Top

BMC Psychiatry

Published in:

Open Access 01-12-2015 | Research article

Quantifying and predicting depression literacy of undergraduates: a cross sectional study in Sri Lanka

Authors: Santushi D. Amarasuriya, Anthony F. Jorm, Nicola J. Reavley

Published in: BMC Psychiatry | Issue 1/2015

Abstract

Background

The high rates of depression and low rates of related help-seeking among undergraduates are matters for concern. In response to the need to examine their knowledge about depression and its management, and the dearth of such research from non-western developing countries, this study examined the depression literacy of undergraduates in Sri Lanka.

Methods

A questionnaire was administered among 4671 undergraduates to examine their depression literacy relating to problem-recognition, measured using a vignette of a depressed undergraduate, and their treatment beliefs measured by assessing their perceptions about the helpfulness of various options of help for the presented problem. Responses for the latter aspect were quantified using a scale comprising the options of help endorsed by Sri Lankan mental health professionals. Regression analysis models were used to identify the correlates of these aspects of depression literacy.

Results

Females, medical undergraduates and those in higher years of study (compared to first-years) were more likely to recognise the problem as depression. The undergraduates obtained a mean percentage score of 76 % on the constructed Depression Treatment Beliefs Scale. Scores on this scale were higher among females, medical undergraduates, those who got help for the problem after trying to deal with it alone and those who recognised the problem as depression, as well as those who used other mental health-related labels for this purpose. Scores were lower among undergraduates in years 2–4 (compared to first-years), those with family or friends with the problem and those with higher stigma on a Social Distance Scale. However, the effect sizes of these relationships were small.

Conclusions

As factors such as gender, discipline, year of study, exposure to depression and stigma are associated with differences in the depression literacy of these undergraduates, concerning their ability to recognise the problem and their related treatment beliefs, these must be considered when designing related educational initiatives. Recognising the problem as depression or the use of other mental health-related labels is associated with better treatment beliefs as per expert consensus, indicating that such labelling could have value for appropriate help-seeking.

Available only for authorised users

Jorm AF, Korten AE, Jacomb PA, Christensen H, Rodgers B, Pollitt P. “Mental health literacy”: a survey of the public’s ability to recognise mental disorders and their beliefs about the effectiveness of treatment. Med J Aust. 1997;166:182–6.PubMed

Ibrahim AK, Kelly SJ, Adams CE, Glazebrook C. A systematic review of studies of depression prevalence in university students. J Psychiatr Res. 2013;47(3):391–400. doi:10.1016/j.jpsychires.2012.11.015.CrossRefPubMed

Steptoe A, Tsuda A, Tanaka Y, Wardle J. Depressive symptoms, socio-economic background, sense of control, and cultural factors in university students from 23 countries. Int J Behav Med. 2007;14(2):97–107. doi:10.1007/BF03004175.CrossRefPubMed

Blanco C, Okuda M, Wright C, Hasin DS, Grant BF, Liu SM, et al. Mental health of college students and their non-college-attending peers results from the national epidemiologic study on alcohol and related conditions. Arch Gen Psychiatry. 2008;65(12):1429–37. doi:10.1001/archpsyc.65.12.1429.PubMedCentralCrossRefPubMed

Zivin K, Eisenberg D, Gollust SE, Golberstein E. Persistence of mental health problems and needs in a college student population. J Affect Disord. 2009;117:180–5. doi:10.1016/j.jad.2009.01.001.CrossRefPubMed

Eisenberg D, Golberstein E, Gollust SE. Help-Seeking and access to mental health care in a university student population. Med Care. 2007;45(7):594–601. doi:10.1097/MLR.0b013e31803bb4c1.CrossRefPubMed

Gulliver A, Griffiths KM, Christensen H. Perceived barriers and facilitators to mental health help-seeking in young people: a systematic review. BMC Psychiatry. 2010;10:113. doi:10.1186/1471-244X-10-113.PubMedCentralCrossRefPubMed

Rickwood DJ, Deane FP, Wilson CJ, Ciarrochi J. Young people’s help-seeking for mental health problems. Aust E J Adv Ment Health. 2005;4(3):218–51. doi:10.5172/jamh.4.3.218.CrossRef

Furnham A, Hamid A. Mental health literacy in non-western countries: a review of the recent literature. Ment Health Rev J. 2014;19(2):84–98. doi:10.1108/mhrj-01-2013-0004.CrossRef

10.

