Mental health literacy and its influence on mental well-being and help-seeking attitudes among secondary school students in Homa bay county, Kenya

Abstract

The World Health Organization (WHO) estimates that one in four Kenyans experiences a mental health problem, with depression and anxiety symptoms being the most prevalent. Among secondary school students, prevalence of depression and anxiety symptoms are 28.1% and 38% nationally. Prevalence of depression symptoms among students is 44.8% in Kakamega County while Kisii and Migori Counties record 23% and 23.6% respectively. In Homa Bay County, these rates are notably higher, at 57.5% for depression and 49.4% for anxiety. Such figures highlight the urgent need for interventions given the academic, social, and health implications of untreated mental health conditions. Previous studies suggest that enhancing Mental Health Literacy (MHL) can improve well-being and promote positive help-seeking behaviour. The purpose of the study therefore was to examine the influence of MHL on mental well-being and help-seeking attitudes of secondary school students in Homa Bay County, Kenya. Objectives of the study were to: evaluate levels of MHL, assess the nature of relationship between MHL, mental well-being and help-seeking attitudes; establish moderation effect of availability of school-based mental health resources and gender in the relationship between MHL, mental well-being and help-seeking attitudes and establish interventions that can be put in place to improve levels of MHL among students in secondary schools in Homa Bay County. The study was anchored on Health Belief Model, Social Cognitive Theory and a conceptual framework showing the interaction between MHL (independent variable), mental well-being and help-seeking attitudes (dependent variables). Descriptive, correlational and quasi-experimental research designs were employed. The study population was 131,749 students from form1 (F1) to form 4 (F4). Stratified random and purposive sampling were used to select 400 respondents using Yamane’s formula. Data were collected using questionnaires and focus group discussions (FGDs). A pilot study was conducted among 30 students. Reliability of the instruments was established using test–retest method, with Pearson’s correlation and Cronbach’s alpha were used to determine the reliability coefficients. The results were as follows: MHL Scale (r̄ = .78, α = .98), General Help-Seeking Questionnaire (r̄ = .89, α = .99), Questionnaire on interventions (r̄ = .74, α = .98), General Anxiety Disorder (GAD-7) (r̄ = .88, α = .98) and Depression Assessment Questionnaire (DAQ-9) (r̄ = .91, α = .99). Face and content validity of the instruments were ascertained by experts in the area of Educational Psychology. Quantitative data was analyzed using means, percentages, Pearson’s r, independent samples t-test, ANOVA and linear regression analysis. Qualitative data was transcribed, categorized and reported thematically. Results showed that levels of MHL was moderate (M = 42.84, SD = 5.80), levels of MHL positively correlated with mental well-being r(382) = .822, p = .00 and attitudes towards help-seeking (r(382) = .102, p = .046); The moderating effect of school-based resources was statistically non-significant for mental well-being (R = .534, R² = .285, Adjusted R² = .279,F(3, 373) = 49.569, p < .001, Durbin–Watson = 2.134) and help-seeking attitudes (R = .223, R² = .050, Adjusted R² = .042, F(3, 373) = 6.530, p < .001, Durbin–Watson = 1.924). Moderating effect of gender was also statistically insignificant for mental well-being (R = .534, R² = .285, Adjusted R² = .280, F(3, 378) = 50.326, p < .001, Durbin–Watson = 2.126) and help-seeking attitudes (R = .132, R² = .017, Adjusted R² = .010, F(3, 378) = 2.220, p = .085, Durbin–Watson = 1.962). MHL programme was the most effective (M = 3.52, SD = .65) and use of school computers the least effective (M = 2.71, SD = .89). It was concluded that levels of MHL were moderate, MHL positively correlated with both mental well-being and help-seeking attitudes; interaction effect of availability of school-based mental health resources and gender were non-significant. MHL programme was the best strategy to improve MHL. It was recommended that schools teach MHL and make mental health resources accessible to improve MHL and help-seeking attitudes among students. Findings of this study are expected to inform development of policies to improve levels of MHL and mental well-being among students in secondary schools.