion of the
Mental Health Literacy Scale.

Authors: Chao, H. J., Lien, Y. J., Kao, Y. C., Tasi, I., Lin, H. S., & Lien, Y. Y.

Year of Publication: 2020

Introduction

What is this study about?

The study was about the development of mental health literacy scale for healthcare students.
The study sought to construct a scale-based measure to assess various components of mental
health literacy in healthcare students.

Is there a problem that needs to be solved? Why is this problem important?

The problem that the study sought to solve was lack of a reliable tool for measuring mental
health literacy among public health and medical students. Existing tools for assesing mental
health literacy are designed for the general public instead of healthcare professoionals. The
tools are also limited in scope as they tend to generally focus on various aspects of mental
health literacy, such as how to recognize mental illness. Few, if any of them, focus on mental
health promotion. The available mental health literacy tools also do not include important
items, such as assessing one’s stigma towards patients suffering from mental health. Thus, the
study sought to create a mental health literacy scale that addresses weaknesses of existing
tools. Without such a tool, it would be hard to effectively evaluate mental health literacy
among healthcare professionals. Lack of such evaluation can potentially hamper efforts to

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implement effective intervention measures to address mental health literacy among healthcare
professionals.

What concepts/variables are relevant?

The concepts that are relevant in this study are mental health awareness and mental health
promotion.

What are the previous findings that inform the current study?

Previous researches on the subject have focused on mental health literacy of the general
public. While focusing on the general public, the researches have also called for further
research that is focused on health professionals. This is because they too suffer from mental
health problems and failure to identify their condition may negatively affect the care that they
provide to their patients. Additionally, lack of mental health literacy may prevent health
professionals from correctly diagnosing the condition or may cause them to perpetuate stigma
against mental health illness. For the reasons discussed here, previous studies called for the
development of a mental health literacy assessment tool that was focused on healthcare
professionals.

What is the purpose of conducting this study?

The purpose of the study was to develp a scale that could assess the mental health literacy
(MHL) of healthcare professionals and students. Another aim of the study was to evaluate
psychometric properties of such a scale.

What are the hypotheses?

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The goal of the study was to create a reliable and valid tool for evaluating mental health
literacy among health students and professions. Therefore, it did not have a hypothesis.

Method

How were the hypotheses tested?

The study did not have a hypothesis or hypotheses. Therefore, there was no hypothesis
testing.

What was the research design?

The researchers used quantitative research design. In particular, the researchers used cross-
sectional study design.

Was a correlational, experimental, or a single case study design used?

No

What were the procedures for selecting participants?

Participants of the study were selected through invitations. Invitations were sent out to
medical and public health students in eleven universities in Taiwan. As long as one met the
requirements of the study with regards to their age and area of study, they were accepted as
participants of the study.

What was the setting/location where data were collected?

The setting of the study was Taiwan. All participants came from eleven universities with
public health and medicine departments in Taiwan. The study was conducted in 2018
between April and June.

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What was the sample size?

The study used two samples. The first sample was that of the pilot study while the second one
was the sample of the final study. In the pilot study, the sample had 33 individuals. 23 of
them were medical students while 10 were public health students. All of the 23 participants
were drawn from two universities in northern Taiwan.

In the final study, 1685 individuals were invited to participate in the study. 354 of the invited
individuals refused to participate in the study. An additional 37 were excluded from
participating in the study because their responses were deemed by the researchers to be
unreliable. Thus, the 1294 individuals who accepted the invitation of the respondents and
provide fairly reliable responses made the study’s sample.

What were the characteristics (e.g., demographic) of the sample?

In the pilot study, the demographics for medical students and that of public health students
were different. For medical students, the average age of the participants was 23.78. 61% were
male and the rest were female. As for public health students, the average age of the
participants was 22. Half of the participants were male and the other half were female. In the
final study, all participants were over 20 years old. No information about their gender was
provided.

What measures were used?

Measures that were taken during the study were social distance to assess the level of desire
for social distance for persons with mental health problems. The other measure was level of
contact report. The measure assessed the familiarity of the respondent with mental illness.
The other measure was positive mental health scale.

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Were quantitative and/or qualitative data collected?

The data collected was quantitative. The data collected was the answers that participants to
various questions. These answers were numerical values chosen from a Likert scale. Thus,
the data was quantitative because its value was measured in form of counts or numbers.