Ganasen KA, Parker S, Hugo CJ, Stein DJ, Emsley RA, Seedat S. Mental health literacy: focus on developing countries. Afr J Psychiatry. 2008;11(1):23–8. doi:10.4314/ajpsy.v11i1.30251.CrossRef

11.

Rong Y, Luscombe GM, Davenport TA, Huang Y, Glozier N, Hickie IB. Recognition and treatment of depression: a comparison of Australian and Chinese medical students. Soc Psychiatry Psychiatr Epidemiol. 2009;44(8):636–42. doi:10.1007/s00127-008-0471-5.CrossRefPubMed

12.

Hickie IB, Davenport TA, Luscombe GM, Rong Y, Hickie ML, Bell MI. The assessment of depression awareness and help-seeking behaviour: experiences with the International Depression Literacy Survey. BMC Psychiatry. 2007;7:48. doi:10.1186/1471-244X-7-48.PubMedCentralCrossRefPubMed

13.

Nieuwsma JA, Pepper CM, Maack DJ, Birgenheir DG. Indigenous perspectives on depression in rural regions of India and the United States. Transcult Psychiatry. 2011;48(5):539–68. doi:10.1177/1363461511419274.CrossRefPubMed

14.

Jorm AF. Mental health literacy: Empowering the community to take action for better mental health. Am Psychol. 2012;67(3):231–43. doi:10.1037/a0025957.CrossRefPubMed

15.

Somasundaram D, Thivakaran T, Bhugra D. Possession states in Northern Sri Lanka. Psychopathol. 2008;41(4):245–53. doi:10.1159/000125558.CrossRef

16.

Sumathipala A, Siribaddana S, Hewege S, Sumathipala K, Prince M, Mann A. Understanding the explanatory model of the patient on their medically unexplained symptoms and its implication on treatment development research: a Sri Lanka Study. BMC Psychiatry. 2008;8:54. doi:10.1186/1471-244X-8-54.PubMedCentralCrossRefPubMed

17.

Hollifield M, Hewage C, Gunawardena CN, Kodituwakku P, Bopagoda K, Weerarathnege K. Symptoms and coping in Sri Lanka 20–21 months after the 2004 tsunami. Br J Psychiatry. 2008;192:39–44. doi:10.1192/bjp.bp.107.038422.CrossRefPubMed

18.

Ediriweera HW, Fernando SM, Pai NB. Mental health literacy survey among Sri Lankan carers of patients with Schizophrenia and Depression. Asian J Psychiatry. 2012;5(3):246–50. doi:10.1016/j.ajp.2012.02.016.CrossRef

19.

de Zoysa P, Wickrama T. Mental health and cultural religious coping of disabled veterans’ in Sri Lanka. J Mil Vet Health. 2011;19(3):4–12.

20.

Institute for Research and Development. National survey on mental health in Sri Lanka. Colombo: Institute for Research and Development; 2009.

21.

Bruckner TA, Scheffler RM, Shen G, Yoon J, Chisholm D, Morris J, et al. The mental health workforce gap in low- and middle-income countries: a needs-based approach. Bull World Health Organ. 2011;89(3):184–94. 10.2471/BLT.10.082784.PubMedCentralCrossRefPubMed

22.

Kuruppuarachchi KALA, Kuruppuarachchi KAJM, Wijerathne S, Williams SS. Psychological distress among students from five universities in Sri Lanka. Ceylon Med J. 2002;47(1):13–5. doi:10.4038/cmj.v47i1.6401.PubMed

23.

Torabi MR, Perera B. A study of depressive symptomatology, its behavioral correlates and anxiety among undergraduates in Sri Lanka. In: Landlow MV, editor. College students: Mental health and coping strategies. New York: Nova; 2006. p. 133–51.