Results/Discussion

What statistical analyses were used?

Various statistical analyses were used in the study. Absolute fit indices, root mean square
error of approximation, incremental fit indices, and goodness fit index were used to
determine goodness of fit of the model. MHLS-HS’s internal consistency reliability was
examined using Cronbach’s alpha. Average variance extraction, standardized factor loading,
and composite reliability were used to determine the scale’s convergent validity.

What were the results of this study?

The results of the study showed that the MHLS-HS scale that was developed had good
internal validity as the overall Cronbach’s alpha coefficient was 0.81. The MHLS-HS also
had discriminant validity and known group validity. Thus, the study found that the 26-item
mental health literacy-health students (MHLS-HS) is a reliable and valid five-dimensional
scale for measuring mental health literacy among health students.

Are the results consistent/inconsistent with hypotheses?

Since there was no hypothesis, the results of the study cannot be measured against
hypothesis.

What are the similarities/differences between results and work of others?

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The study sought to develop a scale for assessing or evaluating mental health literacy among
health students and professionals. It also sought to evaluate the psychometric properties of
such a scale. The resulting scale-based measure for assessing mental health literacy scale
among health students and professionals is the first one of its kind. Thus far, no other work
whose results can be compared to the results of the study has been done.

The study that is closest to the study under examination is The Mental Health Literacy Scale
(MHLS): A new scale-based measure of mental health literacy by O’Connor & Cassey
(2015). The study sought to develop a scale-based mental health literacy scale. Unlike the
study under review which focused on health students and professionals, the O’Connor &
Cassey. study focused on both health professionals and individuals who were not health
professions. Like the study under consideration, O’Conner and Cassey’s study developed the
scale through measure development, pilot testing, and finally, psychometrics assessment
(O’Connor & Cassey, 2015). The resulting scale, just as the scale under review, had good
internal reliability. It also had test-retest reliability, unlike the scale that was developed in the
study under review.

Discussion

What are the main take-aways from the study?

The main take-away from the study is that the Mental Health Literacy Scale for Healthcare
Students (MHLS-HS) that was developed in the study is practical, reliable, and valid tool for
identifying mental health literacy gaps among public health and medical students. As such, it
can be effective in creating curricular intervention to fill mental health literacy gaps in public
health and medical students, and evaluating the effectiveness of the intervention measures.

What are the implications of these findings for clinical practice and research?

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One of the implications of the study for research and clinical practice is its potential to
complement and expand current mental health literacy measures because of its ability to
provide a comprehensive and quick overview of the mental health literacy’s overview. In
practice, the study’s findings can be used to identify various mental health literacy gaps
among public health and medical students. Additionally, the study’s findings can be used to
assess the impact of mental health literacy curricular interventions.

What are the problems/limitations of this study?

The study has various limitations. The first limitation is that the study’s participants were
limited to public health and medical students. As a result, it may be difficult to achieve
generalization of the study’s findings to students and health professionals from other
disciplines. The second limitation is that the scale is a self-report instrument. Thus, even
though the confidentiality and anonymity of the participants was assured in the study, it is
unlikely that the study was completely free of social desirability bias. The third limitation is
that there was no examination of test-retest reliability scale.

How might you have done this study differently?

I would have used a sample that includes participants from different health professionals.
Such a sample would have increased the ability of the study to be generalized. Using a
sample that included participants from only two healthcare professional groups greatly
limited the ability of the study’s findings to be generalized.

What future work still needs to done in this area? (be specific)

Various works need to be done in this area in future. First, studies need to be done to
determine whether this study’s findings can be replicated for healthcare professionals.

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Secondly, future studies should conduct the scale’s test-retest reliability analysis in order to
examine its temporal stability.

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References

Chao, H. J., Lien, Y. J., Kao, Y. C., Tasi, I., Lin, H. S., & Lien, Y. Y. (2020). Mental Health
Literacy in Healthcare Students: An Expansion of the Mental Health Literacy
Scale. International Journal of Environmental Research and Public Health, 17(3),
948.
O’Connor, M., & Casey, L. (2015). The Mental Health Literacy Scale (MHLS): A new scale-
based measure of mental health literacy. Psychiatry research, 229(1-2), 511-516.