24.

Amarasuriya SD, Jorm AF, Reavley NJ. Prevalence of depression and its correlates among undergraduates in Sri Lanka. Asian J Psychiatry. 2015;15:32–7. doi:10.1016/j.ajp.2015.04.012.CrossRef

25.

Amarasuriya SD, Jorm AF, Reavley NJ, Mackinnon AJ. Stigmatising attitudes of undergraduates towards their peers with depression: a cross-sectional study in Sri Lanka. BMC Psychiatry. 2015;15:129. doi:10.1186/s12888-015-0523-9.PubMedCentralCrossRefPubMed

26.

Yap MBH, Wright A, Jorm AF. The influence of stigma on young people's help-seeking intentions and beliefs about the helpfulness of various sources of help. Soc Psychiatry Psychiatr Epidemiol. 2011;46(12):1257–65. doi:10.1007/s00127-010-0300-5.CrossRefPubMed

27.

Dunn KI, Goldney RD, Grande ED, Taylor A. Quantification and examination of depression-related mental health literacy. J Eval Clin Pract. 2009;15(4):650–3. doi:10.1111/j.1365-2753.2008.01067.x.CrossRefPubMed

28.

Lauber C, Nordt C, Rössler W. Recommendations of mental health professionals and the general population on how to treat mental disorders. Soc Psychiatry Psychiatr Epidemiol. 2005;40(10):835–43. doi:10.1007/s00127-005-0953-7.CrossRefPubMed

29.

Reavley NJ, Morgan AJ, Jorm AF. Development of scales to assess mental health literacy relating to recognition of and interventions for depression, anxiety disorders and schizophrenia/psychosis. Aust N Z J Psychiatry. 2014;48(1):61–9. doi:10.1177/0004867413491157.CrossRefPubMed

30.

University Grants Commission Sri Lanka. Sri Lanka University Statistics 2013. http://www.ugc.ac.lk/en/publications/1418-sri-lanka-university-statistics-2013.html. Accessed 30th December 2014.

31.

Reavley NJ, McCann TV, Jorm AF. Mental health literacy in higher education students. Early Interv Psychiatry. 2012;6(1):45–52. doi:10.1111/j.1751-7893.2011.00314.x.CrossRefPubMed

32.

American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th, text rev ed. Washington: Author; 2000.

33.

Chen A, Mond JM, Kumar R. Eating disorders mental health literacy in Singapore: beliefs of young adult women concerning treatment and outcome of bulimia nervosa. Early Interv Psychiatry. 2010;4(1):39–46. doi:10.1111/j.1751-7893.2009.00156.x.CrossRefPubMed

34.

McCann TV, Lu S, Berryman C. Mental health literacy of Australian Bachelor of Nursing students: a longitudinal study. J Psychiatr Ment Health Nurs. 2009;16(1):61–7. doi:10.1111/j.1365-2850.2008.01330.x.CrossRefPubMed

35.

Smith CL, Shochet IM. The impact of mental health literacy on help-seeking intentions: results of a pilot study with first year psychology students. Int J Ment Health Promot. 2011;13(2):14–20. doi:10.1080/14623730.2011.9715652.CrossRef

36.

Griffiths KM, Christensen H, Jorm AF, Evans K, Groves C. Effect of web-based depression literacy and cognitive-behavioural therapy interventions on stigmatising attitudes to depression: randomised controlled trial. Br J Psychiatry. 2004;185:342–9. doi:10.1192/bjp.185.4.342.CrossRefPubMed

37.

Jorm AF, Wright A. Influences on young people's stigmatising attitudes towards peers with mental disorders: national survey of young Australians and their parents. Br J Psychiatry. 2008;192(2):144–9. doi:10.1192/bjp.bp.107.039404.CrossRefPubMed

38.

Link BG, Phelan JC, Bresnahan M, Stueve A, Pescosolido BA. Public conceptions of mental illness: labels, causes, dangerousness, and social distance. Am J Public Health. 1999;89(9):1328–33. doi:10.2105/AJPH.89.9.1328.PubMedCentralCrossRefPubMed

39.

Kroenke K, Spitzer RL. The PHQ-9: A new depression diagnostic and severity measure. Psychiatr Ann. 2002;32(9):509–15.CrossRef

40.

Wright A, Harris MG, Wiggers JH, Jorm AF, Cotton SM, Harrigan SM, et al. Recognition of depression and psychosis by young Australians and their beliefs about treatment. Med J Aust. 2005;183(1):18–23.PubMed

41.

Amarasuriya SD, Jorm AF, Reavley NJ. Depression literacy of undergraduates in a non-western developing context: the case of Sri Lanka. BMC Res Notes. 2015;8:593. doi:10.1186/s13104-015-1589-7.

42.

Furnham A, Cook R, Martin N, Batey M. Mental health literacy among university students. J Public Ment Health. 2011;10(4):198–210. doi:10.1108/17465721111188223.CrossRef

43.

Swami V. Mental health literacy of depression: gender differences and attitudinal antecedents in a representative British sample. PLoS ONE. 2012;7(11). doi:10.1371/journal.pone.0049779.

44.

Tang MO JLO, Galdas PM, Phinney A, Han CS. College men's depression-related help-seeking: a gender analysis. J Ment Health. 2014;23(5):219–24. doi:10.3109/09638237.2014.910639.CrossRefPubMed

45.

Lauber C, Ajdacic-Gross V, Fritschi N, Stulz N, Rössler W. Mental health literacy in an educational elite – an online survey among university students. BMC Public Health. 2005;5:44. doi:10.1186/1471-2458-5-44.

46.

Eisenberg D, Downs M, Golberstein E, Zivin K. Stigma and help-seeking for mental health among college students. Med Care Res Rev. 2009;66(5):522–41. doi:10.1177/1077558709335173.CrossRefPubMed

47.

Downs MF, Eisenberg D. Help seeking and treatment use among suicidal college students. J Am Coll Health. 2012;60(2):104–14. doi:10.1080/07448481.2011.619611.CrossRefPubMed

48.

Ajzen I. The Theory of Planned Behavior. Organ Behav Hum Decis Process. 1991;50(2):179.CrossRef

49.

Jorm AF, Christensen H, Medway J, Korten AE, Jacomb PA, Rodgers B. Public belief systems about the helpfulness of interventions for depression: associations with history of depression and professional help-seeking. Soc Psychiatry Psychiatr Epidemiol. 2000;35(5):211–9. doi:10.1007/s001270050230.CrossRefPubMed

50.

Jorm AF, Mackinnon A, Christensen H, Griffiths KM. Structure of beliefs about the helpfulness of interventions for depression and schizophrenia. results from a national survey of the Australian public. Soc Psychiatry Psychiatr Epidemiol. 2005;40(11):877–83. doi:10.1007/s00127-005-0991-x.CrossRefPubMed

Title: Quantifying and predicting depression literacy of undergraduates: a cross sectional study in Sri Lanka
Authors: Santushi D. Amarasuriya
Anthony F. Jorm
Nicola J. Reavley
Publication date: 01-12-2015
Publisher: BioMed Central
Published in: BMC Psychiatry / Issue 1/2015
Electronic ISSN: 1471-244X
DOI: https://doi.org/10.1186/s12888-015-0658-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Quantifying and predicting depression literacy of undergraduates: a cross sectional study in Sri Lanka

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2015

Distinguishing bipolar and major depressive disorders by brain structural morphometry: a pilot study

Client perceptions of the mental health engagement network: a qualitative analysis of an electronic personal health record

Challenges for group leaders working with families dealing with early psychosis: a qualitative study

Visualization analysis of author collaborations in schizophrenia research

Direct and indirect exposure to violence and psychological distress among civil servants in Rio de Janeiro, Brazil: a prospective cohort study

Evaluation of the impact of a psycho-educational intervention for people diagnosed with schizophrenia and their primary caregivers in Jordan: a randomized controlled trial